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PURPOSE This paper aims to investigate the diagnostic performance of magnetic resonance imaging (MRI) in predicting the pathologic stage of locally advanced rectal cancer (LARC) after neoadjuvant chemoradiotherapy (CRT) and the role of MRI in selecting patients with a pathologic complete response (ypCR). METHODS Restaging MRI (yMRI) examinations of 136 patients with LARC treated with neoadjuvant CRT followed by surgery were retrospectively analyzed by two radiologists. All examinations were performed on a 1.5 Tesla MRI machine with a pelvic phased-array coil. T2-weighted turbo spin-echo images and diffusion-weighted imaging were obtained. Histopathologic reports of the surgical specimens were the reference standard. The accuracy, sensitivity, specificity, positive and negative predictive values (PPV and NPV) of yMRI in predicting the pathologic T-stage (ypT), N-stage, and ypCR were calculated. The inter-observer agreement was evaluated using kappa statistics. RESULTS The yMRI results showed 67% accuracy, 59% sensitivity, 80% specificity, 81% PPV, and 56% NPV in identifying ypT (ypT0-2 versus ypT3-4). In predicting the nodal status, the yMRI results revealed 63% accuracy, 60% sensitivity, 65% specificity, 47% PPV, and 75% NPV. In predicting ypCR, the yMRI results showed 84% accuracy, 20% sensitivity, 92% specificity, 23% PPV, and 90% NPV. The kappa statistics revealed substantial agreement between the two radiologists. CONCLUSION Utilization of yMRI showed high specificity and PPV in predicting the tumor stage and high NPV in predicting the nodal stage; in addition, yMRI revealed moderate accuracy in the T and N classifications, mainly due to underestimating the tumor stage and overestimating the nodal status. Finally, yMRI revealed high specificity and NPV but low sensitivity in predicting the complete response. [ABSTRACT FROM AUTHOR]

Amaç: Meme kanseri tanılı hastalarda klinik (anatomik) ve biyolojik belirteçlerin eklenmesi ile elde edilen prognostik evre grupları arasındaki farkları, evre değişim oranını ve evre değişiminin sağkalıma etkisini saptamaktır. Gereç ve Yöntem: Tüm merkezlere çalışma protokolü gönderilmiştir. Dört merkez çalışmaya hasta girişi yapmıştır. Biyobelirteçleri (hormon reseptörleri ve c-erb B2) eksiksiz olarak bilinen, neoadjuvan tedavi almamış, tanıda metastatik olmayan 1470 hasta çalışmaya dahil edilmiş ve geriye dönük olarak değerlendirilmiştir. Anatomik evrelemede patolojik tümör boyutu (pT), lenf nodu durumu (pN) dikkate alınırken, prognostik evrelemede AJCC 8. versiyona göre biyobelirteçlerin evrelemeye katılması ile evre grupları belirlenmiştir. Sağkalım analizleri Kaplan-Meier yöntemi, genel sağkalım (GSK) ve hastalıksız sağkalım (HSK) için değişkenlerin anlamlılık analizi log-rank testi ile hesaplanmıştır. Bulgular: Hastalarda median yaş 52 (20-88) olup, 865 olgu (%58.8) postmenapozal dönemdedir. Histopatolojik tanı 859 hastada invaziv duktal karsinom (İDK)'dur (%58.4). Aksilla 765 hastada negatif (N0) (%52.1), 438 olguda N1mic-N1a'dır (%29.8). Tümör derecesi 200 hastada derece I (%13.6), 812 derece II (%55.2), 452 derece III (%30,7) şeklindedir. ER; 1247 hastada pozitif (%84.8), 223 olguda negatif (%15.2), PR; 1178 hastada pozitif (%80.1), 292 hastada negatiftir (%19.9). Her2-neu; 1263 hastada negatif (%85.9), 207 hastada pozitiftir (%14.1). Toplam 777 hastada evre değişimi saptanırken (%52.9), 693 hastada evre değişimi olmamıştır (%47.1). Anatomik evreleme ile karşılaştırıldığında, prognostik evre gruplarında %46.4 olguda alt evreye, %6.5 olguda üst evreye değişim saptanmıştır. Ortanca izlem süresi 80 (6-237) aydır. Hastalarda 5 ve 10 yıllık GSK ve HSK değerleri sırasıyla; %73.7, %44.3 ve %91.9, %86.3 şeklindedir. GSK için çok değişkenli analizde yaş (p<0.001), tümör derecesi (p<0.001), ER reseptör durumu (p<0.001), PR reseptör durumu (p<0.001), cerbB2 reseptör durumu (p=0.025); HSK için çok değişkenli analizde yaş (p=0.027), tümör derecesi (p=0.005) anatomik evre (p<0.001) ve evre atlaması (p=0.001) anlamlı değişkenlerdir. Sonuç: Anatomik evrelemeye göre çoğunluğunu erken evre olguların oluşturduğu hasta grubumuzda hormon reseptörleri ve c-erb B2 reseptörü durumu GSK ve HSK etkileyen bağımsız değişkenlerdir. Prognostik evrelemede evre atlaması olması HSK'ı etkileyen bağımsız prognostik faktör olarak öne çıkmaktadır. Anatomik evrelemeye göre biyobelirteçlerin durumu prognozu daha iyi belirlemektedir. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Oncology / Türk Onkoloji Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Oncology / Türk Onkoloji Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Oncology / Türk Onkoloji Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Oncology / Türk Onkoloji Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Oncology / Türk Onkoloji Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Amaç: Tolere edemeyecekleri endişesiyle yaşlı hastaların standart kanser tedavilerine erişimi sınırlı olabilmekte, geriatrik popülasyon birçok çalışmada yeterli temsil edilmemektedir. Bu çalışmada rektum kanseri tanısıyla radyoterapi (RT) uygulanmış geriatrik hastaların tedavi sonuçlarının ve tedavi tolerabilitesinin G-8 Geriatrik Skoru (G8GS) eşliğinde değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Rektum kanseri tanısıyla RT uygulanan 65 yaş ve üzeri hastaların tıbbi bilgileri çok merkezli ve retrospektif toplanmıştır. Evre I-III rektum adenokarsinomu tanısıyla neoadjuvan, definitif ya da palyatif amaçla en az 3B konformal RT alan, RT öncesi G8GS kaydedilmiş veya G8GS için yeterli anamnez verisi bulunan hastalar değerlendirilmiştir. Literatür önerisine göre G8GS >14 hastalar zinde, =14 puanlılar ise kırılgan kabul edilmiştir. SPSS23.0 kullanılarak G8GS ilişkili prognostik faktörler Ki-kare ve logistik regresyon; sağkalım (SK) analizleri Kaplan-Meier testi ile hesaplanmıştır. Bulgular: Toplam 16 merkeze ait 699 hasta verisi değerlendirilmiştir. Ortanca yaş 72 (65-96), ortanca izlem 43 (1-190) ay, erkek/kadın oranı %61/%39 olup hastaların %74'ünde =1 komorbid hastalık öyküsü mevcuttur. Evre I, II ve III hasta oranı sırasıyla %1, %20 ve %79 olup 671 (%96) hastaya neoadjuvan RT uygulanmıştır. Ortanca RT dozu 47.8 (9-69) Gy'dir. Toplam 561 (%80) hasta eşzamanlı kemoterapi (KT) alabilmiştir. Sadece 44 (%6) hastada tedaviye ara verilmiş, 24'ünde (%3.4) derece 3-4 erken, 13'ünde (%1,9) derece 3-4 geç yan etki görülmüştür. Neoadjuvan tedavi alan hastaların 566'sına (%84) cerrahi yapılabilmiş, bunların 341'inde (%60) adjuvan KT uygulanmıştır. G8GS =14 puan olan 450 (%64) kırılgan hasta saptanmış, zinde ve kırılgan hasta grupları arasında cinsiyet, evre, toplam RT dozu, hospitalizasyon, RT'ye verilen ara ve cerrahi yapılabilirlik açısından fark saptanmamıştır. Kırılgan hastalarda yaş (p=0.001) ve komorbidite sayısı (p<0.001) daha yüksek bulunmuştur. Konkomitan KT (p=0.002) ve adjuvan KT alabilme oranı (p=0.001) zinde hastalarda istatistiksel anlamlı yüksektir. Her iki grup için derece 3-4 erken ve geç toksisite açısından anlamlı fark görülmemiştir. İzlemde yineleme 57 (%12), uzak metastaz 145 (%21) hastada saptanmıştır. Kansere bağlı ölüm oranı %18'dir (n=127). Beş ve sekiz yıllık genel, yinelemesiz, metastazsız SK sırasıyla %58, %50; %87, %86; %72, %69'dur. Kırılgan hasta grubunda kansere bağlı ölüm daha yüksek (p=0.003) olup 5 ve 8 yıllık SK anlamlı düşüktür (p=0.001). Lokal yinelemesiz ve metastazsız SK açısından gruplar arasında fark bulunmamıştır. Adjuvan KT almanın genel SK (p=0.004) üzerinde olumlu etkisi olmuştur. Bağımsız değişkenlerin incelendiği modellemede yaş [1.04 (1.01-1.087, p=0.013)], kırılgan hasta olmak [1.66 (1.06-2.6, p=0.026)] istatistiksel anlamlı risk faktörleridir. Alt grup analizinde gri zon kabul edilebilecek 14 tam puanlı hastalar değerlendirilmiş, yan etkiler, yineleme ve uzak metastaz açısından 14 puan altı ve üstü olan hastalarla anlamlı fark saptanmamıştır. Bu üç grup içinde <14 puan olmanın (p=0.002) sağ kalıma olumsuz etki eden bir faktör olduğu da bulunmuştur. Sonuç: Rektum kanserli geriatrik hastalarda radyoterapi, tolere edilebilen etkin bir tedavi seçeneğidir. G8GS'ye göre kırılgan grupta olmak SK'a olumsuz yansımaktadır. Radyoterapi öncesi Kapsamlı Geriatrik Değerlendirme ile kırılgan hastaların tıbbi gereksinimlerinin karşılanması, G8GS'yi iyileştirerek standart tedaviye ulaşma ve sağkalım oranlarını arttırabilir. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Oncology / Türk Onkoloji Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Oncology / Türk Onkoloji Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Pathology is the property of Turkish Journal of Pathology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Pathology is the property of Turkish Journal of Pathology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: In this study, long-term follow-up results and prognostic determinants of tripple negative breast cancer patients treated with adjuvant radiotherapy (RT) according to the protocol of Dokuz Eylul Breast Tumors Group were evaluated retrospectively. Materials and Methods: Between January 1992 and December 2005, 215 tripple negative breast cancer patients were included in the study. Ninety-nine (46%) patients underwent breast conserving surgery (BCS), and 115 (53.5%) patients underwent modified radical mastectomy (MRM). Five patients (2.3%) underwent sentinal lymph node biopsy and 208 patients (96.7%) underwent axillary dissection. 50 Gy or more radiotherapy was applied to peripheral lymphatics together with chest wall or breast in 53 patients (75.4%), and to chest wall or breast in 53 (24.6%) patients. One hundred and thirty-two (61.4%) patients received an additional dose of 10-16 Gy. One hundred and seventy-three patiants (80.5%) received adjuvant or 15 (7%) received neoadjuvant chemotherapy (CT) (6 cycles of CAF - CEF, 4 cycles of AC or CMF or equivalent). The staging was done according to AJCC-2018, and the survival analyzed by Kaplan-Meier and the variables were analyzed by Log-Rank and Cox regression analysis. Results: Patients were aged between 25-75 years and median age was 47 years. The median follow-up was 142 months. 119 (55.3%) of the patients were premenopausal. Histologically, 131 patients (60.9%) had invasive ductal carcinoma (IDC), 21 patients (9.8%) had invasive lobular carcinoma (ILC), 11 patients (5.1%) had both ILK and IDC, and 52 (24.2%) had other histopathologic types. Pathologic T stages of the patients were 4 (1.9%) pT1a, 5 (2.3%) pT1b, 52 (24.2%) pT1c, 124 (57.7%) pT2, 18 (8.4%) pT3, 7 (3.3%) pT4b, 5 (2.3%) as pT4d; N stages were staged as 82 (38.1%) pN0, 65 (30.2%) pN1, 45 (20.9%) pN2, 23 (10.7%) pN3. Distribution of patients according to stages were; stage 1; 38 patients (17.6%), stage 2; 103 patients (47.9%), stage 3; 74 patients (33.5%). Pericapsular invasion (PCI) was positive in 69 (32.1%) patients. Skin invasion was present in 13 (6%) patients and surgical margin was positive in 11 (5.1%) patients. While 67 (31.2%) of the patients had distant recurrence during follow-up, 11 (5.1%) had local recurrence. 5, 10, 15 and 20-year overall (OS) and disease-free survival (DFS) rates, respectively; 77.5%, 64.1%, 57.2%, 49.7% and 72.5%, 66.2%, 64.8%, 61.9%. In univariate analyzes, menopause status, surgery type, PCI, pT3-4 disease, pN, stage, CT scheme, distant invasion, and skin invasion were significant factors affecting prognosis on both OS and DFS, while local spread and pT were significant for DFS. In multivariate analyzes, stage is a significant prognostic factor for OS and DFS. Conclusion: In tripple negative breast cancer patients, stage has a significant effect on survival regardless of molecular subtype at long follow-up. Disease-free survival of our patients during median 10-year follow-up is quite good. [ABSTRACT FROM AUTHOR]

Objective: Invasive breast carcinoma is the most common cancer in women. Accurate staging after diagnosis is very important in predicting prognosis and evaluating treatment response. According to the TNM classification of breast cancer, tumors that show direct extension to the chest wall and/or skin regardless of size are considered pT4. However, to diagnose pT4 breast cancer, skin invasion must be accompanied by ulceration or macroscopically defined skin nodules. Only the presence of dermal invasion is not sufficient for the pT4 stage. In this study, we aimed to evaluate the effect of epidermal ulceration on prognosis in breast cancer patients with microscopic dermal invasion. Materials and Methods: The study included 193 patients diagnosed with breast cancer in our hospital between 2002 and 2016 who had microscopic dermal invasion. Preparations were re-evaluated for tumor type, histological grade, tumor size, lymphovascular invasion, receptor and HER2 status as well as the presence of epidermal ulceration. Local recurrence and overall survival data of the patients whose treatment was continued in our hospital after diagnosis and followed up were obtained and statistical analysis was performed using SPSS 15.0. Results: 184 patients were female and their ages ranged between 26-91 (mean 59.5). Microscopic epidermal ulceration was detected in 17.6% of the patients. The most common tumor type was invasive ductal carcinoma (45.8%) and most of the patients (62.4%) were grade 2. The presence of microscopic epidermal ulceration was significantly associated with blood vessel invasion (p=0.035). Distant metastasis was detected in 76.2% of the patients who had epidermal ulceration in pathology specimens (p=0.006). In patients with a mean follow-up of 76.7 months, distant metastasis was significantly associated with survival (p<0.001). The presence of epidermal ulceration did not show a significant relation ship with survival. Conclusion: Although the presence of microscopic epidermal ulceration is significantly associated with blood vessel invasion and distant metastasis, it is not related to overall survival. However, in breast cancer patients with microscopic dermal invasion accompanied by epidermal ulceration, chemotherapy can be planned more effectively for distant metastasis. [ABSTRACT FROM AUTHOR]