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OBJECTIVE Breast cancer is the most diagnosed cancer in females. Cancer screening programs increase the detection of early-stage breast cancer. This study aimed to assess the long-term outcomes and the effect of adjuvant therapies for recurrence in stage I breast cancer patients. METHODS We recorded clinicopathological and treatment features of the stage I breast cancer patients and evaluated long-term outcomes retrospectively. Kaplan-Meier analysis and Cox regression analysis were used for recurrence and overall survival. RESULTS 308 patients with stage I breast cancer were involved in the study. The average age was 52 (range 21-81). The median follow-up was 99 (12-380) months. Forty-three (14%) patients were aged over 65, and 162 (52.7%) patients were postmenopausal. ER, PR, and HER2 receptor positivity were 78.9%, 60.8%, and 14.3%, respectively. Lumpectomy plus adjuvant radiotherapy was performed in 82.1% of the patients, and mastectomy in 10.7% of the patients for primary treatment. The patients received adjuvant chemotherapy (42.5%) and adjuvant hormonal therapy (79.9%). Recurrence (local-47.8%, metastatic-52.2%) occurred in 23 (7.5%) patients. In multivariate Cox regression analysis, we found that primary treatment (lumpectomy + adjuvant RT or mastectomy) (p=0.614), surgical margin status (p=0.495), adjuvant chemotherapy (p=0.259), and adjuvant hormonal therapy (p=0.289) were not statistically significant factors for recurrence. However, aged over 65 years (p=0.002) was statistically significant. CONCLUSION In this study, we showed long-term outcomes in stage I breast cancer patients. It was shown that the primary treatment type (lumpectomy + adjuvant RT or mastectomy) was not different in terms of recurrence. In addition, it was determined that adjuvant chemotherapy did not provide benefit for recurrence in stage I breast cancer patients in our results. For this reason, in patients with stage I cancer, more care should be taken in the decision of adjuvant therapy. [ABSTRACT FROM AUTHOR]

Background/aim: The study is aimed to determine the relationship between the delivery and breastfeeding history of the patients and the clinicopathological properties of breast cancer. Materials and methods: A questionnaire was utilized for the study, which included the age of diagnosis, the number of children at the time of diagnosis, the age of the children, and the breastfeeding period of each child. Results: The study included 828 patients. The median age at diagnosis was 47 years for parous women and 42 years for nonparous women (p < 0.001). The tumor size of the patients diagnosed within the breastfeeding period was significantly larger compared to the other patients. Estrogen and progesterone receptor positivity were lower in patients diagnosed during breastfeeding. Additionally, the mean number of positive lymph nodes, dissected lymph nodes, and positive lymph node/dissected lymph node ratio in parous and breastfed patients with a nonmetastatic disease were statistically significantly higher in multivariable analysis than those patients who were nulliparous and have not breastfed. Conclusion: Breast cancer is seen at a later age in patients who are parous than those who have never given birth. Patients who are parous and have breastfed tend to present with a higher stage of the disease. [ABSTRACT FROM AUTHOR]

OBJECTIVE It is known that cancer patients are more prone to infections than the general population. We aimed to describe the risk factors affecting the survival of cancer patients infected with COVID-19 and clinical findings compared with a large COVID-19 patient population without cancer diagnosis. METHODS The clinical data of 61 cancer and 558 non-patients with COVID-19 infection who applied to the emergency room were compared retrospectively. Risk factors affecting overall survival in cancer patients were analyzed. RESULTS Gender and mean age were comparable in both groups. In the entire cohort, cancer diagnosis was found to be an independent poor prognostic factor (hazard ratio [HR] = 3.09, p<0.001) among other comorbidities. In univariate analysis; lung cancer, activated partial thromboplastin time >32 seconds, INR >1.1, N-terminal-pro-B-type natriuretic peptide (NT-proBNP) >400 pg/ml, C-reactive protein >100 mg/L, and procalcitonin >0.23 ng/mL were determined as prognostic risk factors. Lung cancer (HR=5.277, p=0.012) and NT-proBNP >400 pg/ml (HR=0.139, p=0.021) were determined as independent prognostic risk factors in multivariate analysis. CONCLUSION Cancer patients with COVID-19 infection have poor survival outcomes. Lung cancer diagnosis and elevated NT-proBNP levels were identified as the most crucial prognostic risk factors in cancer patients infected with COVID-19. [ABSTRACT FROM AUTHOR]

OBJECTIVE Regorafenib, a multikinase inhibitor, is an approved third-line therapy for advanced gastrointestinal stromal tumors (GISTs). However, its routine clinical application is difficult due to the associated adverse events (AEs) reported by patients in the 1st month, which leads to early discontinuation. In this study, we presented our experiences in toxicities management and the effectiveness of regorafenib in our institutional cancer center. METHODS Twenty-two patients treated with regorafenib as a third-line therapy for advanced GISTs were retrospectively evaluated who had progressive disease after imatinib and sunitinib treatments. All patients received a full dose of 160 mg/day of regorafenib. RESULTS The average age of the patients was 49 years (range: 25-61 years), with a male preponderance (63.6%). The average follow-up time for the subjects was 114.2 months (16.2-210.3), while the median time of regorafenib using time was 7.7 months (1.9-29.1). The median overall survival (OS) of the patients was found as 10 months, while the 1-year OS rate was 38.3%. The median progression-free survival was found as 7.1 months. Regorafenib-related partial response was observed in 5 patients (22.7%), stable disease in 9 (40.9%), and progressive disease in 8 (36.4%). The disease control rate was 63.7%. Treatment- related grade 3/4 AEs were seen in ten (45.4%) patients. The most common AE was hand-foot skin reaction (5; 18.2%), followed by fatigue (3; 13.6%) and hypertension (2; 9.1%). Dose reductions were required in 7 patients (31.8%). The treatment was discontinued in a patient due to stroke. CONCLUSION Our results demonstrate promising activity and manageable side effects of regorafenib as third-line therapy of GIST in daily clinical practice in the Turkish population. [ABSTRACT FROM AUTHOR]

OBJECTIVE ROS1 positivity is seen in 1-2% of patients with metastatic lung cancer. Targeted drugs such as crizotinib, lorlatinib, and entrectinib are used in the treatment. We aimed to evaluate the efficacy of crizotinib and the prognosis of patients with ROS1 fusion-positive metastatic non-small cell lung cancer (NSCLC) in this study. METHODS We analyzed data of the advanced NSCLC patients with ROS1 mutation retrospectively. We determined the clinicopathological features of the patients. We evaluated the parameters affecting the prognosis with survival analyzes. RESULTS The research enlisted the participation of 21 patients. Median progression-free survival with crizotinib treatment was found 26.1 (95% Confidence interval [CI], 8.1-44.1) months. Median overall survival was 35.2 (95% CI, 13.5-56.9) months. Treatment-related Grade 1-2 adverse effects were observed in 9 (42.9%) patients and Grade 3-4 adverse effects were detected in 1 (4.8%) patient. Clinicopathological parameters affecting survival were evaluated; age (p=0.02) and liver metastasis (p=0.03) were defined as prognostic parameters. ROS1 positivity rate (p=0.08) was not found to be a prognostic factor. CONCLUSION In patients with ROS1 fusion-positive metastatic NSCLC, crizotinib was shown to be both efficacious and safe. We also found that in this patient group, age and the existence of liver metastases are prognostic factors. [ABSTRACT FROM AUTHOR]

OBJECTIVE The aim of the present study was to evaluate the impact of conventional hemogram parameters as a biomarker in epithelial ovarian cancer (EOC) patients; and the clinical importance of the difference after chemotherapy. METHODS We have evaluated the patients with advanced-stage EOC who diagnosed between January 2012 and December 2017. RESULTS Elevated levels of neutrophils, neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio at the time of diagnosis were significantly associated with excess amount of ascites. Lower levels of neutrophils and hemoglobin (HGB); and higher levels of red cell distribution width (RDW), and RDW/HGB ratio were predictors of platinum-sensitivity. In univariate analysis, while decreased mean platelet volume (MPV) was associated with longer disease free survival (DFS); elevated RDW, decreased neutrophils, MPV, and NLR were effective for better overall survival (OS). In multivariate analysis, platinum sensitivity and MPV were significantly associated with DFS and OS. Importantly, patients with persistently low MPV group after chemotherapy had the best OS; while persistently high MPV group had the worst OS. CONCLUSION MPV is a marker that can be easily evaluated during complete blood counts, and might be a promising and practical prognostic biomarker in the field of EOC. Hemogram parameters are found useful to predict disease properties and survival in EOC. [ABSTRACT FROM AUTHOR]

BACKGROUND: Novel biomarkers are needed to predict the effectiveness of the treatment of presurgical neoadjuvant chemotherapy (NAC) in breast cancer (BC). OBJECTIVE: This is an exploratory study to assess the impact of 3 cancer-related long non-coding RNAs (lncRNAs) (H19, MALAT1 and GA5) in blood plasma of patients with BC in predicting the response to NAC. METHODS: The plasma levels of RNAs were relatively measured by quantitative PCR at baseline, and at the end of the fourth cycle of NAC in patients with locally advanced BC. RESULTS: Only H19 was associated with patients' characteristics, and with the response to NAC. Higher plasma expression of H19 was associated with younger age at diagnosis, triple negative tumors, and Ki-67 index. Patients with a pathological complete response (20%) had lower pre-therapeutic levels of H19 compared with the non-complete responders (relative levels 0.1 vs 0.2, respectively, P : 0.04). In addition, the patients with higher degree of downstaging of initial tumors had lower baseline levels of H19 among non-complete responders. CONCLUSION: Our study reveals that H19, but not MALAT1 and GAS5, may be a useful marker of response to NAC in BC. [ABSTRACT FROM AUTHOR]

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Objective: We aimed to determine the relationship between histopathological features of breast cancer and pregnancy or breastfeeding history in the Turkish patient population. Materials and Methods: A questionnaire was applied to the patients with breast cancer who came to Istanbul Oncology Institute Medical Oncology Outpatients Clinic between 2018 - 2019 and accepted to participate in the study. The age, the number of births at the time of diagnosis, the age of the children and the duration of breastfeeding were questioned. Clinical data such as menopause status, height and weight at the time of diagnosis, clinical and histopathological features of the tumor, stage of the disease at the time of diagnosis were recorded. Statistical analyzes were performed using SPSS 21.0 program and p<0.05 was considered significant. Results: A total of 828 patients were included in the study. In the whole group, the birth rate was 89.5% and the rate of breastfeeding of parous women was 94.7%. For statistical analysis, cumulative and longest period of breastfeeding a child were evaluated separately. The total duration of breastfeeding was median 24 months (range 0 to 174) and the longest period of breastfeeding for a child was median 16 months (range 0 to 60). The median age at diagnosis was 47 years for parous women and 42 years for those who are non-parous. Non-parous women with breast cancer was diagnosed at an earlier age which was statistically significant (p<0.001). Similarly, those who delivered once, were diagnosed at an earlier age to those who delivered 2 or more (p<0.001). Patients were divided into groups according to hormone and Her 2 receptor status. The number of hormone receptor positive patients was 615 (74.3%), the number of positive patients was 194 (23.4%), and the number of triple negative patients was 90 (10.9). There was no correlation between the presence of birth and breastfeeding, histological subtype of tumor, ER status, HER2 status and history of breastfeeding and delivery. The relationship between breastfeeding time and time after breastfeeding, stage and histological subtype was evaluated by non-parametric tests. However, there was no correlation between stage and histological type and breastfeeding exposure. Conclusion: Breast cancer is seen at a later age in patients who have had 2 or more births than those who have never given birth and have had a single birth. The presence of birth and breastfeeding had no effect on the histological features of the tumor. [ABSTRACT FROM AUTHOR]

Background: Bone metastasis is rarely seen in colorectal cancer (CRC) patients, and there is insufficient data available regarding such cases. The study aimed to identify the prognostic factors and characteristics associated with overall survival in patients with bone metastatic CRC., Method: Data from bone metastatic CRC patients referred to a high-volume tertiary cancer center in Turkey, between January 2018 and April 2021, were retrospectively collected. The records of 150 consecutive patients treated for bone metastases due to CRC were reviewed. Overall survival curves were generated by the Kaplan-Meier method and analyzed using the log-rank test., Results: Median age was 55 years (19-86 years). Bone metastases were more common in men and those with metachronous metastases. The axial skeleton was the most commonly involved site, and patients were frequently presented with single bone metastasis. Peritoneal metastases were significantly correlated with extra-axial metastases (P = 0.002), and radiotherapy was applied to axial metastases significantly, more frequently (P = 0.02). Lung metastasis was also more prevalent in K-RAS mutated patients (P = 0.008). The median survival time from diagnosis of bone metastasis was 8.3 months (95% confidence interval (CI), 5.5-10.6), and the three-year survival rate was 76.9% (95% CI, 69.8-84.0). Multivariate analysis revealed that brain metastases, right-sided colon tumor, high serum ALP, and Ca 19-9 levels were independent poor prognostic factors (P = 0.01, 0.02, <0.001, and 0.04, respectively)., Conclusions: The location of CRC correlates significantly with the site of bone metastasis; the prognosis of CRC patients with bone metastasis is very poor, and the significant poor prognostic factors are brain metastases, right-sidedness, high serum ALP, and Ca 19-9 levels. More attention should be paid to bone metastasis in CRC patients., (Copyright © 2024 Copyright: © 2024 Journal of Cancer Research and Therapeutics.)

Background/aim: The study is aimed to determine the relationship between the delivery and breastfeeding history of the patients and the clinicopathological properties of breast cancer., Materials and Methods: A questionnaire was utilized for the study, which included the age of diagnosis, the number of children at the time of diagnosis, the age of the children, and the breastfeeding period of each child., Results: The study included 828 patients. The median age at diagnosis was 47 years for parous women and 42 years for nonparous women (p < 0.001). The tumor size of the patients diagnosed within the breastfeeding period was significantly larger compared to the other patients. Estrogen and progesterone receptor positivity were lower in patients diagnosed during breastfeeding. Additionally, the mean number of positive lymph nodes, dissected lymph nodes, and positive lymph node/dissected lymph node ratio in parous and breastfed patients with a nonmetastatic disease were statistically significantly higher in multivariable analysis than those patients who were nulliparous and have not breastfed., Conclusion: Breast cancer is seen at a later age in patients who are parous than those who have never given birth. Patients who are parous and have breastfed tend to present with a higher stage of the disease., (© TÜBİTAK.)

Background: In this study, we aimed to evaluate the factors that contribute to survival outcomes in patients with thymoma treated with multimodal approaches., Methods: A total of 203 patients (105 males, 98 females; median age: 49 years; range, 17 to 77 years) with Masaoka-Koga Stage II-IV thymoma between January 2002 and December 2018 were retrospectively analyzed. Data including diagnosis of myasthenia gravis, diagnosis of diabetes mellitus, disease stage, histological type of tumor, capsule invasion and surgical margin status, lymphadenectomy, adjuvant radiotherapy or chemotherapy, time from surgery to the first day of adjuvant treatment, length of hospital stay, and overall and disease-free survival rates were recorded., Results: Of the patients, 91 had Stage II, 67 had Stage III, and 45 had Stage IV disease. A total of 123 patients (61%) had myasthenia gravis. Seventy-six patients received adjuvant radiotherapy and 48 patients received either neoadjuvant (n=35) or adjuvant (n=25) chemotherapy. Higher disease stage, presence of R1 resection, and treatment with chemotherapy were significant factors for decreased disease-free survival time. Older age, higher disease stage, longer postoperative hospital stay, chemotherapy, and disease recurrence were effective contributors to decreased overall survival time. Adjuvant radiotherapy had a statistically significant positive effect on overall survival only in patients with completely resected Stage IV disease (five-year overall survival: 94.7% vs. 79.1%, respectively; p=0.015). In the multivariate analysis, older age (hazard ratio: 4.26), higher disease stage (hazard ratio: 2.95), and longer hospitalization time (hazard ratio: 3.81) were significant prognostic factors for overall survival. Patients with local recurrence who underwent complete resection had a survival time comparable to non-recurrent patients (p=0.753)., Conclusion: For patients with thymoma, higher disease stage, age ≥50 years, longer hospitalization, and need for chemotherapy are associated with worse survival rates. Adjuvant chemotherapy has a positive impact on Stage IV disease. Resection of recurrent lesions has a valuable impact on survival., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article., (Copyright © 2021, Turkish Society of Cardiovascular Surgery.)