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Background/aim: The aim of our study was to compare the efficacy and the safety of the FLOT and the modified DCF (mDCF) regimens in patients with metastatic gastric (GC) and gastroesophageal junction (GEJ) adenocarcinoma as first-line treatment. Materials and methods: The medical records of 72 patients were retrospectively reviewed. Survivals and hematological adverse events of the patients were examined. Factors affecting survivals were analyzed in univariate analysis. A multivariate analysis was performed with the factors contributing to survivals in univariate analysis. Results: The median PFS (mPFS) was 10.1 months (95% CI, 6.8-13.4) in the FLOT arm (n = 33) and 7.4 months (95% CI, 9.1-21.6) in the mDCF arm (n = 39) (p = 0.041). The median OS (mOS) was 12.9 months (95% CI, 9.7-16.1) in the FLOT arm and 15.4 months (95% CI, 9.1-21.6) in the mDCF arm (p = 0.622). It was found that all grade neutropenia was 51.3% vs. 72.7% (p = 0.063), febrile neutropenia was 8.3% vs. 6.3% (p = 0.743), and thrombocytopenia was 48.7% vs. 51.5% (p = 0.813) in the FLOT and mDCF arms, respectively. Anemia was 59% in the FLOT arm and 100% in the mDCF arm (p < 0.001). Grade 3-4 anemia was 7.7% in the FLOT arm and 24.2% in the mDCF arm (p = 0.052). Conclusion: It was shown that the mPFS was significantly increased in the FLOT arm compared to the mDCF arm as the first-line treatment in patients with metastatic GC and GEJC. Hematological adverse events were more favorable in the FLOT arm than in the mDCF arm. [ABSTRACT FROM AUTHOR]

Purpose: Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in cancer patients. However, the association of VTE with immunotherapy remains poorly defined. We therefore evaluated the frequency of VTE in patients receiving immunotherapy and tried to determine predisposing factors. Methods: A total of 133 adult metastatic cancer patients treated with immunotherapy for any cancer between were included. Baseline demographics, ECOG performance status, type of tumors, and baseline blood count parameters were recorded. Possible predisposing factors were evaluated with univariate and multivariate analyses. Results: The median age was 60 (interquartile range (IQR) 48–66) years, and the median follow-up was 10.1 (IQR 5.8–18.5) months. Renal cell carcinoma (26.3%) and melanoma (24.1%) were most common diagnoses. Fifteen patients (11.3%) had an episode of VTE. Most of the VTEs were diagnosed as pulmonary emboli (10/15; 67%). Eighty percent (12/15) of these VTE cases were detected incidentally. Patients with a baseline ECOG performance status of 1 or more (29.3% of patients) had a significantly increased risk of venous thrombosis (ECOG ≥1 vs. 0, HR: 3.023, 95% CI: 1.011–9.039, p=0.048). Other factors, including patient age, tumor type, body mass index, baseline thrombocyte, neutrophil, and lactate dehydrogenase levels were not significantly associated with VTE risk. Conclusions: In this study, we observed VTE development in more than 10% of immunotherapy-treated patients and increased VTE risk in patients with poorer ECOG status. With the asymptomatic nature of VTEs in most cases, a high index of suspicion level for VTE is required in patients treated with immunotherapy. [ABSTRACT FROM AUTHOR]

Colorectal cancer accounts for one third of non-genital tumors metastasize to the ovaries. We aimed to investigate the role of cytoreductive surgery in colon and small intestinal cancer patients with adnexal metastases, which were operated as primary epithelial ovarian cancer. This analysis included 26 patients with adnexal metastasis from colon and distal ileum, patients presented as primary ovarian cancer cases and were operated upon in Zekai Tahir Burak Women's Health Hospital, Gynecologic Oncology Unit between 2008 and 2014. Patients with history of intestinal cancers were not included in the study. The median age of patients was 54 (range= 26-77). Among all patients, 63% were premenopausal and 37% were postmenopausal. Most common presenting symptom was abdominal distention (80%). Optimal cytoreduction was performed in 21 patients. Right hemicolon was the primary site of tumor in 8 patients, while recto-sigmoid and appendiceal tumors were present in 7 and 7 patients, respectively. Isolated ovarian metastases were found in 6 patients, the remaining 20 patients had peritoneal carcinomatosis. Median follow-up was 25 months (ranging 3-59). In total, 11 patients died, of them, two patients had isolated ovarian metastasis, while the remaining nine patients had peritoneal carcinomatosis. Estimated median overall survival was 36.8 months (95% CI= 28.6-45.1 months). Median overall survival of patients who underwent cytoreductive surgery was not reached (36.8+ months), compared with 18.3 (95% CI= 0.0-46.4) months for patients with suboptimal cytoreductive surgery (p= 0.008). This retrospective study showed that cytoreductive surgery might have beneficial effect in selected patients with intestinal cancer metastatic to the adnexal. [ABSTRACT FROM AUTHOR]