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    Classic Kaposi's sarcoma: A review of 156 cases
    (Elsevier Taiwan, 2018) Cetin, Bulent; Aktas, Bilge; Bal, Oznur; Algin, Efnan; Akman, Tulay; Koral, Lokman; Kaplan, Mehmet Ali
    Background: Kaposi's sarcoma (KS) is a reactive, multifocal, multicentric, angiogenic neoplastic proliferation that is thought to originate from endothelial cells that are infected with human herpesvirus-8 (HHV-8). This report examines a cohort of patients with classic Kaposi's sarcoma (KS) evaluated at the national institute of oncology over the 13-year period. Methods: A retrospective analysis of 156 patients with classic KS, between January 2000 and November 2013, was performed. This study focused on the clinical presentation, staging, diagnosis, and treatment of classic KS. Results: One hundred fifty-six patients (median age 69 and 115 male) were enrolled into the study. Median age at diagnosis was 69 (range: 32e95 years). Male/female ratio was 2.80. The most common location was the lower limbs. There were 75 stage I patients (48.1%), 8 stage II patients (22.4%), 31 stage III patients (19.9%) and 15 stage IV patients (9.6%). Surgery was the most common local treatment method (43%). 44 patients (28.2%) received radiotherapy (RT) at diagnosis. Cytotoxic treatment with chemotherapy or interferon-a was administered in 57 patients. Visceral involvement was observed in 10 patients (lung: nine patients, liver: one patient) and bone metastasis occurred in two patients at relapse. Conclusion: This study is one of the largest reported series. Further studies are required and it will be important to standardize the assessment of disease activity and clinical response. Copyright (C) 2018, Taiwanese Dermatological Association. Published by Elsevier Taiwan LLC.
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    Comparison of granisetron and palonosetron in triplet anti-emetic prophylaxis in non-small cell lung cancer patients receiving cisplatin-based highly emetogenic chemotherapy
    (Sage Publications Ltd, 2024) Araz, Murat; Beypinar, Ismail; Inci, Fatih; Koral, Lokman; Kocak, Mehmet Zahid; Korkmaz, Mustafa; Demirkiran, Aykut
    Introduction We compared the efficacy of first-generation granisetron and second-generation palonosetron in triplet anti-emetic prophylaxis in patients with non-small cell lung cancer (NSCLC) receiving cisplatin-based high emetogenic chemotherapy (HEC).Methods This prospective, multicenter, non-randomized, observational study was conducted between June 2018 and December 2021. Patients diagnosed with NSCLC who received triplet anti-emetic prophylactic treatment with aprepitant and dexamethasone plus granisetron or palonosetron before the first cycle of chemotherapy were included in the study. At the end of the first week after chemotherapy, the emesis scale was applied to the patients during the outpatient control. The primary endpoint was complete response (CR) and total control (TC).Results One hundred twenty-one patients were included in the study. Sixty-one patients were in the granisetron group and 60 patients were in the palonosetron group. CR was higher with granisetron in the acute phase (70.5% vs. 58.3%, p = 0.16; respectively) and higher with palonosetron in the delayed phase (61.7% vs. 55.7%, p = 0.5; respectively), although not statistically significant. The TC rates were also not significantly different between the groups (54.1% vs.57.6%, p = 0.69).Conclusions There was no significant difference between granisetron and palonosetron in both acute and delayed control of emesis in NSCLC patients receiving cisplatin-based HEC.
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    Comparison of palonosetron and granisetron in triplet antiemetic therapy in nonmetastatic breast cancer patients receiving high emetogenic chemotherapy: a multicenter, prospective, and observational study
    (Springer, 2019) Araz, Murat; Karaagac, Mustafa; Korkmaz, Levent; Koral, Lokman; Inci, Fatih; Beypinar, Ismail; Uysal, Mukremin
    PurposeWe aimed to investigate the efficacy of 0.25mg dose of palonosetron and granisetron in triplet antiemetic prophylaxis in breast cancer patients receiving HEC.MethodsPatients with nonmetastatic breast cancer who received HEC [doxorubicin or epirubicin plus cyclophosphamide (AC/EC)] were enrolled in the study. The prophylactic triplet antiemetic regimens were used according to the doctor's preference during the first cycle of HEC as intravenous dexamethasone and palonosetron 0.25mg or granisetron 3mg on day 1 as well as oral aprepitant (125mg on day 1 and 80mg on days 2 and 3).The primary endpoint was complete response rate (CR) on acute and delayed chemotherapy-induced nausea and vomiting (CINV), separately.ResultsA total of 118 female patients were included in the study. Patients received AC (83%), EC (3%), and dose-dense AC (14%) as adjuvant (88%) or neoadjuvant (12%). The majority of patients received palonosetron (59%) containing antiemetic treatment. The CR rate on acute and delayed vomiting was very high and not statistically different in both of the arms (acute 87% vs. 96%, p=0.089; delayed 90% vs. 92%, p=0.489), respectively. Nevertheless, the CR rate on either acute or delayed nausea was lower than vomiting (acute 51% vs. 51%; delayed 38% vs. 29%, p=0.203; respectively).ConclusionsThis is the second study that compared a 0.25mg dose of palonosetron with first-generation setron in triplet antiemetic prophylaxis in cancer patients receiving HEC. We could not find meaningful statistical differences between two arms, regarding CR rate on acute and delayed CINV.
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    Decrease in estimated glomerular filtration rates in non-small cell lung cancer patients treated with crizotinib
    (NLM (Medline), 2023) İriagaç, Yakup; Çavdar, Eyyüp; Karaboyun, Kubilay; Tacar, Seher Yıldız; Akkoç Mustafayev, Fatma Nihan; Çelik, Emir; Koral, Lokman
    Introduction: Crizotinib is a tyrosine kinase inhibitor used in patients with non‑small cell lung cancer, and there are uncertainties about its effect on kidney function. In this study, it was aimed to document the possible adverse effect of the drug on kidney functions. Materials and Methods: The estimated glomerular filtration rates (eGFRs) of the patients were calculated by creatinine‑based Chronic Kidney Disease Epidemiology Collaboration and compared by months using the paired samples t‑test. Kaplan–Meier survival method was used for progression‑free survival and overall survival (OS) analysis. Results: Twenty‑six patients who received crizotinib were included in the study, and the median progression‑free survival time with crizotinib was 14.2 months and the median OS time was 27.4 months. There was a significant reduction of eGFR after the 1st month of crizotinib treatment when compared to the rate before treatment initiation (P < 0.001). The eGFR values at the end of the 1st month and the 2nd month of treatment and the 2nd and 3rd months of treatment were statistically similar (P = 0.086, P = 0.663; respectively). This decrease in eGFR values was reversible, and there was no difference detected between pretreatment and posttreatment discontinuation (P = 0.100). Conclusion: A reversible decrease in renal functions was detected in patients using crizotinib. When the literature data are examined, it is thought that the reason for this decrease may be related to the increase in renal inflammation or a pseudo decrease due to the decrease in creatinine excretion. When evaluating renal functions in these patients, using noncreatine‑based (iothalamate, etc.) calculations can give more accurate results.
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    Efficacy and safety profile of COVID-19 vaccine in cancer patients: a prospective, multicenter cohort study
    (Future Medicine Ltd, 2022) Yasin, Ayse Irem; Aydin, Sabin Goktas; Sumbul, Bilge; Koral, Lokman; Simsek, Melih; Geredeli, Caglayan; Ozturk, Akin
    Aim: To compare the seropositivity rate of cancer patients with non-cancer controls after inactive SARS-CoV-2 vaccination (CoronaVac) and evaluate the factors affecting seropositivity. Method: Spike IgG antibodies against SARS-CoV-2 were measured in blood samples of 776 cancer patients and 715 non-cancer volunteers. An IgG level >= 50 AU/ml is accepted as seropositive. Results: The seropositivity rate was 85.2% in the patient group and 97.5% in the control group. The seropositivity rate and antibody levels were significantly lower in the patient group (p < 0.001). Age and chemotherapy were associated with lower seropositivity in cancer patients (p < 0.001). Conclusion: This study highlighted the efficacy and safety of the inactivated vaccine in cancer patients. Clinical Trials Registration: ClinicalTrials.gov) Plain language summary Cancer patients are at high risk for infection with SARS-CoV-2 and of developing the associated disease, COVID-19, which therefore puts them in the priority group for vaccination. This study evaluated the efficacy and safety of CoronaVac, an inactivated virus vaccine, in cancer patients. The immune response rate, defined as seropositivity, was 85.2% in the cancer patient group and 97.5% in the control group. The levels of antibodies, which are blood markers of immune response to the vaccine, were also significantly lower in the patient group, especially in those older than 60 years and receiving chemotherapy. These results highlight the importance of determining the effective vaccine type and dose in cancer patients to protect them from COVID-19 without disrupting their cancer treatment.
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    Investigating the Correlation Between Long-Term Response in Patients with Metastatic HER2+Breast Cancer and the Activity of Regulatory T Cells: A Retrospective Study
    (Dove Medical Press Ltd, 2024) Degirmenci, Mustafa; Diniz, Gulden; Kahraman, Dudu Solakoglu; Sahbazlar, Mustafa; Koral, Lokman; Varol, Umut; Uslu, Ruchan
    Background: Trastuzumab is commonly utilized in the management of metastatic HER2-positive breast cancer. Our main goal was to examine the clinical outcomes and immune markers of patients who received trastuzumab and chemotherapy treatment. Methods: Between 1995 and 2012, a total of 98 patients diagnosed with metastatic HER2-positive breast cancer were retrospectively analyzed at Ege University Hospital and Tepecik Training and Research Hospital. The clinicopathological characteristics and clinical outcomes of the patients were assessed, and the associations between response rates, survival and the immune profiles of tumor infiltrating lymphocytes were statistically evaluated. Results: The average age of patients at the time of diagnosis was 50.1 +/- 10.3 (ranging from 30 to 79) years. The mean follow-up period for all patients was 97.9 +/- 53.8 months. Among the patients, complete response was observed in 24.5%, partial response in 61.2%, and stable disease in 8.2% of cases. The average progression-free survival was 50.3 +/- 26.9 months (ranging from 1 to 163 months), and the average overall survival was 88.8 +/- 59.4 months (ranging from 12 to 272 months). After analyzing all cases, it was found that patients who were younger (p=0.006), exhibited higher CD3-positivity (p=0.041), presented with higher FOXP3-positivity (p=0.025), showed complete or at least partial response to treatment (p=0.008), and experienced a long-term response to trastuzumab (and chemotherapy) treatment had longer survival (p=0.001). Conclusion: Patients with HER2-positive breast cancer, who initially respond positively to palliative trastuzumab and chemotherapy treatment, can achieve long-term tumor remission lasting for several years.
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    KNOWLEDGE, ATTITUDE AND BEHAVIOR OF CHEMOTHERAPY PATIENTS ABOUT INTERVENTIONS FOR FERTILITY PRESERVATION: A DESCRIPTIVE SAMPLE STUDY FROM CANAKKALE
    (Nobel Ilac, 2019) Buyuk, Basak; Oymak, Sibel; Koral, Lokman; Ozerdogan, Ozgur
    Objective: Neoplasm treatments include chemotherapy and radiotherapy methods alternatively in relation to the type of neoplasms. These methods have many side effects for different tissues and organs. One of these side effects is infertility. Infertility is associated with toxic effects of chemotherapeutics to the germ cells. The aim of this study was to investigate the knowledge, attitude and behavior related to fertility preservation among patients who received chemotherapy. Material and Method: This descriptive type epidemiologic research was completed at a University Research Hospital Oncology Clinic after obtaining written permissions from the chief doctor of the hospital and the oncology clinic and ethical board. The study included patients aged 18 and older with neoplasms attending a University Research Hospital Oncology Clinic from November 2016 to April 2017. The data obtained were analyzed with the SPSS 20.0 statistical program. Results: Of 167 people in the study group, 48.5% were female. In our study, 79.1% of patients stated that doctors did not provide information before beginning neoplasm treatment. In our study reproductive technics assisted intervention consultations were requested by 35.3% who reported they were concerned about experiencing reproductive problems after neoplasm diagnosis, 11.4% who were not concerned and 30.0% who didn't remember their emotions about this topic (p<0.05). Conclusion: It is necessary to create awareness among patients of who, where and when to apply about preserving reproduction and to ensure doctors direct these patients to the correct center. With this aim, it may be useful to train oncologists by embryologists about reproductive technics assisted interventions.
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    Knowledge, attitude and behavior of chemotherapy patients about interventions for fertility preservation: A descriptive sample study from Çanakkale
    (Nobelmedicus, 2019) Büyük, Başak; Oymak, Sibel; Koral, Lokman; Özerdoğan, Özgür
    Objective: Neoplasm treatments include chemotherapy and radiotherapy methods alternatively in relation to the type of neoplasms. These methods have many side effects for different tissues and organs. One of these side effects is infertility. Infertility is associated with toxic effects of chemotherapeutics to the germ cells. The aim of this study was to investigate the knowledge, attitude and behavior related to fertility preservation among patients who received chemotherapy. Material and Method: This descriptive type epidemiologic research was completed at a University Research Hospital Oncology Clinic after obtaining written permissions from the chief doctor of the hospital and the oncology clinic and ethical board. The study included patients aged 18 and older with neoplasms attending a University Research Hospital Oncology Clinic from November 2016 to April 2017. The data obtained were analyzed with the SPSS 20.0 statistical program. Results: Of 167 people in the study group, 48.5% were female. In our study, 79.1% of patients stated that doctors did not provide information before beginning neoplasm treatment. In our study reproductive technics assisted intervention consultations were requested by 35.3% who reported they were concerned about experiencing reproductive problems after neoplasm diagnosis, 11.4% who were not concerned and 30.0% who didn’t remember their emotions about this topic (p<0.05). Conclusion: It is necessary to create awareness among patients of who, where and when to apply about preserving reproduction and to ensure doctors direct these patients to the correct center. With this aim, it may be useful to train oncologists by embryologists about reproductive technics assisted interventions. © 2019, Nobelmedicus. All rights reserved.
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    METASTATİK KÜÇÜK HÜCRE DIŞI AKCİĞER KANSERİNDE ORAL VİNORELBİNİN ÜÇÜNCÜ BASAMAK TEDAVİDE ETKİNLİK VE TOKSİSİTE DEĞERLENDİRMESİ: TEK MERKEZ DENEYİMİ
    (2020) Koral, Lokman
    Amaç: Bu çalışma, metastatik küçük hücre dışı akciğer kanserinin (KHDAK) üçüncü basamak tedavisinde oral vinorelbinin etkinlik ve toksisitesini değerlendirmeyi amaçlamaktadır.Materyal ve Metot: Oral vinorelbin, metastatik KHDAK’li 20 hastaya, hastalık progresyonu veya kabul edilemez toksisite gelişinceye kadar her üç haftada bir, birinci ve sekizinci günlerde uygulandı.Bulgular: Hastaların ortanca yaşı 64 (aralık 50-78) olup erkek baskın 9/1 idi. En yaygın iki tümör histolojisi skuamöz hücreli karsinom (%65) ve adenokarsinomdu (%30). Üç hastada parsiyel yanıt, beş hastada stabil hastalık görülürken diğerlerinde progresyon gelişmiştir.Medyan progresyonsuz sağkalım (mPSK) 2 ay (Güven Aralığı [GA] %95=1.3-2.6) ve medyan genel sağkalım (mGS) 8 aydı (%95 GA=0.1-17.5). Ortalama dört kür oral vinorelbin uygulandı. Hiçbir hastada 3/4. derece yan etki görülmedi. Birinci derece anemi hastaların yarısında ve birinci derece nötropeni %20’sinde görüldü. En yaygın hematolojik olmayan yan etkiler bitkinlik (%65), bulantı (%35), vekabızlıktı (%25).Sonuç: Şu anda üçüncü basamak tedavide standart bir yaklaşım yoktur. Bulgularımız, oral vinorelbinin, nispeten uzun vadeli bir hastalık stabilizasyonu sağlayan, kabul edilebilir toksisite ile önemli bir tedavi seçeneği olabileceğini göstermektedir.
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    Perspective of Turkish Medicine Students on Cancer, Cancer Treatments, Palliative Care, and Oncologists (ARES Study): a Study of the Palliative Care Working Committee of the Turkish Oncology Group (TOG)
    (Springer, 2020) Oktay, Esin; Levent, Mustafa; Gelincik, Hakan; Aktas, Gizem; Yumuk, Fulden; Koral, Lokman; Arpaci, Erkan
    Cancer is one of the most common causes of death all over the World (Rahib et al. in Cancer Res 74(11):2913-2921, 2014; Silbermann et al. in Ann Oncol 23(Suppl 3):iii15-iii28, 2012). It is crucial to diagnose this disease early by effective screening methods and also it is very important to acknowledge the community on various aspects of this disease such as the treatment methods and palliative care. Not only the oncologists but every medical doctor should be educated well in dealing with cancer patients. Previous studies suggested various opinions on the level of oncology education in medical schools (Pavlidis et al. in Ann Oncol 16(5):840-841, 2005). In this study, the perspectives of medical students on cancer, its treatment, palliative care, and the oncologists were analyzed in relation to their educational status. A multicenter survey analysis was performed on a total of 4224 medical school students that accepted to enter this study in Turkey. After the questions about the demographical characteristics of the students, their perspectives on the definition, diagnosis, screening, and treatment methods of cancer and their way of understanding metastatic disease as well as palliative care were analyzed. The questionnaire includes questions with answers and a scoring system of Likert type 5 (absolutely disagree = 1, completely agree = 5). In the last part of the questionnaire, there were some words to detect what the words cancer and oncologist meant for the students. The participant students were analyzed in two study groups; group 1 (n = 1.255) were phases I and II students that had never attended an oncology lesson, and group 2 (n = 2.969) were phases III to VI students that had attended oncology lessons in the medical school. SPSS v17 was used for the database and statistical analyses. A value of p < 0.05 was noted as statistically significant. Group 1 defined cancer as a contagious disease (p = 0.00025), they believed that early diagnosis was never possible (p = 0.042), all people with a diagnosis of cancer would certainly die (p = 0.044), and chemotherapy was not successful in a metastatic disease (p = 0.003) as compared to group 2. The rate of the students that believed gastric cancer screening was a part of the national screening policy was significantly more in group 1 than in group 2 (p = 0.00014). Group 2 had a higher anxiety level for themselves or their family members to become a cancer patient. Most of the students in both groups defined medical oncologists as warriors (57% in group 1 and 40% in group 2; p = 0.097), and cancer was reminding them of death (54% in group 1 and 48% in group 2; p = 0.102). This study suggested that oncology education was useful for the students' understanding of cancer and related issues; however, the level of oncology education should be improved in medical schools in Turkey. This would be helpful for medical doctors to cope with many aspects of cancer as a major health care problem in this country.
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    Real-world outcomes of pazopanib in metastatic soft tissue sarcoma: a retrospective Turkish oncology group (TOG) study
    (Springer Science and Business Media Deutschland GmbH, 2023) Bilici, Ahmet; Koca, Sinan; Karaağaç, Mustafa; Eraslan, Emrah; Derin, Sümeyye; Menekşe, Serkan; Koral, Lokman
    Aim: Description of patient characteristics, effectiveness and safety in Turkish patients treated with pazopanib for metastatic soft tissue sarcoma (STS). Patients and methods: This multicenter study is based on retrospective review of hospital medical records of patients (≥ 18 years) treated with pazopanib for non-adipocytic metastatic STS at 37 Oncology clinics across Turkey. Objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS) and overall survival (OS) were evaluated with further analysis of data on the three most common histological subtypes (leiomyosarcoma [LMS], undifferentiated pleomorphic sarcoma [UPS], synovial sarcoma [SS]) in the cohort. Results: Data of 552 adults (57.6% women, median age: 52 years) were analyzed. DCR and ORR were 43.1% and 30.8%, respectively. Median PFS was 6.7 months and OS was 13.8 months. For LMS, UPS and SS, median PFSs were 6.1, 5.9 and 7.53 months and median OSs were 15.03, 12.87 and 12.27 months, respectively. ECOG ≥ 2 was associated with poor PFS and OS. Liver metastasis was only a factor for progression. Second-line use of pazopanib (vs. front-line) was associated with better PFS, its use beyond third line predicted worse OS. Adverse events (AE) occurred in 82.7% of patients. Most common AEs were fatigue (58.3%) and anorexia (52.3%) which were graded as ≥ 3 in 8.2% and 7.4% of patients, respectively. Conclusion: Pazopanib is effective and well-tolerated in treatment of non-adipocytic metastatic STS. Its earlier use (at second-line), good performance status may result in better outcomes. Worldwide scientific collaborations are important to gain knowledge on rarer STS subtypes by conducting studies in larger patient populations.
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    Risk perception, burnout, and knowledge of chemotherapy nurses during the COVID-19 pandemic
    (2021) Koral, Lokman
    Introduction: Not every individual exposed to the same stressors will develop the same symptoms of burnout. We aimed to evaluate the risk perception and burnout of chemotherapy nurses working with patients having possibly low immune resistances and investigate the relationship with the COVID-19 knowledge of the participants. Methods: We carried out a cross-sectional study in oncology nurses between May and June 2020. Using Delphi panels, instruments were developed on COVID-19-related burnout and risk perception. Of the 857 nurses registered to the Association of Oncology Nurses, 267 responded to an online survey, including 28 items on demographic features, burnout, risk perception, and COVID-19 knowledge. Results: The mean age of the participants was 34.8±8.4 (min. 20, max. 58) years. The mean risk perception scores were 17.34±3.00 (min. 6, max. 24) and burnout scores were 16.74±4.44 (min. 2, max. 27), both above two-thirds of the maximum possible limits. Knowledge scores, on the other hand, were relatively high (72.09±20.0%). COVID-19 knowledge scores showed a significant positive correlation with burnout scores (r=0.499, p<0.001) but a negative correlation with age (r=-0.153, p=0.013). There was no significant correlation between burnout scores and risk perception or risk perception and age (p>0.05). Linear regression analysis showed that after adjusting for the possible confounders, the COVID-19 knowledge score was the only significant variable independently affecting burnout scores (Beta=0.109, 95% Confidence Interval (CI): 0.086-0.133, p<0.001). Conclusions: During the COVID-19 pandemic, chemotherapy nurses are under significant pressure concerning risk perception and burnout. Increasing the knowledge of the nurses by in-service training could raise their awareness and risk perception. However, precautions must be taken to prevent work-related exhaustion and support nurses experiencing burnout.
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    The comparison of FOLFOX regimens with different doses of 5-FU for the adjuvant treatment of colorectal cancer: a multicenter study
    (Springer Science and Business Media Deutschland GmbH, 2021) Akdeniz, Nadiye; Kaplan, Muhammet Ali; Kaya, Serap; Koral, Lokman
    Purpose: We aim to compare the efficiency and toxicity of three different 5-fluorouracil (5-FU) administration types in 5-FU, leucovorin, and oxaliplatin (FOLFOX) combination treatment for adjuvant therapy in colorectal cancer (CRC). Methods: Five hundred and seventy patients with stage III colorectal carcinoma who received different FOLFOX regimens after curative resection were included. Patients were divided into three groups as FOLFOX-4, modified FOLFOX-6 (mFOLFOX-6), and mFOLFOX-4 for comparison of toxicity and disease-free survival (DFS) and overall survival (OS) times. Results: Three-year DFS rates for FOLFOX-4, mFOLFOX-6, and mFOLFOX-4 groups were 65%, 72%, and 72%, respectively. Five-year OS rates for FOLFOX-4, mFOLFOX-6, and mFOLFOX-4 groups were 69%, 75%, and 67%, respectively. There was no statistically significant difference between the three treatment groups in terms of DFS and OS (p = 0.079, and p = 0.147, respectively). Among grade 1–2 adverse events (AE), thrombocytopenia, neuropathy, and stomatitis were more common in the mFOLFOX-6-treated group. The frequency of grade 1–2 nausea and vomiting were similar in mFOLFOX-6 (36.3% and 24%, respectively) and mFOLFOX-4 (32.4% and 24.7%, respectively) groups but were higher than that in the FOLFOX-4 (19.5% and 11.3%, respectively) group. Among the most common grade 3–4 AE, neutropenia (53.4%, 9%, and 13.5%, respectively) and diarrhea (10.5%, 2.2%, and 2.4, respectively) were more common in FOLFOX-4. The rate of anemia and febrile neutropenia was similar in treatment groups (p = 0.063, and p = 0.210, respectively). Conclusion: In the adjuvant treatment of stage III CRC patients, three different 5-FU administration types in FOLFOX combination treatment can be used with similar efficiency and manageable toxicity.
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    The prognostic significance of the 18F-fluorodeoxyglucose positron emission tomography/computed tomography in early-stage nonsmall cell lung cancer
    (Wolters Kluwer Medknow Publications, 2020) Geredeli, Caglayan; Artac, Mehmet; Kocak, Ismail; Koral, Lokman; Sakin, Abdullah; Altinok, Tamer; Kaya, Bugra
    Context: The prognostic criteria for early-stage nonsmall cell lung cancer (NSCLC) wait to be explored. Aim: In this study, our aim was to evaluate the prognostic significance of the positron emission tomography/computed tomography (PET/CT) maximum standardized uptake value (SUVmax) value of the primary tumor in patients with a diagnosis of early-stage NSCLC who received surgical treatment. Settings and Design: This was a multicenter retrospective design. Materials and Methods: Patients who had been diagnosed with early-stage NSCLC and who underwent surgery for the condition were included in this study. The preoperative fluorodeoxyglucose (18F-FDG) PET/CT results of the patients were retrospectively accessed from their medical files. The disease-free survival (DFS) rates of patients who had SUVmax values above and below the determined cutoff value were compared. Statistical Analysis Used: SPSS version 22 and Kaplan-Meier method were used for statistical analysis. Results: A total of 92 patients were included in the study. The median age of the patients was 60 years (range: 36-79). The determined cutoff SUVmax value of the primary tumor was 13.6. A comparison of the DFS rates of the patients with an SUVmax value above and below 13.6 revealed a significant difference in patients with Stage I (22.9 months vs. 50.3 months; P = 0.02) and Stage II (28 months vs. 40.4 months; P = 0.04), Stage I + II (43.5 months vs. 26.1 months; P = 0,02), and Stage IIIA (14.7 months vs. 13.6 months; P = 0.92) NSCLC. Conclusions: We found that in early-stage NSCLC patients, the SUVmax value of the primary mass in 18F FDG PET/CT was a prognostic indicator for the DFS rates.
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    The relationships between fear of cancer recurrence, spiritual well-being and psychological resilience in non-metastatic breast cancer survivors during the COVID-19 outbreak
    (John Wiley and Sons Ltd, 2021) Koral, Lokman; Çırak, Yalçın
    Objectives: This study examines the relationships between fear of cancer recurrence (FCR), spiritual well-being (SWB) and psychological resilience in breast cancer survivors during the COVID-19 outbreak, and investigates to what extent breast cancer survivors’ sociodemographic characteristics affect FCR, SWB and psychological resilience levels. Methods: The study was conducted at Canakkale University Hospital in Turkey. Included in the study were 82 non-metastatic breast cancer patients whose clinical outcomes were followed-up after primary treatment, but suspended due to the COVID-19 outbreak. FCR, SWB and psychological resilience were assessed using the FCR inventory-short form (FCRI-SF), SWB scale and the brief resilience scale (BRS), respectively. Results: The mean scores of breast cancer survivors concerning FCR, SWB, and psychological resilience were 17.77 ± 5.38, 36.20 ± 6.21 and 20.01 ± 4.51, respectively. A significant negative correlation was noted between the scores of FCR and SWB and psychological resilience (r = −0.329, p < 0.001 and r = −0.316, p = 0.004, respectively). Additionally, a significantly positive correlation was identified between psychological resilience and SWB (r = 0.501, p = 0.003). A hierarchical linear regression analysis with FCRI-SF as the dependent variable, and SWB and BRS as explanatory variables, indicated that SWB affects FCRI-SF scores and is a potential predictor of FCR. A mediation analysis revealed that SWB partially mediated the relationship between psychological resilience and FCR. Conclusion: Breast cancer survivors with high SWB and psychological resilience scores experience less FCR, despite their failure to maintain the medical follow-up due to the COVID-19 outbreak. Efforts should be made to increase the psychological resilience and SWB of patients diagnosed with breast cancer.
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    The role of AQP3 and AQP4 channels in cisplatin?induced cardiovascular edema and the protective efect of melatonin
    (Springer, 2021) Koral, Lokman; Ovalı, Mehmet Akif; Tüfekçioğlu, Nezahat Kübra; Karakılıç, Ersen; Adalı, Yasemen; Uzun, Metehan
    Background The present study evaluates the development of edema, the change in the AQP3, AQP4, p53 and Bax gene expressions, and the protective efects of melatonin in rat hearts administered with cisplatin. Methods and Results A total of 28 Wistar albino rats were divided into four groups. The vehicle was administered intraperitoneally (i.p.) to the rats in the control group. The melatonin group (Mel) received melatonin at a dose of 10 mg/kg for 13 days. The cisplatin group (Cis) received cisplatin on days 1, 5, 9 and 13 at a dose of 4 mg/kg. The rats in the cisplatin + melatonin (Cis+Mel) group underwent the procedures both in the Mel and Cis groups. Blood and left ventricular samples were taken and analyzed on day 14 of the study. AQP3, p53 and Bax gene expressions were found to be signifcantly increased following cisplatin administration compared to the control, while melatonin administration signifcantly decreased the expression of these genes (p < 0.05). Melatonin administration also signifcantly decreased the level of AQP4 gene expression compared to the cis. On histological examination, congestion, hemorrhage, extracellular and intracellular edema, and degenerative changes were signifcantly more common in the Cis than in the control. Melatonin administration signifcantly decreased intracellular edema (p = 0.010) and degenerative changes (p = 0.010), and the improvement in extracellular edema was close to statistical signifcance (p = 0.051) in melatonin. Conclusions These results indicate that melatonin had an ameliorative efect on myocardial edema and AQP channels, and that it may be used as a protective molecule against myocardial edema secondary to cisplatin administration.
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    Thrombosis of the inferior vena cava presenting with findings of radiculopathy
    (Elsevier Science Inc, 2016) Resorlu, Hatice; Koral, Lokman; Aylanc, Nilufer; Ozcan, Sedat
    [Anstract Not Available]