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WOS: 000383306700010, PubMed ID: 27685904, Purpose: To determine the predictive value of the mean platelet volume (MPV) and the MPV/platelet count ratio on the development of isolated bone metastasis in patients with breast cancer. Methods: A total of 121 previously untreated female patients with isolated bone metastases from breast cancer (group 1) were included in this retrospective cohort study. The patients enrolled in this study had similar age, biological subtypes, and duration of follow-up after diagnosis. Group 1 was compared with both 71 previously untreated women with breast cancer with no metastases at all (group 2) and 39 healthy women (group 3). Demographic data, laboratory tests and histological features of all of the patients in groups 1 and 2 were recorded and the study variables from each of the three groups were compared. Results: In group 1, the cut-off value (9.2 fL) for the MPV was determined and patients were stratified into 4 subgroups. The MPV was higher in group 1 than in either group 2 or group 3. Group 1 patients had a MPV of 8.8 +/- 3.1 fL (mean 5.1, range: 6.1-15.6) and the cut-off value for MPV was 9.2fl. For patients in group 1, the MPV distribution was stratified into 4 groups as follows: group A included MPV values 10.06fL. MPV and the presence of lymphovascular invasion were found to be independent risk factors for the development of isolated bone metastases. Conclusion: We concluded that MPV can be used to predict the development of isolated bone metastases.

Insomnia, poor sleep quality and short sleep durations are the most common problems seen in cancer patients. More studies are needed about sleep disorders in cancer patients. In our study, we aimed to investigate the prevalence of sleep disorders and the impact of these problems on the quality of life in cancer patients. Pittsburgh Sleep Quality Index (PSQI) was given to a total of 314 patients. The psychometric evaluation of the Turkish version of PSQI in cancer patients revealed that 127 (40.4%) patients had global PSQI scores >5, indicating poor sleep quality. There was no statistically significant relationship between PSQI scores and sexuality, marital status, cancer stage and chemotherapy type (P > 0.05); while the patients with bone and visceral metastasis had much lower PSQI scores (P = 0.006). Patients with Eastern Cooperative Oncology Group performance scores of 3 or more had also significantly lower PSQI scores (P = 0.02). In conclusion, PSQI questionnaire may be used to evaluate the sleep disorders in cancer patients. Consistent use of multi-item measures such as PSQI with established reliability and validity would improve our understanding of difficulties experienced by cancer patients with chronic insomnia.

Background: Pazopanib (PZP) may induce prolonged cardiac repolarization and proarrhythmic effects, similarly to other tyrosine kinase inhibitors. Objectives: To demonstrate PZP-induced prolonged cardiac repolarization and proarrhythmic electrophysiological effects and to investigate possible preventive effects of metoprolol and diltiazem on ECG changes (prolonged QT) in an experimental rat model. Methods: Twenty-four Sprague-Dawley adult male rats were randomly assigned to 4 groups (n = 6). The first group (normal group) received 4 mL of tap water and the other groups received 100 mg/kg of PZP (Votrient® tablet) perorally, via orogastric tubes. After 3 hours, the following solutions were intraperitoneally administered to the animals: physiological saline solution (SP), to the normal group and to the second group (control-PZP+SP group); 1 mg/kg metoprolol (Beloc, Ampule, AstraZeneca), to the third group (PZP+metoprolol group); and 1mg/kg diltiazem (Diltiazem, Mustafa Nevzat), to the fourth group (PZP+diltiazem group). One hour after, and under anesthesia, QTc was calculated by recording ECG on lead I. Results: The mean QTc interval values were as follows: normal group, 99.93 ± 3.62 ms; control-PZP+SP group, 131.23 ± 12.21 ms; PZP+metoprolol group, 89.36 ± 3.61 ms; and PZP+diltiazem group, 88.86 ± 4.04 ms. Both PZP+metoprolol and PZP+diltiazem groups had significantly shorter QTc intervals compared to the control-PZP+SP group (p < 0.001). Conclusion: Both metoprolol and diltiazem prevented PZP-induced QT interval prolongation. These drugs may provide a promising prophylactic strategy for the prolonged QTc interval associated with tyrosine kinase inhibitor use. Fundamento: Pazopanibe (PZP) pode induzir prolongamento da repolarização cardíaca e efeitos pró-arrítmicos, à semelhança de outros inibidores da tirosina quinase. Objetivos: Demonstrar prolongamento da repolarização cardíaca e efeitos eletrofisiológicos pró-arrítmicos induzidos pelo PZP, assim como investigar possíveis efeitos de metoprolol e diltiazem na prevenção de alterações no ECG (prolongamento do intervalo QT) em um modelo experimental em ratos. Métodos: Ratos Sprague-Dawley adultos machos (24) foram designados de modo aleatório para quatro grupos (n = 6). O primeiro grupo (normal) recebeu 4 ml de água da torneira, enquanto os demais receberam 100 mg/kg de PZP (comprimido de Votrient®) através de sonda orogástrica. Após 3 horas, os animais receberam por via intraperitoneal: solução salina, para o grupo normal e para o segundo grupo (controle-PZP+SP); 1 mg/kg de metoprolol (Beloc, Ampola, AstraZeneca), para o terceiro grupo (PZP+metoprolol); e 1mg/kg de diltiazem (Diltiazem, Mustafa Nevzat), para o quarto grupo (PZP+diltiazem). Uma hora após a administração desses medicamentos, e sob anestesia, calculou-se o intervalo QTc registrando-se o ECG em DI. Resultados: Os valores médios do intervalo QTc foram: grupo normal, 99,93 ± 3,62 ms; grupo controle-PZP+SP, 131,23 ± 12,21 ms; grupo PZP+metoprolol, 89,36 ± 3,61 ms; e grupo PZP+diltiazem, 88,86 ± 4,04 ms. Os grupos PZP+metoprolol e PZP+diltiazem apresentaram intervalos QTc significativamente mais curtos comparados aos do grupo controle-PZP+SP (p < 0,001). Conclusão: Ambos metoprolol e diltiazem evitaram o prolongamento do intervalo QT induzido por PZP. Tais medicamentos podem ser uma promissora estratégia para evitar o prolongamento do intervalo QTc associado ao uso de inibidores da tirosina quinase.

OZTURK, MEHMET AKIF/0000-0003-1365-7944; Ozyigit, Gokhan/0000-0002-7497-4348 WOS: 000342543200008 There is a new improvement in oncology nearly in every day as a result of preclinical or clinical. As the number of publication per capita, Turkey is far behind the other developed European countries. For example, the number of publications in oncology field is 2.134.964 in the world, it is 15.576 in our country. The most important obstacles for clinical trials in Turkey may be listed as financial problems, difficulties of working conditions, time limitation due to work intensity, inadequate experienced/trained man-power, absence of assistance team at all steps of a scientific trial, difficulties faced during project planning and ethics committee submissions, and lack of motivation. In this article, we, as young oncologists, aimed to discuss the place of Turkey in areas of scientific and clinical trials in the world; underlying causes for inadequate number, type and quality of national studies and possible solution proposals in our country.

Hemangiopericytoma (HPC) may develop in every site where the endothelial tissue exits and primarily develops in the skeletal-muscular system or the skin. Adult cases of HPC generally exhibit a benign course. 20–30% of the cases may show a malign course. The tumors that show more than four mitoses, a focal area of necrosis, and increased cellularity on a magnification ×10 are considered as malign. In our paper, we presented our case who showed a lung metastasis at the end of 4 years and who developed a pathological fracture of the right humerus at the end of approximately 2 years, because hemangiopericytoma is rarely seen in the chest wall as a primary tumor.

Background: Synovial sarcoma (SS) is a rare disease and compared with other soft-tissue sarcomas has a relatively high mortality rate. The optimal management of this disease and prognostic factors associated with patient outcome remains controversial. Aims: We aimed to evaluate the factors affecting the outcomes of SS patients in the adjuvant setting. Patients and Methods: In this Turkish multicenter study, we assessed the data of 69 SS patients regarding prognostic factors for SS patients retrospectively. Results: Our study included 69 localized SS patients (38 males and 31 females) with a median age of 34.5 years (minimum-maximum: 14-68 years). Overall survival (OS) and disease free survival (DFS) rates for 5 years were 64% and 25%, respectively. All patients under went surgical treatment; 64 patients were treated with a wide excision and 5 patients had an amputation. According to the univariate analysis, adverse prognostic factors for OS were male sex, higher mitotic activity, high Ki-67 levels, trunk localization and inadequate surgical margins. In multivariate analysis, none of these factors had independent significant association with OS. Prognostic factors for DFS; in the univariate analysis were higher mitotic activity, high Ki-67 levels and inadequate surgical margins. Only higher mitotic activity (>= 10 high-power field) was significantly associated with worse DFS in the multivariate analysis (hazard ratio: 0.30, % confidence interval: 0.11-0.80, P = 0.017). Conclusion: Our study confirms that high mitotic activity is significantly associated with decreased DFS. The question of whether the chemotherapy provides a survival advantage in patients having adverse prognostic factors requires confirmation in randomized trials.

1 Izmir Tepecik Education and Research Hospital, Department of Medical Oncology, Izmir 2 Dokuz Eylul University Medical Faculty, Department of Internal Medicine, Izmir 3 Istanbul Hospital, Division of Medical Oncology, Van, Turkey 4 Ataturk University Medical Faculty, Department of Medical Oncology, Erzurum 5 Dokuz Eylul University Medical Faculty, Department of Thoracic Surgery, Izmir 6 Izmir University Medical Park Hospital, Department of Medical Oncology, Izmir, TURKEY

WOS: 000320292300004, PubMed: 23698146, Several studies have now demonstrated that the lymph node ratio (LNR), as a superior indicator of axillary tumor burden to the number of excised nodes. While, about the prognostic value of LNR on the the survival of elderly patients is limited. The aim of this retrospective multicenter study is to evaluate the prognostic value of lymph node ratio in elderly patients with node positive breast cancer. METHODS: Onehundredeightyfour patient with operable breast cancer, recruited from 17 institutions, were enrolled into the retrospectively study. Eleven potential prognostic variables were chosen for analysis in this study. Univariate and multivariate analyses were conducted to identify prognostic factors associated with survival. RESULT: Among the eleven variables of univariate analysis, four variables were identified to have prognostic significance for Overall survival (OS): pathologic tumor size (T), No. of positive nodes (N), LNR and estrogen receptor-positive (ER). Among the eleven variables of univariate analysis, two variables were identified to have prognostic significance for Disease-free survival (DFS): N and LNR. Multivariate analysis by Cox proportional hazard model showed that 7; LNR and ER were considered independent prognostic factors for OS. Furthermore, LNR was considered independent prognostic factors for DFS. CONCLUSION: In conclusion, the LNR was associated with the prognostic importance for DFS and OS in elderly patients who were administered adjuvant treatments.

Amaç ve Hipotez: Kolorektal kanserde RAS-RAF-MEK-ERK yolağının ardışık aktivasyonunda KRAS ve BRAF mutasyonları önemli rol oynamaktadır. Sporadik Kolorektal Kanserlerin yaklaşık %30-%35'sinde KRAS mutasyonu bulunmaktadır. KRAS'ın farklı tip klinik ve histopatolojik özelliklerle ilişkili olduğunu gösteren veriler ve prognostik bir belirteç olarak kullanılmasının yararı ile ilişkili elde edilen veriler günümüzde halen belirsiz ve çelişkilidir. Bu çalışmada metastatik kolorektal tanısı ile kliniğimizde takip ve tedavi edilen hastaların KRAS genotiplerinin klinikopatolojik özellikler ve sağkalımlarla olan ilişkisinin değerlendirilmesi amaçlanmıştırYöntem: Bu çalışmamızda 2000-2011 yılları arasında Dokuz Eylül Üniversitesi Tıbbi Onkoloji bölümüne başvurmuş olan, KRAS mutasyon durumu belirlenmiş 115 metastatik kolorektal kanser hastasının dosya kayıtları retrospektif olarak incelendi. Demografik özellikler, klinik ve patolojik özellikler, uygulanan tedavi şekilleri ve sonuçları ile sağkalıma ilişkin verileri kaydedildi. KRAS mutasyon durumu analizi için arşiv parafin bloklarından PCR amplifikasyonu ile DNA dizilme yöntemi kullanıldı. Hastalarda KRAS mutasyon durumuna göre klinikopatolojik özellikler ve sağkalım analizleri istatistiksel olarak karşılaştırıldı.Tartışma ve Sonuç: : KRAS mutasyon durumu ile tümör lokalizasyonu arasında anlamlı biri ilişki saptanırken, diğer klinikopatolojik özelliklerle anlamlı bir ilişki saptanmadı. Benzer şekilde KRAS mutasyon durumunun genel sağkalım, hastalıksız sağkalım ve progresyonsuz sağkalım süreleri ile de herhangi bir ilişkisi bulunmadı. Sonuç olarak KRAS mutasyon durumunun klinikopatolojik, sağkalım süreleri ve prognoz üzerine etkisi belirsizdir. KRAS mutasyon durumunun erken ve ileri evre kolorektal kanserde sağkalımlarla ilişkili prognostik bir faktör olarak değerlendirilmesi konusunda literatürde çelişkili sonuçlar bulunmaktadır. KRAS mutasyon durumunun klinikopatolojik özelliklerle ve prognozla ilişkisi ile ilgili kesin sonuçlara varılabilmesi için spesifik KRAS mutasyon alt tiplerinin ve BRAF mutasyon tiplerinin bilindiği homojen hasta gruplarında yapılacak, geniş çaplı çalışmalara ihtiyaç vardır. Aim: KRAS and BRAF mutations play an important role in colorectal cancer by inducing the sequential activation of RAS-RAF-MEK-ERK pathway. KRAS mutation exists in 30-35% sporadic colorectal cancer. The evidence showing the association between KRAS and different types of clinical and hystopathological features are conflicting and indefinite. In this present study we aimed to evaluate the association between the clinicopathological features and survival with KRAS mutation status in the metastatic colorectal cancer patients receiving follw-up and treatment in our clinic.Methods: In our study we investigated the data of 115 metastatic colorectal cancer patients followed up in our clinic through 2000 to 2011 retrospectively whom the KRAS mutation status was determined. Demographic features, clinical and pathological features, the survival data and types of treatment administered and the responses to the treatments were recorded. DNA sequencing method with PCR amplification was used for the analysis of KRAS mutation status in the archived paraffin sections. The clinicopathological features and survival analysis were compared statistically according to the KRAS mutation status.Results and Conclusion: While determining significant association between KRAS mutation status and tumor localisation, no significant association was determined between overall survival, disease free survival, progression free survival and KRAS mutation status. There are conflicting results in the literature evaluating the KRAS mutation status as a prognostic factor associated with survival in early stage or advanced colorectal cancer. To identify definite results about the association between clinicopathological features, prognosis and KRAS mutation status, large scaled studies in homogeneous patients with known KRAS mutation status and BRAF mutation are needed 103