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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 Metadata only A case of pathologic complete response after neoadjuvant triplet chemotherapy for locally advanced colon cancer with mismatch repair enzyme proficiency(Via Medica, 2023) Kocak, Mehmet Zahid; Cakir, Murat; Kerimoglu, Ulku; Araz, Murat; Eryilmaz, Melek Karakurt; Artac, Mehmet; Yumuk, Perran Fulden; School of MedicinePatients with potentially resectable colon cancer and expected to have negative margins should undergo resection rather than neoadjuvant chemotherapy. Recent studies have suggested that neoadjuvant immunotherapy may be an option for tumors with mismatch repair enzyme deficiency (dMMR), but standard treatment for locally advanced colon cancer with mismatch repair enzyme proficiency (pMMR) is still unclear. A 37-year-old male patient was diagnosed with clinical stage IIIC (T4b N1a M0) transverse colon cancer. Mismatch repair proteins were proficient. After 3 cycles of oxaliplatin (85 mg/m(2), day 1), irinotecan (150 mg/m2, IV, day 1), leucovorin (200 mg/m(2), IV, day 1), and 5-fluorouracil (3000 mg/m(2), 46 hours of continuous infusion initiating from day 1), there was a remarkable reduction in the tumoral mass on the abdominal computed tomography. A right hemicolectomy was performed. A pathologic complete response was obtained. Although there is no consensus on which patients are suitable for neoadjuvant therapy in pMMR locally advanced colon cancer, triplet chemotherapy may be a reasonable option in selected patients.Publication Metadata only A population-based validation of the IGCCCG update consortium for survival in metastatic non-seminoma testis cancer(Oxford Univ Press, 2024) Incesu, Reha-Baris; Morra, Simone; Scheipner, Lukas; Barletta, Francesco; Baudo, Andrea; Garcia, Cristina Cano; Tappero, Stefano; Piccinelli, Mattia Luca; Tian, Zhe; Saad, Fred; Shariat, Shahrokh F.; de Cobelli, Ottavio; Terrone, Carlo; Chun, Felix K. H.; Carmignani, Luca; Briganti, Alberto; Ahyai, Sascha; Longo, Nicola; Tilki, Derya; Graefen, Markus; Karakiewicz, Pierre, I; Tilki, Derya; School of Medicine; Koç University HospitalBackground: In 2021, the International Germ Cell Cancer Collaborative Group (IGCCCG) Update Consortium reported improved overall survival (OS) rates in a modern cohort of metastatic non-seminoma testis cancer patients within each of the IGCCCG prognosis groups (96% in good vs. 89% in intermediate vs. 67% in poor), compared to the previous IGCCCG publication (92% in good vs. 80% in intermediate vs. 48% in poor). We hypothesized that a similar survival improvement may apply to a contemporary North-American population-based cohort of non-seminoma testis cancer patients. Patients and Methods: The Surveillance, Epidemiology, and End Results (SEER) database (2010-2018) was used. Kaplan-Meier plots and multivariable Cox regression models tested the effect of IGCCCG prognosis groups on overall mortality (OM). Results: Of 1672 surgically treated metastatic non-seminoma patients, 778 (47%) exhibited good vs. 251 (15%) intermediate vs. 643 (38%) poor prognosis. In the overall cohort, five-year OS rate was 94% for good prognosis vs. 87% for intermediate prognosis vs. 65% for poor prognosis. In multivariable Cox regression models predicting OM, intermediate (Hazard ratio [HR] 2.4, 95% confidence interval [CI] 1.4-3.9, P < 0.001) and poor prognosis group (HR 6.6, 95% CI 1.0-1.0, P < 0.001) were independent predictors of higher OM, relative to good prognosis group. Conclusions: The survival improvement reported by the IGCCCG Update Consortium is also operational in non-seminoma testis cancer patients within the most contemporary SEER database. This observation indicates that the survival improvement is not only applicable to centres of excellence, but also applies to other institutions at large.Publication Metadata only A Post-International Gastrointestinal Cancers’ Conference (IGICC) position statements(DOVE MEDICAL PRESS LTD, 2024) Yalcin, Suayib; Kaseb, Ahmed Omar; Peynircioglu, Bora; Cantasdemir, Murat; Hurmuz, Pervin; Dorul, Ahmet Bulent; Bozkurt, Murat Fani; Abali, Huseyin; Akhan, Okan; Simsek, Halis; Sahin, Berksoy; Aykan, Faruk N.; Yucel, Idris; Philip, Philip; Laçin, Şahin; Tellioğlu, Gürkan; Selçukbiricik, Fatih; Çil, Barbaros Erhan; School of Medicine; Koç University HospitalHepatocellular carcinoma (HCC), the most prevalent liver tumor, is usually linked with chronic liver diseases, particularly cirrhosis. As per the 2020 statistics, this cancer ranks 6th in the list of most common cancers worldwide and is the third primary source of cancer-related deaths. Asia holds the record for the highest occurrence of HCC. HCC is found three times more frequently in men than in women. The primary risk factors for HCC include chronic viral infections, excessive alcohol intake, steatotic liver disease conditions, as well as genetic and family predispositions. Roughly 40-50% of patients are identified in the late stages of the disease. Recently, there have been significant advancements in the treatment methods for advanced HCC. The selection of treatment for HCC hinges on the stage of the disease and the patient's medical status. Factors such as pre-existing liver conditions, etiology, portal hypertension, and portal vein thrombosis need critical evaluation, monitoring, and appropriate treatment. Depending on the patient and the characteristics of the disease, liver resection, ablation, or transplantation may be deemed potentially curative. For inoperable lesions, arterially directed therapy might be an option, or systemic treatment might be deemed more suitable. In specific cases, the recommendation might extend to external beam radiation therapy. For all individuals, a comprehensive, multidisciplinary approach should be adopted when considering HCC treatment options. The main treatment strategies for advanced HCC patients are typically combination treatments such as immunotherapy and anti-VEGFR inhibitor, or a combination of immunotherapy and immunotherapy where appropriate, as a first-line treatment. Furthermore, some TKIs and immune checkpoint inhibitors may be used as single agents in cases where patients are not fit for the combination therapies. As second -line treatments, some treatment agents have been reported and can be considered.Publication Metadata only A systematic review of the efficacy and toxicity of brachytherapy boost combined with external beam radiotherapy for nonmetastatic prostate cancer(Elsevier, 2023) Slevin, F; Zattoni, F; Checcucci, E; Cumberbatch, MGK; Nacchia, A; Cornford, P; Briers, E; De Meerleer, G; De Santis, M; Eberli, D; Gandaglia, G; Gillessen, S; Grivas, N; Liew, M; Linares Espinós, EE; Oldenburg, J; Oprea-Lager, DE; Ploussard, G; Rouvière, O; Schoots, IG; Smith, EJ; Stranne, J; Smith, CT; Van Den Bergh, RCN; Van Oort, IM; Wiegel, T; Yuan, CY; Van den Broeck, T; Henry, AM; Tilki, Derya; School of Medicine; Koç University HospitalContext: The optimum use of brachytherapy (BT) combined with external beam radiotherapy (EBRT) for localised/locally advanced prostate cancer (PCa) remains uncertain. Objective: To perform a systematic review to determine the benefits and harms of EBRT-BT. Evidence Acquisition: Ovid MEDLINE, Embase, and EBM Reviews-Cochrane Central Register of Controlled Trials databases were systematically searched for studies published between January 1, 2000 and June 7, 2022, according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Eligible studies compared low- or high-dose-rate EBRT-BT against EBRT ± androgen deprivation therapy (ADT) and/or radical prostatectomy (RP) ± postoperative radiotherapy (RP ± EBRT). The main outcomes were biochemical progression-free survival (bPFS), severe late genitourinary (GU)/gastrointestinal toxicity, metastasis-free survival (MFS), cancer-specific survival (CSS), and overall survival (OS), at/beyond 5 yr. Risk of bias was assessed and confounding assessment was performed. A meta-analysis was performed for randomised controlled trials (RCTs). Evidence Synthesis: Seventy-three studies were included (two RCTs, seven prospective studies, and 64 retrospective studies). Most studies included participants with intermediate-or high-risk PCa. Most studies, including both RCTs, used ADT with EBRT-BT. Generally, EBRT-BT was associated with improved bPFS compared with EBRT, but similar MFS, CSS, and OS. A meta-analysis of the two RCTs showed superior bPFS with EBRT-BT (estimated fixed-effect hazard ratio [HR] 0.54 [95% confidence interval {CI} 0.40-0.72], p < 0.001), with absolute improvements in bPFS at 5-6 yr of 4.9-16%. However, no difference was seen for MFS (HR 0.84 [95% CI 0.53-1.28], p = 0.4) or OS (HR 0.87 [95% CI 0.63-1.19], p = 0.4). Fewer studies examined RP ± EBRT. There is an increased risk of severe late GU toxicity, especially with low-dose-rate EBRT-BT, with some evidence of increased prevalence of severe GU toxicity at 5-6 yr of 6.4-7% across the two RCTs. Conclusions: EBRT-BT can be considered for unfavourable intermediate/high-risk localised/locally advanced PCa in patients with good urinary function, although the strength of this recommendation based on the European Association of Urology guideline methodology is weak given that it is based on improvements in biochemical control. Patient Summary: We found good evidence that radiotherapy combined with brachytherapy keeps prostate cancer controlled for longer, but it could lead to worse urinary side effects than radiotherapy without brachytherapy, and its impact on cancer spread and patient survival is less clear.Publication Metadata only Achieving global standards in pediatric oncology nursing: pediatric oncology clinical profile of Turkey(Elsevier, 2022) Yılmaz, P.; N/A; Semerci, Remziye; Faculty Member; School of Nursing; 216754Background: Nurses have an important role in improving the quality of care for pediatric oncology patients. In this context, it is important for nurses to apply care within the framework of international standards. This study aimed to examine the status of reaching the global nursing standards determined by SIOP in pediatric oncology nursing in Turkey. Methods: The descriptive study was conducted with nurse managers in 62 pediatric oncology centers in Turkey between February and May 2022. The ‘Information Form' and six global nursing standards created by the SIOP Nurse Working Group were transformed into a form by the researchers. were used for data collection. Participants were asked to respond as ‘Available' or ‘Not Available' in the clinics of these standards. The data were obtained online by reaching the nurse managers in cooperation with the Oncology Nursing Association and the Turkish Pediatric Oncology Group. Results: It was determined the mean number of beds in the clinics was 21.73±11.28, the number of nurses working in the clinics was 14.00±6.96, there were no specialist nurses in 68.2% of the clinics, and specialist nurses were included in the rotations in 18.2% of the clinics. It was found that 27.3% of the clinics met the nurse standard for five patients, I72.7% of the clinics applied for an orientation program, 77.3% of clinics applied at least 10 hours of continuous training program annually. 77.3% of clinics accepted nurses as part of a multidisciplinary team, 63.6% had all resources available for safe pediatric oncology care, 63.6% adopted evidence-based pediatric oncology nursing policies and procedures, and 36.4% were financially supported in research conducted to improve nursing policies and procedures. Conclusions: It was determined that it was insufficient to meet the standards developed for pediatric oncology nurses in pediatric oncology clinics in Turkey. It was determined that the number of specialist nurses working in the clinics is low, the number of patients a nurse takes care of is high, and the nurses are not financially supported enough in their research to develop nursing policies and procedures. It is important that managers and associations have action plans that require pediatric oncology nurses to reach global standards.Publication Metadata only Acinar cell induced autolysis is a frequent occurrence in Cytolyt-fixed pancreatic fine needle aspiration specimens: an analysis of 157 cytology samples(Wiley, 2021) Alwelaie, Yazeed; Point du Jour, Kimberly S.; Pandya, Sonal; Goodman, Abigail L.; Centeno, Barbara A.; Reid, Michelle D.; N/A; Adsay, Nazmi Volkan; Faculty Member; School of Medicine; Koc University Hospital; 286248Background Although 10% formalin is a standard preservative in pancreatic FNAs, the effect of CytoLyt on pancreatic tissue preservation has not been systematically explored. Methods Smears and cell blocks from CytoLyt-fixed (CF-CBs) and formalin-fixed (FF-CBs) pancreatic FNAs were blindly reviewed without knowledge of the fixative used, and the presence of tissue/tumor autolysis was noted. Controls included FF-CBs from pancreatic FNAs, CF-CBs from nonpancreatic FNAs, and 4 pancreatic FNAs with matched CF-CBs and FF-CBs. Results We found that 62 of 85 (73%) pancreatic FNAs with CF-CBs showed significant autolysis, which was most pronounced in acinar cells and/or tumor cells with benign acinar cells in the background, compared with 2 of 46 (4%) FF-CBs (P < .0001) and 3 of 26 (12%) CF-CBs from nonpancreatic FNAs (73% vs 12%; P < .0001). Of the 4 pancreatic FNAs with matched CF-CBs and FF-CBs, all 4 CF-CBs showed marked autolysis versus none of the matched FF-CBs. Of the 23 (27%) pancreatic FNAs with CF-CBs that did not show autolysis, 10 had no acinar cells, and 7 had only minute tissue fragments on CB. Conclusion While CytoLyt is a useful fixative for nonpancreatic FNAs it is a suboptimal fixative for pancreatic FNAs and is associated with tissue/tumor autolysis in the majority of cases, influencing morphologic evaluation, and potentially immunocytochemical staining. Autolysis appears to be due to acinar enzymes whose effect is likely interrupted/inhibited by formalin fixation. Cytopathologists and cytotechnologists should be mindful of this pitfall and should avoid using CytoLyt as a fixative for pancreatic FNAs.Publication Metadata only Adrenocortical cancer in the real world: a comprehensive analysis of clinical features and management from the Turkish Oncology Group (TOG)(Elsevier Inc., 2024) Yasar,H.; Aktas,B.Y.; Ucar,G.; Goksu,S.S.; Bilgetekin,I.; Cakar,B.; Sakin,A.; Ates,O.; Basoglu,T.; Arslan,C.; Demiray,A.G.; Paydas,S.; Cicin,I.; Sendur,M.A.N.; Karadurmus,N.; Kosku,H.; Uner,A.; Utkan,G.; Kefeli,U.; Tanriverdi,O.; Cinkir,H.; Gumusay,O.; Turhal,N.S.; Menekse,S.; Kut,E.; Beypinar,I.; Sakalar,T.; Demir,H.; Yekeduz,E.; Kilickap,S.; Erman,M.; Urun,Y.; Yumuk, Perran Fulden; School of MedicineIntroduction: Adrenocortical carcinoma (ACC) is a rare yet highly malignant tumor associated with significant morbidity and mortality. This study aims to delineate the clinical features, survival patterns, and treatment modalities of ACC, providing insights into the disease's prognosis. Materials and Methods: A retrospective analysis of 157 ACC patients was performed to assess treatment methodologies, demographic patterns, pathological and clinical attributes, and laboratory results. The data were extracted from the hospital's database. Survival analyses were conducted using the Kaplan–Meier method, with univariate and multivariate analyses being performed through the log-rank test and Cox regression analyses. Results: The median age was 45, and 89.4% had symptoms at the time of diagnosis. The median tumor size was 12 cm. A total of 117 (79.6%) patients underwent surgery. A positive surgical border was detected in 26 (24.1%) patients. Adjuvant therapy was administered to 44.4% of patients. The median overall survival for the entire cohort was 44.3 months. Median OS was found to be 87.3 months (95% confidence interval [CI] 74.4-100.2) in stage 2, 25.8 (95% CI 6.5-45.1) months in stage 3, and 13.3 (95% CI 7.0-19.6) months in stage 4 disease. Cox regression analysis identified age, Ki67 value, Eastern Cooperative Oncology Group performance status, and hormonal activity as significant factors associated with survival in patients with nonmetastatic disease. In metastatic disease, only patients who underwent surgery exhibited significantly improved overall survival in univariate analyses. Conclusion: ACC is an uncommon tumor with a generally poor prognosis. Understanding the defining prognostic factors in both localized and metastatic diseases is vital. This study underscores age, Ki67 value, Eastern Cooperative Oncology Group performance status, and hormonal activity as key prognostic determinants for localized disease, offering critical insights into the complexities of ACC management and potential avenues for targeted therapeutic interventions.Publication Metadata only Advanced practice pediatric oncology nursing as imagined or in place in four lower- and upper-middle-income countries(Elsevier Science Inc, 2024) Samba, Vera Larfi; Diaz, Dorian René Navarro; Punjwani, Rehana; Challinor, Julia; Semerci, Remziye; School of NursingObjectives: The implementation of pediatric oncology advanced practice nurse (s) roles in low- and middleincome countries (LMICs) presents opportunities and challenges. The authors explore the implications of pediatric oncology advanced practice nursing roles in Pakistan, Cameroon, Turkey, and Mexico. Potential bene fits and drawbacks of advanced practice nursing roles, impacts on nursing care, and strategies for advanced practice nursing role development in LMIC settings are considered. Methods: Information from scholarly articles, policy documents, and four LMIC pediatric oncology nurse expert perspectives on existing and imagined advanced practice nursing roles in pediatric oncology in LMIC were synthesized. Results: Current literature and policies point to efforts across LMICs to establish a wide variety of advanced nursing practices, not necessarily aligned with internationally accepted advanced practice nursing standards of practice or education. The LMIC nurses describe a wide range of national general nurse education and government advanced practice nurse recognition/licensing. Challenges to achieving or strengthening advanced practice nursing roles include, for example, healthcare professional resistance, government unwillingness to recognize/license advanced practice nurses, and lack of advanced practice nursing faculty. To promote a pediatric oncology advanced practice nursing role in LMICs requires navigating the national nursing scope of practice and nursing culture. Conclusion: The strategic introduction of pediatric oncology advanced practice nursing roles in LMICs has the potential to signi ficantly enhance patient care by, for example, addressing healthcare workforce shortages and facilitating timely care delivery. However, challenges related to role complexity, resistance from traditional healthcare structures, and role overlap must be considered. Tailoring these roles to local contexts and fostering stakeholder collaboration are essential for successful implementation. Implications for Nursing Practice: The adoption of advanced practice nursing roles can lead to improved quality of care for pediatric oncology patients and their families in LMICs, where cancer care is challenging. The positive impact of pediatric oncology advanced practice nurses on patient outcomes and healthcare delivery cannot be discounted but must align with local nursing and healthcare culture and expectations. (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.Publication Metadata only African American vs Caucasian race/ethnicity in adrenocortical carcinoma patients(Bioscientifica Ltd, 2023) Panunzio, Andrea; Tappero, Stefano; Hohenhorst, Lukas; Cano Garcia, Cristina; Piccinelli, Mattia; Barletta, Francesco; Tian, Zhe; Tafuri, Alessandro; Briganti, Alberto; De Cobelli, Ottavio; Chun, Felix K. H.; Terrone, Carlo; Saad, Fred; Shariat, Shahrokh F.; Bourdeau, Isabelle; Cerruto, Maria Angela; Antonelli, Alessandro; Karakiewicz, Pierre, I.; Tilki, Derya; School of Medicine; Koç University HospitalIn some primaries, African American race/ethnicity predisposes to higher stage and worse survival. We tested for differences in cancer-specific mortality (CSM) and other-cause mortality (OCM) in patients with adrenocortical carcinoma (ACC) according to African American vs Caucasian race/ethnicity. We hypothesized that African Americans present with higher tumor stage and grade, do not receive the same treatment, and experience worse oncological outcomes than Caucasians. Within Surveillance, Epidemiology, and End Results database, we identified 1016 ACC patients: 123 (12.1%) African Americans vs 893 (87.9%) Caucasians. Propensity score matching (PSM) (age, sex, marital status, grade, T, N, and M stages, and treatment type), Poisson-smoothed cumulative incidence plots, and competing risk regression (CRR) were used. Compared to Caucasians, African Americans were more frequently unmarried (56.9% vs 35.5%, P < 0.001). No clinically meaningful or statistically significant differences were observed for age, grade, T, N, and M stages, as well as treatment type (all P > 0.05). After PSM (1:4), 123 African Americans and 492 Caucasians remained and were included in CRR analysis. In multivariable CRR models, CSM and OCM rates were not different between the two race/ethnicities (hazard ratio: 0.84, P = 0.3). In African Americans, 5-year CSM rates were 31.2% and 75.3% in European Network for the Study of Adrenal Tumors (ENSAT) stages I-II and III-IV, respectively vs 32.9% and 75.4% in Caucasians. Overall 5-year OCM rates were 11.0% vs 10.1% in respectively African Americans and Caucasians. Unlike other primaries, in ACC, African American race/ethnicity is not associated with higher disease stage at initial diagnosis or worse survival.