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Objective: We aimed to investigate the roles of inflammatory parameters, including neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR), and C-reactive protein/albumin ratio (CAR), in predicting disease recurrence in patients with stage IIA (T3N0M0) high microsatellite instability and microsatellite-stable colon cancer who had no risk factors associated with relapse.Materials and methods: We evaluated 155 patients with colon cancer followed in 3 hospitals in Turkey between February 2009 and March 2020. These patients had stage IIA disease and had no risk factors associated with relapse. None of the patients received adjuvant chemotherapy. NLR, PLR, LMR, and CAR parameters were retrospectively obtained from laboratory results at the time of diagnosis, and their associations with disease recurrence were assessed.Results: Over a median follow-up period of 38 months (range: 4-98 months), 11 of the 155 patients experienced relapse or developed metastases. Multivariate Cox analyses revealed that NLRs of ≥3.12 (hazard ratio [HR]: 0.041, 95% confidence interval [CI]: 0.048-0.826, p = 0.006) and CARs of ≥0.027 (HR: 0.199, 95% CI: 0.004-0.404, p = 0.026) were independent prognostic markers predicting relapse. The median 5-year recurrence-free survival rate of patients with NLRs of ≥3.12 at the time of diagnosis was 88.0%; this rate was 100% in patients with NLRs of

Aim: Rhabdomyosarcoma is more frequent and has a better prognosis in children. In adults, it is relatively rare and has a worse prognosis. The most effective treatment is achieved with a multimodal approach. We aimed to share the clinical, pathological and survival results of 14 patients with adult rhabdomyosarcoma. Methods: In our study, we evaluated 14 patients with RMS who were followed up and treated between January 2000 and January 2018 in three medical oncology departments in Turkey. The uses of surgery, chemotherapy and radiotherapy for curative and palliative purposes were considered multimodal in all patients. Results: The median age of all patients was 44.5 years (range: 16-83). Ten (71.4%) of our patients were male. The tumors of nine (64.3%) of 14 patients were localized and 5 (35.7%) patients had metastatic disease. Five (55.6%) of 9 patients with localized disease developed relapse. Histological examination of the patients revealed that 10 (71.4%) had pleomorphic, 3 (21.4%) had alveolar and 1 (7.1%) had undifferentiated RMS. The median follow-up period of all patients was 14.6 (range; 2.3-267) months. Relapse-free survival (RFS) was 15.17 months (95% CI; 1.1-29.2). The time to progression of disease after metastatic first-line treatment (PFS) was 10.18 (95% CI; 7.08-13.2) months. At evaluation of the data, 9 patients had died. Median overall survival (OS) at local and metastatic stages were 29.3 months (95% CI; 20.8-37.9) and 11.2 months (95% CI; 9.29-13.1), respectively, while the OS of all participants was 22.8 months (95% CI; 0-47). Five-year OS was 28.2% (Standard error (SE); 13.4%) and 5-year relapse-free survival was 41.2% (SE; 17.3%). Conclusions: The multimodal approach is the best option in early and advanced stage rhabdomyosarcoma. Among our few patient series, clinic and survival results are consistent with the literature.

Background: Advanced pancreatic cancer (APC) is a highly lethal malignancy which has one of the worst treatment outcomes. Modified (m)FOLFIRINOX is an intense but a proven treatment approach with a survival benefit for APC. Although mFOLFIRINOX demonstrated survival benefit compared with gemcitabine monotherapy, the standard treatment in previous years, toxicity is a difficult aspect of this treatment. Methods: A retrospective analysis of patients referred to Medical Oncology Clinics of Ankara Oncology Research and Training Hospital with the diagnosis of inoperable locally advanced or metastatic pancreatic cancer and treated with mFOLFIRINOX or gemcitabine monotheraphy from March 2013 to April 2018 was performed. Results: Forty three patients and 37 patients were included in mFOLFIRINOX and gemcitabine groups, respectively. The mean age of the patients was 53.74 years (range: 32–69) and 65,7 years (range: 47–82) for mFOLFIRINOX and gemcitabine, respectively (95% CI, p

Background: Merkel cell carcinoma (MCC) is a rare but highly aggressive neuroendocrine carcinoma of the skin. In this study, we aimed to evaluate the clinicopathologic characteristics, treatment outcomes, and survival of MCC cases in Turkey. Materials and methods: The patients diagnosed with MCC between 1999 and 2018 at twenty different centers in Turkey were included in the study. Patient and tumor characteristics and adjuvant and metastatis treatment outcomes were analyzed retrospectively. Results: The median age of totally 89 patients was 70 (26-93). The most common primary location was lower limbs (n = 29, 32.5%). Immunohistochemically, CK20 positivity was present in 59 patients (66.3%). Only two patients had secondary malignancy. The majority of the patients (n = 76, 85.4%) were diagnosed at the localized stage. Surgery was performed for all patients in the early stage, and adjuvant radiotherapy or/and chemotherapy was applied to 52.6% (n = 40) of nonmetastatic patients. The median follow-up was 29 months. Recurrence developed in 21 (27.6%) of the 76 patients who presented with local or regional disease. Two-year disease-free survival (DFS) was 68.1% and 5-year DFS was 62.0% for localized stage. The 5-year DFS was similar for patients receiving adjuvant treatment (chemotherapy, radiotherapy, or sequential chemoradiotherapy) and without adjuvant therapy (P > 0.05). Two-year overall survival in patients who presented with localized disease was 71.3% and 18.5% in metastatic patients (P < 0.001). In the metastatic stage, platinum/etoposide combination was the most preferred combination regimen. Median progression-free survival (PFS) in first-line chemotherapy was 7 months (95% confidence interval: 3.5-10.5 months; standart error: 1.78). Conclusions: Although MCC is rare in Turkey, the incidence is increasing. Gender, CK20 status, tumor size, lymph node involvement, and adjuvant treatment were not associated with recurrence.

Background There are limited data for Male breast carcinoma(MBC) in the era of adjuvant taxanes and trastuzumab. We have previously reported outcome of non-metastatic 113 patients(pts) with MBC. We aimed to evaluate outcome of the changing adjuvant systemic treatment practices and survival in operable MBC. Methods The medical records of 261 MBC pts followed between 1986-2018 at 8 cancer center were reviewed retrospectively. 222 patients had non-metastatic MBC at the time of diagnosis were included in current study. Results Median age was 61(29-91) years. Median follow-up 55(1-275)months(mths). %91 of the pts had invasive ductal carcinoma. Also, 30.6% had T3-4 tumors. About half of study group had axillary lymph node-positive tumors. The proportion of positivity of ER, PgR and HER2 status were % 82.5, 73.1 and %18.4. Ten pts had TN MBC. 55 of pts had at least one comorbid chronic illness. 83.9 % of pts had modified radical mastectomy(MRM). 79.9% of pts received adjuvant radiotherapy. Adjuvan hormonotherapy were advised for %78.8, whereas adjuvant chemotherapy(CT) for 71.2 % of the pts(CMF 10.6%, adjuvant trastuzumab %7.5 and antracycline and/or taxane based 81.9% ). 9 HER2-positive pts had no adjuvant CT. Locoregional and/or distant recurrence rate was 36.9%. 77 (34.5%) pts died during follow-up. 52 of them died from metastatic breast cancer. 5-year disease-free survival(DFS) was found to be 66.6 % whereas overall survival(OS) was 73.5 %. Patients with stage I/II tumor were significantly longer DFS as compared to pts had stage III MBC( median not reached vs 78 mths, P Conclusions Although the adjuvant use of anthracyclines /taxanes and trastuzumab for MBC have increased in the last 10 years, stage at diagnosis is still important prognostic factor for survival in MBC. Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.

Aim: Desmoid tumors (DTs) are very rare tumors that grow gradually anywhere in the body they are locally aggressive, but with a low potential for metastasis. Very good results can be obtained with different combinations of treatments, such as surgery, chemotherapy, hormonal therapy, tyrosine kinase inhibitor therapy and radiotherapy. Case series even with a small number of patients are of considerable importance as experience with DTs limited. Therefore, in this study, we aimed to discuss the management of DTs with our case series. Materials and Methods: In our study, 15 patients with DT, who were treated and followed up between January 2005 and January 2020 in two hospital medical oncology departments in Turkey, were evaluated. Results: The median age of diagnosis of the patients was 34 (range 18-48) years. Seven (46.6%) of the patients were female and eight (53.4%) were male. Seven (46.6%) of the tumors were located in the abdominal wall, four (26.7%) were in the limbs three (20%) were in the intra-abdominal area, and one (6.7%) was in the chest wall. In terms of resectability, 14 (93.3%) were resectable, and one (6.7%) was unresectable. The five-year overall survival rate was 73.85%, and the average disease-free survival time until relapse was 35 (range 15-83) months in patients who relapsed. The two- and five-year relapse-free survival rates were 90.9% and 66.5%, respectively. The median progression-free survival (PFS) for first-line treatment was 25 (range 8.6-89.8) months. The median PFS for second-line treatment was seven (range 4.3-38.0) months. In the one patient who received third-line treatment, PFS was 8.3 months. Conclusion: Frequent relapses in DTs are still the biggest problem in treating this disease. Although surgery treatment is the main treatment method used in desmoid tumors, controversy about adjuvant therapy after surgery continues, and new treatment modalities are required.

Aim: In patients who have reached third-line treatment, survival times are short and response to treatment is poor. However, in some patients, survival times and treatment responses are good despite advanced treatment lines. The present study investigates the prognostic factors that affect survival among patients who have undergone third-line treatment for non-small cell lung cancer (NSCLC).Methods: Among the 1,150 patients who were treated for and followed-up with a diagnosis of NSCLC between January 2008 and December 2015, 102 (8%) who had received third-line treatment were included in this retrospective cohort study. Results: The mean patient age was 56 years (SD: 10.1), and 70.6% were male. The third-line treatment provided a median PFS of 2.36 (range: 1.15–36.1) months and an OS of 4.2 (range: 1.28–38.1) months. Cox hazard-model analyses indicated significant associations between prolonged survival and gender, smoking, non-squamous histology, age below 45 years, the presence of EGFR mutations and the use of EGFR tyrosine kinase inhibitors. Conclusion: The prognosis may be better for some patients who have reached third-line treatments, namely, young patients, females, non-smokers, and those with a non-squamous histology. In these patients, physicians should be alert in terms of driver mutations, such as EGFR mutation., Amaç: Üçüncü basamak tedaviye ulaşmış hastalarda sağkalım süreleri kısa ve tedaviye yanıtları kötüdür. Ancak bazı hastalarda sağkalım süreleri ve tedavi yanıtları ilerlemiş tedavi basamağına rağmen iyidir. Bu çalışmadaki amacımız, küçük hücreli dışı akciğer kanserinde (KHDAK) üçüncü basamak tedaviye ulaşmış olan hastaların sağkalımlarını etkileyen prognostik faktörleri saptamaktır.Yöntemler: Ocak 2008-Aralık 2015 tarihleri arasında KHDAK tanısı ile tedavi edilen ve takip edilen 1.150 hastadan üçüncü basamak tedavi alan 102 (%8) hasta bu retrospektif kohort çalışmada değerlendirildi. Bulgular: Hastaların ortalama yaşı 54 (Standard sapma: 10,1) ve %70,6 sı erkekti. Üçüncü basmakta ortanca progresyonsuz sağkalım süresi ortanca 2.36 (Aralık: 1,15-36,1) ve ortanca toplam sağkalım 4.2 (1,28-38,1) aydı. Cox hazard modeli analizinde uzun sağkalımı etkileyen temel faktörler; cinsiyet, sigara, skuamöz dışı histoloji, 45 yaş altında olmak, EGFR mutasyon durumu ve Anti-EGFR tedavi almış olmak olarak saptandı.Sonuç: Kadın, sigara içmeyen, skuamöz dışı histolojisi olan, genç olan üçüncü basamak tedaviye ulaşmış hastalarda prognozun daha iyi olabileceği ve bu hastalarda EGFR mutasyonu gibi driver mutasyonları açısından hassas olunması gerektiği bilinmelidir.

WOS: 000442916006728, …

A case of 64-year-old female patient with early stage gastric medullary carcinoma has been presented, along with a review of the literature.

A 70 year-old women admitted to our hospital with a swelling and discharge of the right inguinal site. Biopsy results was consisted with malignant melanoma. Imaging of thorax and abdomen showed metastatic disease. After first-line temozolamide treatment, palliative radiotherapy was applied to primary site because of progression. After detection of BRAF-V600E mutation, vemurafenib treatment was initiated. Treatment response to vemurafenib was very good partial response after second months of the treatment. Although locally progression of the left lung was seen after fifth months of therapy, partial response remained on the other sites, she was still on the treatment with vemurafenib., Yetmiş yaşında kadın sağ inguinal bölgede akıntılı şişliği olması üzerine başvurdu. Lezyon biyopsisi malign melanomla uyumluydu. Toraks ve batın görüntülemelerinde metastaz bulguları mevcuttu. Birinci basamak temozolomid sonrası lezyon bölgesinde progresyon nedeni ile palyatif radyoterapi uygulandı. BRAF-V600E mutasyonu nedeni ile vemurafenib başlandı. Tedavinin ikinci ayında çok iyi kısmi yanıt elde edildi. Tedavinin 5. ayında sol akciğerde lokal progresyon izlenirken diğer bölgelerde kısmi yanıtı devam ediyordu. Palyatif radyoterapi sonrası vemurafenib tedavisine devam edildi.

Fifty four year-old men with a family history of colon cancer diagnosed multiple colonic poliposis upon colonoscopy. Since pathology of colonic biopsy yielded adenocarcinoma, together with a family history of colon cancer, total colectomy was done. Histopathology of colectomy showed multisentric colonic adenocarcinoma together with grade 1 neuroendocrine tumor of the appendix. Our patient was unique because of the rarity of the coincidence of colonic adenocarcinoma and appendix neuroendocrine tumor.

Esophageal carcinoma ranks 6 th among cancer-releated deaths. It commonly metastasize to the lung, liver and bone. Breast metastasis of esophageal cancer is rarely seen and therefore we aimed to present this case. A 54-year old woman who diagnosed with locally advanced squamous cell esophageal cancer received chemo-radiotherapy. In follow-up, widespread metastasis, including breast, was detected.

e15500 Background: In this study, during a 54-month follow-up period, we presented clinicopathological features and survival results of patients treated with trastuzumab. Methods: We retrospectively analyzed the efficacy of trastuzumab-based chemotherapy in 21 patients with HER2-positive gastric cancer between January 2012 and July 2016. Results: Eighteen (86%) patients were male with a median age of 61 (34-80) years. One of the patients was stage 2, 2 were stage 3 and 18 were stage 4, at the time of diagnosis. From 21 tumours, 11 (52%) were located in the cardia, 5 (23%) in the antrum and 5 (23%) in the corpus. In the histopathological examination, 18 (86%) cases were adenocarcinoma and 3 (14%) were signet-ring cell. Seven of the patients with metastatic disease were operated (total/subtotal gastrectomi). The most common metastatic sites were liver (%86), lung(%33), distant lymph node(%23), and periton(%14). Trastuzumab was administered in combination with chemotherapy as first-line treatment and beyond progression as a secondline, and third-line treatment in 18, 2, and 1 patients, respectively. When tumour response was assessed after three cycles of chemotherapy, one complete response (5%),4 partial response (19%),12 stabil disease (57%) were observed, and 4 (19%) patients had progressive disease. Clinical benefit rate was 81%. The maintenance treatment of trastuzumab was applied to 10 patients (47%). At a median follow-up of 17.8 (5-38) months, median progression-free survival was 12.8 months (3-31) and overall survival 18.6 months (3-91). Conclusions: Proximal gastric carcinomas with intestinal phenotype are found to have a higher expression of HER2-gene (range 8-34%) than distal diffuse gastric carcinomas (range 1-7%). The present results are similar to those of the ToGA study in terms of overall survival and response rate.

e15050 Background: Peritoneal metastasis in colorectal cancer (pCRC) is associated with poor prognosis. This study aimed to present a single centre experience for patients with pCRC. Methods: Between 2012 and 2016, 60 patients diagnosed with pCRC included in this study. Demographic and clinico-pathologic characterictics of patients were retrospectively analysed using patient medical records. Results: A total of 60 patients (31 female) were included and the median age was 61. Fifty-five patients (91%) had peritoneal metastases at the initial diagnosis, 37 patients (61%) had the left-sided colon cancer and 33 patients (55%) had the visceral metastases. Peritoneal metastasis was detected in 7 patients during the primary surgery. 30 patients (50%) received biologic therapy; 25 patients (41.6%) received anti-VEGF (bev) and 5 patients (8.3%) received anti-EGFR (cet/ pan) as the first line therapy. Seven (11%) patients underwent cytoreductive surgery and HIPEC. Median PFS of the analyzed patients was 10 months (SE: 2; 95% CI 6-13.9) and mOS was 20 months (SE: 4.2; 95% CI 11.7-28.7). The mPFS and mOS were 16.6 months (SE: 4.9; 95% CI 6.9-26.4) and 28 months (SE:7.1; 95% CI 13.8-42.1) in the group received surgery and HIPEC, respectively. No statistically significant survival difference was detected in terms of primary tumor localization, the presence of visceral metastasis (Table 1). Conclusions: In our study, the prognosis of pCRC patients was observed to be worse regardless of localization and the presence of accompanying visceral disease. A statistically significant difference was observed in the survival of the patients that received biologics. [Table: see text]

e15507 Background: Esophagus cancer is an important cause of cancer-related deaths in Turkey as well as in the world. In our study, clinicopathological features and survival results of patients treated for esophageal cancer were presented. Methods: This study retrospectively reviewed esophageal squamous cell carcinoma (SCC) and adenocarcinoma (ADC) patients who were admitted to our center, between 2012 and 2016. Results: A total of 82 patients (56 males) with a median age of 56 years were evaluated. Seventy-one (87%) patients were diagnosed with SCC, 10 (12%) with ADC, 1 with adenosquamous carcinoma. All ADC patients were HER2 negative. The localization of tumors; lower third (55%), middle third (27%) and upper third (18%) of the esophagus. Prior to surgery, neoadjuvant chemoradiotherapy (CRT) was administered in 21 patients (26%); 10 of them receiving carboplatin and paclitaxel (CP), and 11 receiving cisplatin and 5-FU (CF). TNM classification of operated patients were as follows; Stage 1 (n = 5), stage 2 (n = 10), stage 3 (n = 8) and stage 4 (n = 1). Adjuvant chemotherapy (CF) was administered in the other 6 (7%) patients. Definitive CRT was given in 36 patients (44%), with CF being administered in 32 patients, and CP therapy in 4 patients. There were 19 patients (23%) with metastatic diagnosis and 13 of whom were treated with CF, and 4 with docetaxel-cisplatin-5FU combination. With median follow up of 21 months, median overall survival (OS) and time to progression (TTP) were 24 and 17 months, respectively. The median OS and TTP of patients with metastatic disease were 14 and th 9 months, respectively. The median OS and TTP of the patients who underwent surgery were 45 and 34 months, respectively. Conclusions: Our findings in this study regarding the rate of histology, the percentages of patients with metastatic vs. locally advanced disease, and survival rates were similar to the literature.

nadir olgu bildirimleri vardır (2). Dünya sağlık örgütü akciğer kanseri sınıflamasında BHK; adenokarsinom, yassı hücreli karsinom ve büyük hücreli sınıflandırılmaktadır (3). Bizde BHK’nın böbrek dışındaki dokularda nadir de olsa görülebileceğini ve akılda tutulması gerektiğini böyle bir olgu ile göstermek istedik