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Öğe Comparison of the clinicopathological features of invasive ductal, invasive lobular, and mixed (invasive ductal + invasive lobular) carcinoma of the breast(Springer-Verlag Tokyo, 2015) Zengel B.; Yararbas U.; Duran A.; Uslu A.; Elıyatkın N.; Demırkıran M.A.; Cengiz F.; Şimşek C.; Postacı H.; Vardar E.; Durusoy R.Background: In this retrospective analysis, the clinicopathological features and pattern of metastatic spread of invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC), and mixed ductal/lobular carcinoma (MDLC), together with the type and outcome of surgical intervention, were comparatively evaluated. Methods: A total of 633 breast cancer patients with histopathological subtype IDC, ILC or MDLC were included in the study. The mean age was 52.6 ± 12.7 years. Follow-up period ranged between 0 and 33 (median 6.0) years. The groups were compared with respect to age, tumor size, nodal involvement, stage, hormonal therapy, multicentricity, multifocality, bilaterality, estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2)/neu, p53, and Ki67 expression, disease-free survival (DFS) and overall survival (OS) rates, and surgical approach. Results: The distribution of patients was as follows: IDC 508 (80.3 %), ILC 78 (12.3 %), MDLC 47 (7.4 %). Among the parameters evaluated, statistically significant differences were observed in mean tumor size (IDC 2.5 ± 1.98 cm, ILC 3.0 ± 1.8 cm, MDLC 3.2 ± 2.4 cm), advanced T stage (T3 + T4) at diagnosis (IDC 14.7 %, ILC 21.4 %, MDLC 25.6 %), N stage (N0 was dominant in IDC and ILC; N3 was dominant in MDLC), tumor–node–metastasis (TNM) stage (stage II was dominant in IDC and ILC; stage III was dominant in MDLC), HER2/neu expression (IDC 23.8 %, ILC 11.8 %, MDLC 21.4 %), and frequency of bone metastasis (IDC 14.3 %, ILC 17.9 %, MDLC 25.5 %). Conclusions: MDLC-type tumors have different histopathological characteristics and are often diagnosed at advanced stage. However, their survival outcomes do not vary significantly from ILC and IDC. © 2013, The Japanese Breast Cancer Society.Öğe Fluorouracil and folinic acid bolus schedule (nordic regimen) combined with irinotecan as a first-line chemotherapy in metastatic colorectal cancer(2010) Küçükzeybek Y.; Karabulut B.; Yetiş H.; Uslu R.; Sanli U.A.; Uslu A.; Demir C.; Göker E.The recent incorporation of irinotecan (CPT-11) for the management of advanced colorectal cancer has generated further improvement in survival. The goal of this retrospective analysis was to evaluate the efficacy and toxicity of irinotecan plus bolus FU/FA (Nordic regimen) as first-line therapy in patients with advanced colorectal cancer. A total of 43 patients with metastatic colorectal cancer treated with irinotecan plus bolus FU/FA (Nordic regimen) as first-line chemotherapy were reviewed. Patients with metastatic adenocarcinoma of the colon or rectum and who had measurable disease and WHO performance status of 2 or less were treated with irinotecan 210 mg/m2 as a 30-90 min intravenous infusion on day 1, followed by 5-FU 500 mg/m2 and FA 60 mg/m2 bolus on days 1 and 2, every 2 weeks, until disease progression or unacceptable toxicity. Patients were evaluated for response rates, survival and toxicity. Median patient age was 56 (29-76) years. Response rates were 72% as a carcino embryogenic antigen (CEA) level and 45% as a clinic evaluation. Disease control rates were 76% as a CEA level and 80% as a clinic evaluation. Median duration of response was 5,8 (2-9) months as a clinic evaluation and median duration of response was 6,6 (2-11) months as a CEA level. Median progression free interval was 9 (2-13) months and median overall survival was 16 (3-18) months. Grade 3-4 neutropenia occurred in 30% of the patients. Non-haematological toxicities were mild. There was no treatment-related death. Irinotecan - Nordic regimen is considered as a reasonable option for first-line treatment of patients with metastatic colorectal cancer.Öğe Potentiation of cytotoxicity by combination of imatinib and chlorimipramine in glioma(2008) Bilir A.; Erguven M.; Oktem G.; Ozdemir A.; Uslu A.; Aktas E.; Bonavinda B.Rat C6 glioma is a chemo-resistant experimental brain tumor that is difficult to treat with various drug combinations. Previous studies suggested that imatinib mesylate (Gleevec) is effective in pre-clinical trials for glioblastoma. Also, chlorimipramine (Anafranil) is an anti-depressant drug in use in the clinic and shown to have anti-neoplastic activity. We hypothesized that treatment of resistant C6 glioma with combination of imatinib and chlorimipramine may potentiate cytotoxicity and reverse resistance. C6 glioma was examined both as monolayer and as spheroid cultures. Several experimental designs were examined all of which showed synergistic activity albeit at different time kinetics. Combination treatment resulted in inhibition of cell growth and enhanced cell death as determined by dye exclusion. Further, the combination treatment resulted in significant induction of apoptosis as determined by Annexin V-FITC and Pl. Also, there was inhibition of DNA synthesis and cAMP. Altogether, these findings supported the antiproliferative and cytotoxic effects of the combination treatment. Morphological studies were also performed using transmission and scanning electron microscopy. Significant synergistic apoptosis was detected by the combination treatment in both the monolayers and spheroid cultures. There was also a synergistic effect in autophagy by the combination. Several altered morphological features were noted by both the individual compound and enhanced by the combination treatment. The present findings support our hypothesis and demonstrate the potentiation of cytotoxicity by the com-bination of imatinib and chlorimipramine in C6 glioma. Further, the findings suggest the potential clinical application of the combination in the treatment of drug-resistant glioma.Öğe Sentinel lymph node biopsy in breast cancer: Predictors of axillary and non-sentinel lymph node involvement(Galenos Publishing House, 2013) Postaci H.; Zengel B.; Yararbaş U.; Uslu A.; Eliyatkin N.; Akpinar G.; Cengiz F.; Durusoy R.Background: Sentinel lymph node biopsy is a standard method for the evaluation of axillary status in patients with T1-2N0M0 breast cancers. Aims: To determine the prognostic significance of primary tumour-related clinico-histopathological factors on axillary and non-sentinel lymph node involvement of patients who underwent sentinel lymph node biopsy. Study design: Retrospective clinical study. Methods: In the present study, 157 sentinel lymph node biopsies were performed in 151 consecutive patients with early stage breast cancer between June 2008 and December 2011. Results: Successful lymphatic mapping was obtained in 157 of 158 procedures (99.4%). The incidence of larger tumour size (2.543±1.21 vs. 1.974±1.04), lymphatic vessel invasion (70.6% vs. 29.4%), blood vessel invasion (84.2% vs. 15.8%), and invasive lobular carcinoma subtype (72.7% vs. 27.3%) were statistically significantly higher in patients with positive SLNs. Logistic stepwise regression analysis disclosed tumour size (odds ratio: 1.51, p=0.0021) and lymphatic vessel invasion (odds ratio: 4.68, p=0.001) as significant primary tumour-related prognostic determinants of SLN metastasis. Conclusion: A close relationship was identified between tumour size and lymphatic vessel invasion of the primary tumour and axillary lymph node involvement. However, the positive predictive value of these two independent variables is low and there is no compelling evidence to recommend their use in routine clinical practice. © Trakya University Faculty of Medicine.
