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Objectives: Pancreatic cancer (PC) is one of the cancers with the worst prognosis in the world. Despite protooncogenes such as BRCA and PALB2 , effective, inexpensive, and simple methods for predicting the prognosis of patients with metastatic PC are still lacking. We aim to investigate whether mean platelet volume/ platelet (MPV/PLT) and platelet indices such as MPV and plateletcrit (PCT) have a prognostic significance in patients with metastatic PC. Methods: Patients diagnosed with metastatic PC in 3 centers in Turkey between 2016 and 2022 were analyzed retrospectively. We recorded patient’s demographic data such as age, gender, performance status and platelet, MPV and PCT. Overall survival (OS) and progression-free survival (PFS) were also recorded. There were 80 patients in our study. Results: Median PFS was found 6.2 months for MPV/PLT ratio 0.045 group retrospectively. The median PFS of the MPV/PLT ratio ≤0.045 groupwas shorter than MPV/PLT ratio >0.045 group, but there wasn’t statistically meaningful difference between the groups (p:0,957). Median OS for the MPV/PLT ratio ≤0.045 groupwas 10.1 months and the MPV/PLT ratio for the >0.045 group was 9 months, but there wasn’t statistically significant difference between the groups (p:0.506).There was nosurvival difference between the groups when comparing both MPV and PCT status. Conclusion: MPV/PLT ratio is a cheap, simple and useful marker and can be used in our daily practice to predict the prognosis of patients with advanced PC, if confirmed by prospective studies and larger patient numbers.

Background:Aromatase inhibitors (AIs) are used for the adjuvant treatment of early breast cancer. Although generally well-tolerated, they have some adverse effects. Because of AIs are used long term in adjuvant treatment, side effects are also very important. Preclinical and a little clinic data indicate that estrogens exert neurotrophic and neuroprotective actions in the brain. So estrogen appears to play an important role in cognitive function and memory. We know that AIs reduce circulating estrogen to very low levels. For this reason, there has been concern that these agents may have a negative effect on cognitive functions. However, this situation is still unclear. The purpose of our study is to evaluate the relationship between duration of treatment and cognitive functions in patients with breast cancer who use AIs in adjuvant therapy. Methods:Patients diagnosed with breast cancer who use AIs as adjuvant treatment and followed up at the Akdeniz University Medical Oncology Clinic were included. The patients were surveyed for demographic characteristics. Montreal Cognitive Assessment (MoCA) and Standardized Mini-Mental State Examination (SMMT) tests were applied to patients by the same investigator to evaluate their cognitive functions. The total scores of the tests and the orientation, naming, short-time memory, visuospatial functions-executive functions, attention, abstract thinking, language which are the MoCA subscales were evaluated separately. In the Turkish population, the normal range of the MoCA and SMMT tests are 21-30 points and 24-30 points, respectively. Patients were grouped as 0-6, 6-12, 12-24, 24-36, 36 and more months according to the duration of AIs using time. 200 patient’s data were analyzed with SPSS package program. This study was approved by the Akdeniz University Faculty of Medicine Clinical Research Ethnics Committee and was conducted in accordance with declaration of Helsinki. Results:The median follow-up time was 55.5 months. The median duration of AIs treatment was 36.5 months. The mean age of patients was 61.3 years-old. There was no relationship between duration of treatment and MoCA and SMMT scores which indicates cognitive functions (p>0.05). In addition, no statistically relationship was found in the evaluation of MoCA subscales (p>0.05). As expected, the total MoCA and SMMT scores were affected by factors such as age, education level, and employment status. Interestingly, although it was not our main purpose, a causal relationship between the presence of hypertension and cognitive decline was shown in our study (p: 0.004). A statistically strong correlation was found between the MoCA and SMMT scores. So, our data are reliable. The duration of treatment with AIs and MoCA and SMMT scores of the patients were given in Table 1. Conclusions:As a result, despite conflicting results in the literature, we showed with 200 patients that adjuvant treatment with AIs does not affect cognitive functions in post-menopausal hormone receptor-positive breast cancer patients. Table 1: Relationship between the duration of treatment with AIs and MoCA and SMMT scoresDuration of AInMoCA*Mean±SDMoCAMed (min-max)SMMT**Mean±SDSMMTMed (min-max)0-6 m2319,7±5,221 (10-26)25±425 (15-30)6-12 m2420,7±5,421,5 (8-28)24,7±3,624 (16-30)12-24 m1418,2±4,118,5 (13-27)24,3±425 (13-29)24-36 m2920,3±4,920 (11-29)24,1±3,225 (17-30)36 m and more11020,3±4,521 (8-29)25±3,225 (14-30)Total20020.1±4,721 (8-29)24,8±3,425 (13-30)AI: Aromatase inhibitors, m: Mounths, n: Number, MoCA: Montreal Cognitive Assessment, SMMT: Standardized Mini-Mental State Examination, SD: Standart Deviation, Med: Median*p: 0.550 **p:0.533 Citation Format: Rukiye Guler Ilhan, Yusuf Ilhan, Sema Sezgin Goksu, Ali Murat Tatli, Hasan Senol Coskun. The effect of using adjuvant aromatase inhibitors on cognitive functions in postmenopausal women with hormone receptor-positive breast cancer [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS9-71.

ObjectiveCisplatin-paclitaxel and bevacizumab is a frequently used treatment regimen for metastatic or recurrent cervical cancer, and carboplatin-paclitaxel and bevacizumab are also among the recommended regimens. In this study we aimed to evaluate the efficacy of these two regimens for the treatment of metastatic or recurrent cervical cancer.MethodsPatients with metastatic or recurrent cervical cancer treated with cisplatin-paclitaxel and bevacizumab or carboplatin-paclitaxel and bevacizumab were retrospectively evaluated in this study. The clinical and demographic characteristics of patients in each group were evaluated. Median overall survival, progression-free survival, and response rates between the two groups were compared.ResultsA total of 250 patients were included. Overall, the numbers of patients with recurrent disease and metastatic disease were 159 and 91, respectively. The most common histologic subtype was squamous cell carcinoma (83.2%). The median duration of follow-up was 13.6 (range 0.5–86) months. The median progression-free survival was 10.5 (95% CI 9.0 to 11.8) months in the cisplatin-paclitaxel and bevacizumab group (group 1), and 10.8 (95% CI 8.6 to 13.0) months in the carboplatin-paclitaxel and bevacizumab group (group 2) (HR 1.20; 95% CI 0.88 to 1.63; p=0.25). The median overall survival was 19.1 (95% CI 13.0 to 25.1) months in group 1 and 18.3 (95% CI 15.3 to 21.3) months in group 2 (HR 1.28; 95% CI 0.91 to 1.80; p=0.15).ConclusionsThere is no survival difference between cisplatin or carboplatin combined with paclitaxel and bevacizumab in metastatic or recurrent cervical cancer.

The cost-effectiveness of bevacizumab has been the subject of debate, and we aimed to present our own retrospective data on its effect on survival in recurrent epithelial ovarian cancer.Patients with recurrent ovarian, tubal and primary peritoneal cancer between October 2007 and June 2018 were grouped according to the platinum-free interval. The progression-free and overall survivals of the patients who had received chemotherapy only and chemotherapy with bevacizumab were calculated.Eighty patients had received chemotherapy (CT) only, and 65 had received CT+BV. In platinum-sensitive recurrent epithelial ovarian cancer (PSREOC) patients, the median progression-free survival (PFS) months was 7 months (95% CI; 5.5-8.4) in the group who had received CT only and 13 months (95% CI; 5.8-20.1) in the group who had received CT+BV (p=0.001) and for CT+BV HR (Hazard Ratio):0.39 (95% CI; 0.24-0.64) (p=0.001). The median PFS of platinum-resistant recurrent epithelial ovarian cancer (PRREOC) patients who had received CT only was determined as 2 (95% CI; 1.4-2.5) and as 10 (95% CI; 6.8-13.1) months for patients who had received CT+BV (p=0.001), for patients who had received CT+BV HR: 0.31 (95% CI; 0.17-0.58) (p=0.001). In both PSREOC and PRREOC patients, there was no difference between CT + BV and CT group in terms of overall survival (p=0.978 and p=0.738, respectively).A significant effect of bevacizumab on the progression-free survival of both platinum-sensitive and platinum resistant recurrent ovarian cancers has been demonstrated; however, this effect failed to impact overall survival. Therefore, it could be recommended to use bevacizumab, considering the cost-effectiveness in undeveloped and developing countries.

Venous thromboembolism which consists of pulmonary embolism and deep venous thrombosis is one of the most important problems in cancer patients. The mechanisms of cancer-associated thrombosis are multi-factorial and still unclear. Nutrition is an important factor in the treatment and prognosis of cancer. Assessment of the nutritional status of cancer patients is multifactorial and it should be performed at each visit. We aimed to assess the relationship between nutritional status and thrombosis risk in various cancer types. It was a cross-sectional and single-center study and 582 cancer patients were included. Patients nutritional status was evaluated with their height, weight, BMI, triceps skinfold thickness, waist circumference, and upper arm circumference. It was found that there was a statistically significant relationship between the thrombosis risk and nutritional parameters such as weight, BMI, and waist circumference which are important anthropometric measurements. As a result, thrombosis is an important cause of morbidity and mortality in cancer patients. Obesity and cachexia are both important conditions in cancer patients and should be well evaluated. It has been shown that increased weight, BMI, and waist circumference indicating obesity are important risk factors for thrombosis risk in cancer patients.

Purpose Febrile neutropenia resulting from chemotherapy is a significant cause of morbidity and mortality in cancer patients. We had previously published the associates of the risk of febrile neutropenia, and this study now extends and modifies the previous model as well as tests its external validity. Methods We have recruited documented febrile neutropenia cases with solid tumors, in addition to a selected control group of cancer patients from one institution treated between 2015 and 2019. We then united our sample with our previously published original derivation group, to modify and update our previous model by logistic regression analysis. Additionally, consecutive cancer patients from 5 institutions were recruited in 2020 to test external validity of the resultant algorithm. Results A total of 4075 cycles of chemotherapy in 1282 cases were recruited in the updated, new model derivation group, and a total of 8 variables were selected for the updated algorithm. In the new external validation group, 653 cycles of chemotherapy in 624 patients were analyzed, to indicate that after cycles without prophylactic granulocyte colony-stimulating factor (GCSF) usage, the algorithm yielded a sensitivity value of 91%, specificity of 40%, and an area under curve (AUC) figure of 0.78, when a risk cutoff threshold value of ≥ 0.20 is chosen. This algorithm is now embedded in a web application for free clinical use. Conclusion Our algorithm identifies and quantifies the risk of febrile neutropenia in cancer patients. Further studies are required to improve this model with additional predictors.

Objective: There are many factors that affect prognosis in colorectal cancers. Recent studies have shown the effect of tumor location on the prognosis. The purpose of our study is to evaluate the relationship between tumor location and the overall survival and recurrence rate in patients with stage 3 colon cancer.Material and Methods: Patients diagnosed with stage 3 colorectal cancer and followed up at the Akdeniz University Medical Faculty were included in the study. 231 patients' information was accessed retrospectively using the hospital database. Patients were grouped into right and left colon cancers similar to those in the literature according to tumor location, and all data were analyzed.Results: 171 74% patients had left colon cancer whereas right colon cancer was present in 60 26% . There was no significant relationship between the tumor location and recurrence rates of the patients p=0.82 . The mean overall survival for left colon cancers was 97.5±6.6 95% CI, 84.6110.5 months; for right colon cancers it was 74.3±5.7 95% CI, 63.0-85.5 months. Although the mean duration of overall survival was higher in left colon cancers, there was no statistically significant difference between the groups p=0.38 Conclusion: We think that there may be a relationship between tumor location and prognosis in colon cancer. In our study, the prognosis was worse in right colon cancer but no statistically significant difference was found between the groups. The relationship between tumor location and survival in stage 3 disease could not be shown clearly. Future studies on this subject may be useful in clinical practice, Amaç: Kolorektal kanserlerde prognozu etkileyen birçok faktör vardır. Son yıllarda tümör yerleşim yerinin de prognoz üzerine etkisini gösteren çalışmalar mevcuttur. Çalışmamızın amacı; Evre 3 kolon kanser tanılı hastalarda genel sağ kalım ve nüks oranının, tümör lokalizasyonu ile ilişkisini değerlendirmektir.Gereç ve Yöntemler: Çalışmaya evre 3 kolorektal kanser tanılı, Akdeniz Üniversitesi Tıp Fakültesi’nde takip edilen hastalar dahil edildi. 231 hastanın bilgilerine retrospektif olarak hastane veritabanı kullanılarak ulaşıldı. Hastalar tümör lokalizasyonuna göre, literatürdeki çalışmalara benzer olarak sağ ve sol kolon kanseri olarak gruplandırıldı ve verileri analiz edildi.Bulgular: Hastaların 171’in de %74 sol kolon tümörü; 60’ın da %26 sağ kolon tümörü tespit edildi. Hastaların tümör yerleşim yeri ile nüks oranları arasında anlamlı bir fark saptanmadı p=0,82 . Sol kolon kanserleri için ortalama GSK 97,5±6,6 %95 CI, 84,6-110,5 ay, sağ kolon kanserleri için 74,3±5,7 %95 CI, 63,0-85,5 ay olarak saptandı. Sol kolon kanserlerinde ortalama GSK süresi daha yüksek olmakla birlikte gruplar arası istatistiksel anlamlı bir fark saptanmadı p=0,38 . Sonuç: Kolon kanserinde tümör lokalizasyonu ile prognoz arasında ilişki olabileceği düşünülmektedir. Bizim çalışmamızda evre 3 hastalıkta sağ kolon kanserlerinin prognozu daha kötü görülmekle birlikte gruplar arasında istatistiksel anlamlılık gösterilemedi. Bu konuda ileride yapılacak çalışmaların klinik uygulamada yararlı olabileceği görüşündeyiz