23 research outputs found

    Multiple Primary Malignancies - A Retrospective Analysis at a Single Center in Turkey

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    Background: A literature review on 1,104,269 cancer patients concluded that the prevalence of multiple primary malignancies (MPM) is between 0.73% and 11.7%. MPMs seem to have higher incidence than that influenced by hazard only. The purpose of this study was to investigate clinically useful information for effective screening for synchronous and metachronous second primary cancers and to identify a potential surveillance protocol. Materials and Methods: Using statistical and epidemiological indicators we evaluated the patients with MPMs (double locations) admitted to Dr. Abdurrahman Yurtarslan Ankara Oncology Education and Research Hospital between 1981 and 2010. Results: Out of the 130 cases, 24 (18.4%) were synchronous while 106 cases (81.6%) were metachronous tumours. Mean interval time from first to second primary cancers was 4.65 years (0-27 years). The most frequent malignant associations were breast-breast, breast-endometrium and breast-ovary. Both primary and secondary tumors tended to be in an advanced stage explained by the low compliance of the patients to follow-up. Conclusions: The possibility that MPMs exist must always be considered during pretreatment evaluation. Screening procedures are especially useful for the early detection of associated tumors, whereas careful monitoring of patients treated for primary cancer and a good communication between patients and medical care teams should ensure early detection of secondary tumors, and subsequent appropriate management

    Prognostic factors for teenage and adult patients with high-grade osteosarcoma: an analysis of 240 patients

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    The aim of this retrospective, multicenter study was to evaluate clinicopathological characteristics, prognostic factors and treatment outcomes of teenage and adult patients with high-grade osteosarcoma. A total of 240 osteosarcoma patients who were diagnosed and treated from March 1995 to September 2011 were analyzed. Median age was 20 years (range 13-74 years), and 153 patients (63.8 %) were male. Primary tumor localization was extremity in 204 patients (85.4 %), trunk in 21 patients (8.8 %) and head and neck region in 14 patients (5.9 %). According to American Joint Committee on Cancer staging system, 186 patients (77.5 %) were stage II, 3 (1.3 %) were stage III and 48 (20.0 %) were stage IV. Median overall survival (OS) was 55 months (95 % CI 36.8-73.1 months). OS after 2, 5 and 10 years were 67, 49 and 42 %, respectively. Univariable analysis for OS showed that male gender (p = 0.032), high baseline lactate dehydrogenase (LDH) level (p < 0.001), high baseline serum alkaline phosphatase level (p = 0.002), telangiectatic subtype (p = 0.023), presence of metastasis at diagnosis (p < 0.001), presence of tumor positive margins after primary surgery (p = 0.015), poor pathological response to preoperative chemotherapy (p = 0.006) and presence of recurrent disease during follow-up period (p < 0.001) were significantly associated with poor survival. Patientswho received postoperative methotrexate plus doxorubicin plus cisplatin (M + A + P) combination regimen (p = 0.019), underwent surgery for recurrent disease (p < 0.001) and received chemotherapy for recurrent disease (p < 0.001) had longer OS. Inmultivariable analysis for OS, only high LDH level (p = 0.002) and the presence of metastasis at diagnosis (p = 0.011) were associated with poor OS, whereas the patients who received chemotherapy for recurrent disease had a longer OS (p = 0.009)

    Primary adult soft tissue sarcomas: analysis of 294 patients

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    We retrospectively analyzed 294 patients with primary soft tissue sarcoma followed between 1996 and 2002 in Ankara Oncology Hospital. There were 170 male and 124 female patients with the age range of 16-80 years. The primary tumor was in the extremity in 72.9% of the patients. We determined lung metastasis in 102 (85%) out of the 120 patients as distant metastasis. The most common adult sarcomas were liposarcoma (16.3%), malignant mesenchymal tumor (MMT) (13.9%), malignant fibrous histiocytoma (MFH) (11.2%), rhabdomyosarcoma (10.2%) and synovial sarcoma (10.2%). Seventeen patients (5.3%) had grade 1 tumor, 143 patients (52.2%) had grade 2 tumor, and 112 patients (41.4%) had grade 3 tumor. In 45 patients (15.3%), the grade of the tumors is unknown. The tumor size was 0 to 10 cm in 108 cases (38.7%). In 15 cases (5.1%), tumor size was unknown. Ninety-five patients (32.4%) were treated with adjuvant chemotherapy, and 125 patients (42.7%)) were treated with palliative chemotherapy. Prognostic factors influencing the overall survival were tumor size, grade, adjuvant radiotherapy and chemotherapy. Adjuvant radiotherapy had influence on disease-free survival. While tumor grade and size showed a significant value for predicting local recurrence, grade, localization of tumor, adjuvant chemotherapy and radiotherapy had an impact on metastasis development. The 1-year overall survival for all patients was 73.4%, 3-year overall survival was 51.8%, and 5-year overall survival was 45.1%

    Results of univariate and multivariate Cox's proportional hazard models regarding OS.

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    <p><i>OS</i> overall survival, <i>HR</i> hazard ratio, <i>CI</i> confidence interval, <i>LPI</i> laboratory prognostic index, <i>ECOG</i> Eastern Cooperative Oncology Group, <i>PS</i> performance status, <i>WBC</i> White Blood Cell count, <i>LDH Lactate dehydrogenase, ALP</i> Alkaline phosphatase.</p><p>Results of univariate and multivariate Cox's proportional hazard models regarding OS.</p

    Retrospective evaluation of premenopausal hormone-sensitive breast cancer patients treated with adjuvant gonadotropin-releasing hormone analogue: Anatolian Society of Medical Oncology (ASMO) study

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    AimThe goal of this study is to evaluate possible factors affecting the survival of patients treated with gonadotropin-releasing hormone (GnRH) analogues. MethodsDemographic characteristics, treatment modalities, overall survival (OS) and the possible factors affecting the survival a total of 554 premenopausal breast cancer patients in Turkey evaluated retrospectively. ResultsThe median duration of GnRH analogues use was 2213.6 (range, 1-87) months. Patients were divided into three groups according to the duration of GNRH analogues use; 4-12 months (Group A), 13-24 months (Group B) and 25 months (Group C). Overall, 530 patients were analyzed; 23.2%, 45.8%, 30.9% of the patients were in Group A, B and C, respectively. The median follow-up duration was 34 +/- 30.3 (range, 4-188) months. The OS in patients 35 years of age was found to be significantly longer than that of patients &gt;35 years of age in Group B (log rank, P = 0.023). The disease-free survival of the patients in Group A was significantly shorter than that of patients in Group C (log rank, P = 0.003). The OS of Group A patients was significantly shorter in comparison to that of Group B and Group C patients (log rank, P = 0.000) and the OS of Group B patients was significantly shorter than Group C (log rank, P = 0,000). ConclusionThere is currently no definite data on the optimal duration of GnRH analogues use. One of the important results of this study that will provide an insight to the future studies is the improvement gained in OS by the increase in the duration of GnRH analogues use

    Optimal timing of adjuvant treatment in patients with early breast cancer

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    It is well established that adjuvant treatment reduces mortality after early breast cancer. However, the optimal timing of adjuvant treatment is not well described. To determine the optimal timing of adjuvant treatment, 402 breast cancer patients who received adjuvant treatment at Ankara Oncology Research and Training Hospital between January 1995 and August 2002 were evaluated retrospectively. Three hundred and fifty-seven (88.8%) patients received adjuvant chemotherapy, 204 (50.7%) of these patients received only adjuvant chemotherapy and 153 (38%) patients received tamoxifen following chemotherapy. Remaining 45 (11.2%) patients received only adjuvant tamoxifen. The median time to start adjuvant treatment after surgery was day 21 (range, days 4 to days 258), and the median follow-up was 50 months (range, 6-105 months). The patients were divided into 5 groups according to starting time of chemotherapy (shorter than 14 days, between days 15-29, between days 30-44, between days 45.-59 and more than 59 days). Overall survival (OS) and disease-free survival (DFS) were not shown significantly different between for 5 groups (P > 0.05). Secondly, patients were divided into two groups as starting adjuvant treatment equal to or shorter than 44 days and longer than 44 days (n = 344, 85.6% and vs. n = 58, 14.4%, respectively). OS was significantly better in patients who started to receive adjuvant treatment within 44 days after surgery compared to patients who received adjuvant treatment after 44 days (92 vs. 83.3%, P = 0.03) for 5 years, but DFS was not significantly different between two groups (83.4 vs. 82.2%, P > 0.05). According to our study, adjuvant treatment of breast cancer should be initiated earlier after surgery

    Overall Survival according to patient characteristics and LPI.

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    <p><i>LPI</i> laboratory prognostic index, <i>ECOG</i> Eastern Cooperative Oncology Group, <i>PS</i> performance status.</p><p>Overall Survival according to patient characteristics and LPI.</p

    Baseline Characteristics, Overall Survival and Progression-Free Survival of Patients.

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    <p><i>ECOG</i> Eastern Cooperative Oncology Group, <i>PS</i> performance status, <i>Nonsquamous histology</i> including adenocarcinoma, large cell, and unspecified NSCLC histology, <i>WBC</i> White Blood Cell count, <i>LDH</i> Lactate dehydrogenase, <i>ALP</i> Alkaline phosphatase.</p><p>Baseline Characteristics, Overall Survival and Progression-Free Survival of Patients.</p
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