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Öğe Acute Toxicities and Advers Events of Chemoradiotherapy in Young and Older Adults(Kare Publ, 2024) Erdis, Eda; Yilmaz, Mukaddes; Ucar, Mahmut; Yucel, BirsenOBJECTIVE To evaluate, according to age, the acute toxicity and adverse events, such as interruption or cessation of chemoradiotherapy (CRT) and weight loss, in cancer patients. METHODS A total of 813 patients, 67% aged <65 years and 33% aged >= 65 years, were analyzed retrospectively. Toxicities were graded according to the acute radiation morbidity measurement criteria of the Radiation Therapy Oncology Group. RESULTS For all patients, 5% of the younger and 12% of the elderly patients (p<0.001) ended CRT, 1% of the younger and 4% of the elderly patients died during treatment (p=0.007). There were differences between the groups treated for brain cancer in terms of performance status (p=0.010), cessation (p=0.001), interruption (p=0.026), and death during treatment (p=0.043). For head and neck cancer, the results showed differences in comorbidity (p<0.001), performance status (p=0.017), and death during CRT (p=0.021). In the thoracic area, differences were found in comorbidity (p=0.015), CRT interruption (p=0.014), grade 1-2 skin toxicity (p=0.025), pharynx/esophagus (p=0.002), upper gastrointestinal tract (p=0.036), and hematocrit (p=0.032). For the abdominal area, differences were observed in comorbidity (p<0.001) and grade 1-2 platelet toxicity (p=0.029). For the pelvis, differences were seen in comorbidity (p<0.001), performance status (p=0.045), and CRT interruption (p=0.032). CONCLUSION Cessation, interruption, and death during CRT were observed more frequently in elderly patients.Öğe Comparison of Clinicopathological Features and Survival Outcomes Associated with HER2-Zero and HER2-Low Breast Cancers: A retrospective, Observational Study(Akad Doktorlar Yayinevi, 2024) Ucar, Mahmut; Yilmaz, Mukaddes; Erdis, Eda; Yucel, BirsenDespite being classified as HER2-negative, HER2-zero and HER2-low subtypes are considered distinct entities due to their varying clinicopathological features and survival outcomes. This study was designed to evaluate the sociodemographic, clinical, survival and prognostic differences between HER2-zero and HER2-low patients who were evaluated as HER2 negative. This retrospective singlecenter study included patients with HER2-negative non-metastatic breast cancer between 2003 and 2022. Patients were analyzed in two groups as HER2-zero and HER2-low. Of 680 patients, 484 (71%) were included in the HER2-zero group and 196 (29%) in the HER2-low group. Statistically significant differences were found between the groups in terms of histopathologic subtyping (p< 0.001), ER (p< 0.001) and PR status (p= 0.005), and presence of lymphovascular invasion (p= 0.023). When survival results were analyzed according to HER2 status, overall survival and disease-free survival were not statistically different for all patients. This result was also supported in luminal A, luminal B and triple negative patients (p>0.050). HER-2 status was not observed as a factor affecting OS and DFS in univariant and multivariant analyses (p> 0.050). There were no clinically and pathologically significant differences between HER2-low and HER2-zero, except that HER2-low patients had more ER and PR positivity, more luminal subgroups and more lymphovascular invasion. When evaluated together with histopathologic subgroups, no survival difference was detected between both groups. HER2 status could not be determined as a prognostic factor.Öğe Comparison of Invasive Ductolobular Carcinoma and Lobular Carcinoma: An Observational Study(MDPI, 2025) Ucar, Mahmut; Yilmaz, Mukaddes; Erdis, Eda; Yucel, BirsenBackground and Objectives: Mixed ductolobular carcinomas (mDLCs) are tumors that contain both ductal and lobular components. The clinicopathological characteristics and impacts on survival of the two components, which have distinct biological behaviors, are still not clearly understood. This study aimed to compare the clinicopathological characteristics, recurrence/metastasis patterns, and survival outcomes of mDLC and invasive lobular carcinoma (ILC), as well as to investigate the prognostic significance of both histopathologies. Materials and Methods: The outcomes of 132 patients who were followed and treated between 2010 and 2021 were analyzed. Patients were examined in two groups, ILC and mDLC. Chi-square tests were performed to compare the baseline clinicopathological characteristics and treatments. Survival rates were subsequently analyzed using the Kaplan-Meier method and compared using the Cox proportional hazards model. Results: In this study, 80 (61%) patients had ILC histopathology, while 52 (39%) had mDLC histopathology. Differences between the groups were observed in median age (p = 0.038), N stage (p = 0.046), estrogen receptor (ER) status (p = 0.005), lymphovascular invasion (p = 0.007), median tumor diameter (p = 0.050), and frequency of distant metastasis (p = 0.029). The treatments, relapse patterns, and metastasis patterns were similar (p > 0.05). No differences in overall survival (OS) and disease-free survival (DFS) were observed. In the multivariate analysis, mDLC histopathology was identified as a poor prognostic factor (HR: 2.95, CI 95%: 1.10-7.88, p = 0.030). Histopathology (ILC vs. mDCL) was not identified as a prognostic factor in the Cox regression analysis for DFS. Conclusion: Although mDLC has poor clinicopathological features (younger age, more advanced N stage, more ER negativity, more lymphovascular invasion, and more frequency of metastases) and appears more aggressive than ILC, these changes do not affect survival in this study. However, mDLC histopathology seems to be associated with poor prognosis for OS.Öğe Effects of hormone receptor status on patient clinic and survival in HER2 positive breast cancer(Oxford Univ Press, 2024) Yilmaz, Mukaddes; Erdis, Eda; Ucar, Mahmut; Demir, Necla; Alandag, Celal; Yucel, BirsenBackground In the current study, the effect of hormone receptor (HR) status on clinical and survival in early-stage human epidermal growth factor receptor 2 (HER2)-positive breast cancer was investigated. Methods Two hundred ninety-one patients with HER2- positive were examined in two categories as HR-positive and HR-negative. Results Of these, 197 (68%) were HR-positive and 94 (32%) were HR-negative with a mean follow-up period of 68 +/- 2.7 months. The groups were found to be similar in terms of age, menopausal status, comorbidity, pathologic type, stage, T stage, N stage, lymphovascular invasion, presence and percentage of intraductal component, multicentricity/focality and extracapsular invasion. Family history (P = 0.038), stage 2 tumor rate (P < 0.001), and perineural invasion (P = 0.005) were significantly higher in the HR-positive group. In the HR-negative group, mean Ki-67 value (P = 0.014), stage 3 tumor rate (P < 0.001), tumor necrosis (P = 0.004) and strong (3+) HER2 staining on immunohistochemical staining (P = 0.003) were higher. The incidence of relapse and metastasis, and the localization of metastasis were similar in both patient groups. The rate of locoregional relapse during the first 2 years was higher in the HR-negative patients than in the HR-positive patients (P = 0.023). Overall survival (OS) and disease-free survival (DFS) did not differ between the groups in univariate analysis. However, HR status was determined as an independent prognostic factor (HR: 2.11, 95% CI: 1.17-3.79; P = 0.012) for OS was not found to be significant for DFS in multivariate analysis. Conclusion Both clinicopathologic features and OS outcomes of HR-negative patients were worse than those of HR-positive patients.Öğe EGFR-targeted treatments in patients with metastatic colorectal cancer: Experience of panitumumab.(AMER SOC CLINICAL ONCOLOGY, 2017) Gumus, Mahmut; Geredeli, Caglayan; Ucar, Mahmut; Kaya, Serap; Demir, Hacer; Unal, Olcun Umit; Degirmenci, Mustafa; Dogu, Gamze Gokoz; Turan, Nedim; Yildirim, Nilgun; Basal, Fatma Bugdayci; Arpaci, Erkan; Karaagac, Mustafa; Harputluoglu, Hakan; Turk, Had Mehmet; Dane, Faysal; Ozkan, Metin…Öğe Evaluation of quality of life in patients with gastric adenocarcinoma receiving chemoradiotherapy: a cross-sectional study(Springer, 2023) Yilmaz, Mukaddes; Erdis, Eda; Ucar, Mahmut; Yucel, BirsenPurposeThe aim of this study was to evaluate quality of life (QoL) in patients with gastric adenocarcinoma receiving adjuvant chemoradiotherapy (CRT).MethodsThe European Organization for Cancer Research and Treatment Quality of Life Questionnaire-Core 30 (QLQ-C30) and site-specific module for gastric cancer (QLQ-STO22) were administered at four time points to 156 patients admitted to Cumhuriyet University Oncology Center between 2011 and 2018.ResultsThe patient group comprised 76% men and 24% women with a median age of 61 years (range, 18-88). During CRT, 12 patients (8%) discontinued treatment, 25 (16%) lost weight, and 42 (27%) had reduced performance. There was significant worsening in QLQ-C30 global health status and all functional and symptom scale scores at CRT completion. These changes were also clinically significant except for physical functioning scores and were supported by minimal clinically important difference measurements. In the QLQ-STO22, all symptoms except dry mouth and hair loss were negatively affected at CRT completion. In general, scores were improved at 1 month after CRT and almost all scores reached baseline level by 6 months. Certain scores were more adversely affected in women (global health status, physical functioning, role functioning, fatigue, pain, and insomnia), those who lost weight during CRT (emotional functioning), and those with CRT interruption (emotional functioning and anxiety).ConclusionAlthough CRT reduces QoL in patients with gastric cancer, the effects tend to resolve within 6 months after completing treatment. Female sex, weight loss, and CRT interruption negatively affected some QoL scores.Öğe Exploring the Prognostic Role of Trop-2, CD47, and CD163 Expression Levels on Survival Outcomes in Patients with Triple-Negative Breast Cancer(MDPI, 2025) Yuceer, Ramazan Oguz; Aydin, Sedanur; Gelir, Iclal; Koc, Tulay; Tuncer, Ersin; Ucar, MahmutBackground: This study evaluated the prognostic impact of Trop-2, CD47, and CD163 expression on clinical outcomes in triple-negative breast cancer (TNBC) and investigated their interactions with tumor progression. Methods: A retrospective cohort of 92 patients with TNBC was analyzed. The expression scores for Trop-2, CD47, and CD163 were categorized as negative/low (0-3 points) or high (4-6 points). The primary endpoint was overall survival (OS). Results: The median age of the cohort was 50 years old. High Trop-2 expression was observed in 55.4% of the patients and was significantly associated with advanced disease stage (p < 0.001). High CD47 expression (44.6%) was correlated with advanced stage (p = 0.044), whereas high CD163 expression (45.7%) was associated with advanced stage (p = 0.021), absence of comorbidities (p = 0.022), and lower pT stage (p = 0.023). Moderate positive correlations were found between Trop-2 and CD47 (p = 0.022), Trop-2 and CD163 (p = 0.037), and CD47 and CD163 (p < 0.001), respectively. Kaplan-Meier survival analysis revealed that patients with low Trop-2 expression exhibited significantly prolonged OS (p = 0.021) and progression-free survival (PFS) (p = 0.026) compared to those with high Trop-2 expression. Univariate and multivariate analyses revealed significant associations between OS and PFS for Trop-2, lymphovascular invasion, and BRCA status. Conclusions: Trop-2 expression is a significant prognostic factor for TNBC and is correlated with worse outcomes. Although CD47 and CD163 showed trends for poorer prognosis, their significance was not confirmed. These findings offer promising prospects for future studies on combined antibody-drug conjugates (ADCs), as they may present opportunities to address multiple resistance mechanisms in the management of TNBC and enhance clinical outcomes.Öğe Prognostic Factors and Their Impact on Survival in Patients with De Novo Metastatic Breast Cancer(Akad Doktorlar Yayinevi, 2025) Erdis, Eda; Yilmaz, Mukaddes; Ucar, Mahmut; Yucel, Birsen; Karadayi, KursatThis study aimed to investigate the prognostic factors affecting overall survival (OS) in patients with de novo metastatic breast cancer (dnMBC). Additionally, the importance of local treatments on survival was evaluated. The data of 106 patients with dnMBC were analyzed. Primary breast surgery was performed in 15 patients (14%), while first-line systemic therapy constituted the initial treatment modality for 91 patients (86%). Local treatments were administered to 48 patients (45%), of which 63% underwent breast surgery alone and 37% underwent both breast surgery and radiotherapy. In univariate analysis, patient performance status, extent of metastasis, response of primary breast tumors and metastatic lesions to first-line systemic therapy, administration of local treatments, and the use of breast radiotherapy and surgery were identified as prognostic factors (p< 0.050). In multivariate analysis, being in the triple-negative subgroup (HR: 5.06, 95% CI: 2.46-10.43, p< 0.001), having polymetastatic disease (HR: 1.19, 95% CI: 1.15-3.17, p= 0.013), partial response of metastatic lesions to first-line systemic therapy (HR: 2.25, 95% CI: 1.84-4.29, p= 0.014), and non-response to first-line systemic therapy (HR: 2.67, 95% CI: 1.56-4.59, p< 0.001) were identified as independent poor prognostic factors. The median OS was 34 months, with 2-year OS at 58% and 5-year OS at 19%. The most significant prognostic factors for dnMBC in this study were molecular subtyping, extent of metastasis, and response of metastatic lesions to first-line systemic therapy. Although local treatments targeting the breast influenced prognosis, their impact was not as strong as the aforementioned variables.Öğe Prognostic Importance of Panimmune-Inflammation Value and PILE Scores in Non-Metastatic Luminal A Breast Cancer(Karger, 2025) Yilmaz, Mukaddes; Erdis, Eda; Ucar, Mahmut; Yucel, BirsenIntroduction: The present study evaluated the prognostic significance of panimmune-inflammation value (PIV) and PILE (a composite score of PIV, lactate dehydrogenase [LDH], and Eastern Cooperative Oncology Group Performance Status [ECOG PS]) in patients with non-metastatic luminal A breast cancer. Methods: Non-metastatic stage (I-III) luminal A breast cancer patients who were admitted to Cumhuriyet University Oncology Center were retrospectively examined. The PIV score was calculated using the neutrophil, platelet, monocyte, and lymphocyte counts at the time of diagnosis. The PIV, LDH, and ECOG PS parameters were used for the PILE score. Results: A total of 293 patients were included. The median PIV was 254.89; 239 (82%) patients had low PILE score; and 54 (18%) patients had high PILE score. Patients with low PIV and low PILE scores had significantly better OS and disease-free survival (DFS) (PIV; p = 0.033 for OS and p = 0.024 for DFS and PILE; p = 0.001 for OS and p = 0.005 for DFS). The PIV and PILE scores were found to be significant prognostic factors associated with OS and DFS. The PIV score was found to be an independent prognostic factor for OS and DFS (OS: score 0 vs. 1; HR: 1.89, 95% CI: 1.06-3.35; p = 0.029; and DFS: score 0 vs. 1; HR: 1.75, 95% CI: 1.01-3.01; p = 0.044). The PILE score was not an independent prognostic factor associated with OS or DFS. Conclusion: Survival was better in those with lower PIV and PILE scores. The PIV score was an independent prognostic factor for survival in these patients.
