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Permanent URI for this collectionhttps://hdl.handle.net/20.500.14288/6
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Publication Open Access #COVID19 and #Breastcancer: a qualitative analysis of tweets(Multidisciplinary Digital Publishing Institute (MDPI), 2022) Naganathan, G.; Cleland, J.; Reel, E.; Cil, T.; Bilgen, İdil; School of MedicineRapid and efficient communication regarding quickly evolving medical information was paramount for healthcare providers and patients throughout the COVID-19 pandemic. Over the last several years, social media platforms such as Twitter have emerged as important tools for health promotion, virtual learning among healthcare providers, and patient support. We conducted a qualitative thematic content analysis on tweets using the hashtags #BreastSurgery, #BreastCancer, #BreastOncology, #Pandemic, and #COVID19. Advocacy organizations were the most frequent authors of tweets captured in this dataset, and most tweets came from the United States of America (64%). Seventy-three codes were generated from the data, and, through iterative, inductive analysis, three major themes were developed: patient hesitancy and vulnerability, increased efforts in knowledge sharing, and evolving best practices. We found that Twitter was an effective way to share evolving best practices, education, and collective experiences among key stakeholders. As Twitter is increasingly used as a tool for health promotion and knowledge translation, a better understanding of how key stakeholders engage with healthcare-related topics on the platform can help optimize the use of this powerful tool.Publication Open Access Could the long-term oncological safety of laparoscopic surgery in low-risk endometrial cancer also be valid for the high–intermediate-and high-risk patients? a multi-center Turkish gynecologic oncology group study conducted with 2745 endometrial cancer cases. (TRSGO-end-001)(Multidisciplinary Digital Publishing Institute (MDPI), 2021) Vardar, Mehmet Ali; Güzel, Ahmet Barış; Taşkın, Salih; Güngör, Mete; Özgül, Nejat; Salman, Coşkun; Küçükgöz-Güleç, Ümran; Khatib, Ghanim; Duender, Ilkkan; Ortaç, Fırat; Yüce, Kunter; Terek, Coşan; Şimşek, Tayup; Özsaran, AydIn; Onan, Anıl; Çoban, Gonca; Topuz, Samet; Demirkıran, Fuat; Takmaz, Özgüç; Köse, M. Faruk; Göçmen, Ahmet; Seydaoğlu, Gülşah; Gümürdülü, Derya; Ayhan, Ali; Taşkıran, Çağatay; Faculty Member; School of Medicine; Koç University Hospital; 134190This study was conducted to compare the long-term oncological outcomes of laparotomy and laparoscopic surgeries in endometrial cancer under the light of the 2016 ESMO-ESGO-ESTRO risk classification system, with particular focus on the high–intermediate-and high-risk categories. Using multicentric databases between January 2005 and January 2016, disease-free and overall survivals of 2745 endometrial cancer cases were compared according to the surgery route (laparotomy vs. laparoscopy). The high–intermediate-and high-risk patients were defined with respect to the 2016 ESMO-ESGO-ESTRO risk classification system, and they were analyzed with respect to differences in survival rates. Of the 2745 patients, 1743 (63.5%) were operated by laparotomy, and the remaining were operated with laparoscopy. The total numbers of high–intermediate- and high-risk endometrial cancer cases were 734 (45%) patients in the laparotomy group and 307 (30.7%) patients in the laparoscopy group. Disease-free and overall survivals were not statistically different when compared between laparoscopy and laparotomy groups in terms of low-, intermediate-, high–intermediateand high-risk endometrial cancer. In conclusion, regardless of the endometrial cancer risk category, long-term oncological outcomes of the laparoscopic approach were found to be comparable to those treated with laparotomy. Our results are encouraging to consider laparoscopic surgery for high–intermediate- and high-risk endometrial cancer cases.Publication Open Access Perspectives of gynecologic oncologists on minimally invasive surgery during COVID-19 pandemic: a Turkish Society of Minimally Invasive Gynecologic Oncology (MIJOD) survey(Asian Pacific Organization for Cancer Prevention, 2022) Doğan, Nasuh Utku; Taşkın, Salih; Doğan, Selen; Çelik, Hüsnü; Ortaç, Fırat; Güngör, Mete; Bilir, Esra; Vatansever, Doğan; Taşkıran, Çağatay; Faculty Member; Faculty Member; School of Medicine; Koç University Hospital; N/A; 193687; 134190Background: to evaluate gynecologic oncologists’ trends and attitudes towards the use of Minimally invasive surgery (MIS) in active period of the COVID-19 pandemic in Turkey. Methods: online national survey sent to members of Turkish Endoscopy Platform consisting of six sections and 45 questions between the dates 1-15 June 2020 in Turkey to explore their surgical practice during the pandemic in three hospital types: Education and research hospital/ university hospital, state hospital and private Hospital. Participants were gynecologic oncologists who are members of Turkish Endoscopy Platform. Results: fifty-eight percent of participants canceled all operations except for cancer surgeries and emergent operations. About a quarter of participants (28%) continued to operate laparoscopically and/or robotically. For the evaluation of the suspected adnexial mass (SAM) 64% used laparotomy and only 13 % operated by laparoscopy (L/S). For the management of low-risk early-stage endometrial cancer only fifth of the participants preferred to perform L/S. For endometrial cancer with high-intermediate risk factors more than half of participants preferred complete staging with laparotomy. For advanced stage ovarian cancer, one-fifth of the participants preferred to perform an explorative laparotomy, whilst 15 % preferred diagnostic laparoscopy to triage the patients for either NACT or cytoreductive surgery. On the contrary 41 % of participants chose to have cytology by paracentesis for neo-adjuvant chemotherapy (NACT). Gynecologic oncologists with >10 years L/S experience used MIS more for SAM. Furthermore, experienced surgeons used L/S more for endometrial cancer patients. In busy COVID hospitals, more participants preferred laparotomy over L/S. Conclusion: use of MIS decreased during the pandemic in Turkey. More experienced surgeons continued to perform MIS. Surgical treatment was the preferred approach for SAM, early-stage endometrial cancer. However, NACT was more popular compared to radical surgery.Publication Open Access Prognostic usefulness of advanced lung cancer inflammation index in locally-advanced pancreatic carcinoma patients treated with radical chemoradiotherapy(Dove Medical Press, 2019) Topkan, Erkan; Mertsoylu, Hüseyin; Özdemir, Yurday; Sezer, Ahmet; Küçük, Ahmet; Besen, Ali Ayberk; Özyılkan, Özgür; N/A; Selek, Uğur; Faculty Member; School of Medicine; 27211Background/Aims: previously advanced lung cancer inflammation index (ALI) has been demonstrated to have prognostic utility in the stratification of patients into distinctive survival groups, but the prognostic value of ALI has never been explored in the setting of locally advanced pancreatic carcinomas (LAPC) treated with concurrent chemoradiotherapy (CCRT). Hence, we aimed to investigate the prognostic value of pre-treatment ALI in LAPC patients who underwent radical CCRT. Methods: present retrospective cohort analysis incorporated 141 LAPC patients who received radical CCRT. Accessibility of baseline ALI cutoff(s) impacting survival outcomes was sought by receiver operating characteristic (ROC) curve analysis. Interaction between the ALI and overall- (OS) and progression-free survival (PFS) comprised our primary and secondary endpoints, respectively. Results: at a median follow-up of 14.4 months (range: 3.2-74.2), the median PFS and OS were 7.5 (%95 CI: 5.9-9.1) and 14.6 months (%95 CI: 11.6-17.6), respectively. ROC curve analyses set the ideal ALI cutoff value at 25.3 (AUC: 75.6%; sensitivity: 72.7%; specificity: 70.3%) that exhibited significant associations with both the OS and PFS results. Patient stratification into two groups per ALI [<= 25.3 (N=75) versus>25.3 (N=66)] showed that the ALI>25.3 group had significantly superior median OS (25.8 versus 11.4 months; P<0.001) and PFS (15.9 versus 6.0 months; P<0.001) durations than its ALI <= 25.3 counterpart. Other factors exhibiting significantly better OS and PFS rates were N-0 stage (versus N1; P<0.05 for each endpoint) and CA 19-9 <= 90 U/mL (versus >90 U/mL; P<0.05 for each endpoint), respectively. These three factors were additionally asserted to be independent indicators of longer OS (P<0.05 for each) and PFS (P<0.05 for each) in multivariate analyses. Conclusion: results of this hypothesis-generating research proposed the pre-CCRT ALI as a novel robust associate of OS and PFS outcomes for LAPC patients undergoing CCRT.Publication Open Access Low prognostic nutritional index predicts poor clinical outcomes in patients with stage IIIB non-small-cell lung carcinoma undergoing chemoradiotherapy(Dove Medical Press, 2020) Özdemir, Yurday; Topkan, Erkan; Mertsoylu, Hüseyin; Selek, Uğur; Faculty Member; School of Medicine; 27211Purpose: to investigate the prognostic utility of the prognostic nutritional index (PNI) in stage IIIB non-small-cell lung carcinoma (NSCLC) patients undergoing concurrent chemoradiotherapy (CRT). Methods: a total of 358 stage IIIB NSCLC patients who received a total dose of 60-66 Gy (2 Gy/fraction) radiotherapy and >= 1 cycle(s) of platinum-based chemotherapy were analyzed. The receiver operating curve analysis was utilized to identify the optimal PNI cut-off value demonstrating a significant connection with the overall survival (OS), locoregional progression-free survival (LRPFS), and progression-free survival (PFS). Results: at a median follow-up time of 22.5 months (range: 2.4-123.5), 30.2% and 14% of the patients were still alive and free of disease progression, respectively.The median OS, LRPFS, and PFS were 25.2 [95% confidence interval (CI): 36.3-46.6 months], 15.4 (95% CI: 26.6-35.3 months), and 10.7 (95% CI: 36.8-69.9 months), individually, for the whole study accomplice. The ROC analysis revealed an optimum rounded cut-off that associated meaningfully with each of the OS [area under the curve (AUC): 84.1%; sensitivity: 75.9%;72.4% specificity], LRPFS (AUC: 92.4%; sensitivity: 87.9%; 85.1% specificity), and PFS (AUC: 80.1%; sensitivity: 73.7%; 71.6% specificity) at a value of 40.5. Comparative analyses revealed that the patients presenting with PNI <= 40.5 had significantly inferior OS (16.8 vs 36.7; P<0.001), LRPFS (11.5 vs 19.5; P<0.001), and PFS (8.6 vs 13.6; P<0.001) outcomes compared to patients with PNI>40.5. In univariate analyses, lower T-stage (1-2 vs 3-4; P< 0.001), lower N-stage (N2 vs N3; P< 0.001), anemia status (absent vs present; P< 0.001), weight loss status (<5% vs >= 5%; P< 0.001), and PM group (<= 40.5 vs >40.5; P<0.001) were the factors found to be associated with OS, LRPFS and PFS results. The results of multivariate analysis exhibited that the PM was independently associated with each of the OS (P<0.001), LRPFS (P<0.001), and PFS (P<0.001) outcomes. Conclusion: the pretreatment PNI appears to be a robust novel prognostic factor that stratifies patients with stage IIIB NSCLC into two significantly distinct survival groups after CRT.Publication Open Access Treatment patterns and clinical outcomes in patients with relapsed/refractory Hodgkin lymphoma receiving stem cell transplantation outside Europe and North America: results from the B-HOLISTIC study(Taylor _ Francis, 2022) Al-Mansour, M.; Zerga, M.; Brittain, D.; Yeh, S. -P.; Tumyan, G.; Song, Y.; Karduss, A.; Rivas-Vera, S.; Hertzberg, M.; Tye, L. S.; Kwong, Y. L.; Huang, Z.; Wu, K. -W.; Kim, T. M.; Ferhanoğlu, Ahmet Burhan; Faculty Member; School of Medicine; 18320Information on Hodgkin lymphoma (HL) is mostly limited to Europe and North America. Thisreal-world, retrospective study assessed treatment pathways and clinical outcomes in adults withstage IIB–IV classical HL receiving frontline treatment (n¼1598) or relapsed/refractory HL (RRHL,n¼426) in regions outside Europe and North America between January 2010 and December2013. The primary endpoint was progression-free survival (PFS) in the RRHL group. Amongpatients with RRHL, 89.0% received salvage chemotherapy; most common regimen was etopo-side, methylprednisolone, cytarabine, cisplatin (ESHAP; 26.3%). Median PFS in the RRHL groupwas 13.2months (95% confidence interval [CI]: 9.9–20.2) and was longer in patients withvs.with-out stem cell transplantation (SCT; 20.6vs.7.5 months;p¼0.0071). This large-scale study identi-fied a lower PFS for RRHL in the rest of the world compared with Europe and North America,highlighting the need for novel targeted therapies and SCT earlier in the treatment continuum.Publication Open Access Outcomes of resections for pancreatic adenocarcinoma with suspected venous involvement: a single center experience.(BioMed Central, 2015) Michalski, Christoph W.; Kong, Bo; Jaeger, Carsten; Kloe, Silke; Beier, Barbara; Braren, Rickmer; Esposito, Irene; Friess, Helmut; Kleeff, Jorg; N/A; Erkan, Murat Mert; Faculty Member; School of Medicine; 214689Background: Pancreatic ductal adenocarcinoma (PDAC) patients frequently present with borderline resectable disease, which can be due to invasion of the portal/superior mesenteric vein (PV/SMV). Here, we analyzed this group of patients, with emphasis on short and long-term outcomes. Methods: 156 patients who underwent a resection for PDAC were included in the analysis and sub-stratified into a cohort of patients with PV/SMV resection (n = 54) versus those with standard surgeries (n = 102). Results: While venous resections could be performed safely, there was a trend towards shorter median survival in the PV/SMV resection group (22.7 vs. 15.8 months, p = 0.157). These tumors were significantly larger (3.5 vs 4.3 cm; p = 0.026) and margin-positivity was more frequent (30.4 % vs 44.4 %, p = 0.046). Conclusion: Venous resection was associated with a higher rate of margin positivity and a trend towards shorter survival. However, compared to non-surgical treatment, resection offers the best chance for long term survival.