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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 Adjuvant chemoradiotherapy after D2 resection in gastric cancer: a single-center observational study(Springer, 2015) Saglam, Esra Kaytan; Yucel, Serap; Saglam, Sezer; Asoglu, Oktar; Yamaner, Sumer; Oral, Ethem N.; Kizir, Ahmet; Kapran, Yersu; Sakar, Burak; Akyuz, Ali; Gulluoglu, Mine; N/A; Balık, Emre; Buğra, Dursun; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 18758; 1758Previous studies demonstrated survival benefits in association with the addition of chemoradiotherapy after surgery in gastric cancer. This study aimed to examine the efficacy in terms of loco-regional control and survival and safety of 5-FU-based adjuvant chemoradiotherapy after D2 curative surgery. This study included 228 patients (81 female, 147 male) treated for gastric cancer with curative surgery plus adjuvant chemoradiotherapy. Majority of the patients underwent at least D2 lymph node resection. Median three cycles of fluorouracil chemotherapy were administered, and 45-Gy radiotherapy was delivered at 1.8 Gy/fraction concomitantly during the second cycle of chemotherapy. Local control, regional control, distant metastasis and overall survival rates were estimated. The median age of the patients was 54 years (range 25-74 years). The most common grade III toxicities were nausea (10 %) and neutropenia (9 %). During radiotherapy, grade IV local skin reaction occurred in one patient. Median duration of follow-up was 47 months. Local, regional and distant recurrence developed in 9 (4 %), 41 (18 %) and 45 (20 %) patients, respectively. Overall 5-year survival rate was 57.2 %, and disease-free 5-year survival rate was 53.8 %. Multivariate analysis identified less than 15 lymph node involvement as an independent predictor of better survival (p < 0.001). Concomitant 5-FU-based chemoradiotherapy seems to be an effective and tolerable adjuvant regimen on local control and survival in curatively resected node-positive stomach cancer, particularly when combined with D2 resection.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 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.Publication Metadata only ASO author reflections: prognostic value of subgrading G2 pancreatic neuroendocrine tumors as 2A versus 2B(Springer, 2024) Bağcı, Pelin; Balcı, Serdar; Ohike, Nobuyuki; Baştürk, Olca; Sökmensüer, Cenk; Leblebici, Can Berk; Xue, Yue; Reid, Michelle D.; Krasinskas, Alyssa M.; Kooby, David; Maithel, Shishir K.; Sarmiento, Juan; Cheng, Jeanette D.; Tarcan, Zeynep; Luchini, Claudio; Scarpa, Aldo; Eren, Özgür Can; Saka, Burcu; Taşkın, Orhun Çığ; Kapran, Yersu; Adsay, Nazmi Volkan; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of MedicinePublication Metadata only Assessing functional outcomes of partial versus radical nephrectomy for T1B-T2 renal masses: results from a multi-institutional collaboration(Springer, 2024) Tappero, Stefano; Bravi, Carlo Andrea; Khene, Zine Eddine; Campi, Riccardo; Pecoraro, Angela; Diana, Pietro; Re, Chiara; Giulioni, Carlo; Beksac, Alp T.; Bertolo, Riccardo; Ajami, Tarek; Okhawere, Kennedy E.; Meagher, Margaret; Alimohammadi, Arman; Terrone, Carlo; Mari, Andrea; Amparore, Daniele; Da Pozzo, Luigi; Anceschi, Umberto; Suardi, Nazareno; Galfano, Antonio; Larcher, Alessandro; Schiavina, Riccardo; Zhang, Xu; Shariat, Shahrokh; Porpiglia, Francesco; Antonelli, Alessandro; Kaouk, Jihad; Badani, Ketan; Derweesh, Ithaar; Breda, Alberto; Mottrie, Alexander; Dell'Oglio, Paolo; Canda, Abdullah Erdem; Koç University RMK Academy of Interventional Medicine, Education, and Simulation (RMK AIMES) / Koç Universitesi RMK İleri Düzey Girişimsel Tıp, Eğitim ve Simülasyon Merkezi (RMK AIMES); School of MedicineBackground. Deterioration of renal function is associated with increased all-cause mortality. In renal masses larger than 4 cm, whether partial versus radical nephrectomy (PN vs. RN) might affect long-term functional outcomes is unknown. This study tested the association between PN versus RN and postoperative acute kidney injury (AKI), recovery of at least 90% of the preoperative estimated glomerular filtration rate (eGFR) at 1 year, upstaging of chronic kidney disease (CKD) one stage or more at 1 year, and eGFR decline of 45 ml/min/1.73 m(2) or less at 1 year. Methods. Data from 23 high-volume institutions were used. The study included only surgically treated patients with single, unilateral, localized, clinical T1b-2 renal masses. Multivariable logistic regression analyses were performed. Results. Overall, 968 PN patients and 325 RN patients were identified. The rate of AKI was lower in the PN versus the RN patients (17% vs. 58%; p < 0.001). At 1 year after surgery, for the PN versus the RN patients, the rate for recovery of at least 90% of baseline eGFR was 51% versus 16%, the rate of CKD progression of >= 1 stage was 38% versus 65%, and the rate of eGFR decline of 45 ml/min/1.73 m(2) or less was 10% versus 23% (all p < 0.001). Radical nephrectomy independently predicted AKI (odds ratio [OR], 7.61), 1-year >= 90% eGFR recovery (OR, 0.30), 1-year CKD upstaging (OR, 1.78), and 1-year eGFR decline of 45 ml/min/1.73 m(2) or less (OR, 2.36) (all p <= 0.002). Conclusions. For cT1b-2 masses, RN portends worse immediate and 1-year functional outcomes. When technically feasible and oncologically safe, efforts should be made to spare the kidney in case of large renal masses to avoid the hazard of glomerular function loss-related mortality.Publication Open Access Assessment of health-related quality of life in patients with advanced prostate cancer current state and future perspectives(Multidisciplinary Digital Publishing Institute (MDPI), 2022) Kretschmer, A.; Van Den Bergh, R.C.N., Martini, A.; Marra, G.; Valerio, M.; Tsaur, I.; Heidegger, I.; Kasivisvanathan, V.; Kesch, C.; Preisser, F.; Fankhauser, C.D.; Zattoni, F.; Ceci, F.; Olivier, J.; Chiu, P.; Puche-Sanz, I.; Thibault, C.; Gandaglia, G.; YAU Prostate Cancer Working Group; Tilki, Derya; Other; School of Medicine; Koç University HospitalWith the therapeutic landscape of advanced prostate cancer rapidly evolving and oncological benefits being shown for a plethora of new agents and indications, health-related quality of life (HRQOL)-associated evidence is still subpar. In the current comprehensive review, we discuss the importance of HRQOL for patients with advanced PC (metastatic hormone-sensitive prostate cancer (mHSPC), metastatic castration-resistant prostate cancer (mCRPC) and non-metastatic castrationresistant prostate cancer (nmCRPC)), and present the most frequently used tools to evaluate HRQOL in recent randomized trials. Furthermore, we discuss the ease of use of these validated questionnaires for clinicians and try to focus on the suggested appropriate use in clinical practice, as well as potential strategies for improvement of HRQOL evaluation in these clinical scenarios of advanced prostate cancer.Publication Metadata only Atypical ductal hyperplasia in men with gynecomastia: what is their breast cancer risk?(Springer, 2019) Coopey, Suzanne B.; Li, Clara; Yala, Adam; Barzilay, Regina; Faulkner, Heather R.; King, Tari A.; Acevedo, Francisco; Garber, Judy E.; Guidi, Anthony J.; Hughes, Kevin S.; N/A; Kartal, Kinyas; Doctor; N/A; Koç University Hospital; N/APurpose Atypical ductal hyperplasia (ADH) significantly increases the risk of breast cancer in women. However, little is known about the implications of ADH in men.Methods Review of 932 males with breast pathology was performed to identify cases of ADH. Patients were excluded if ADH was upgraded to cancer on excision, or if they had contralateral breast cancer. Cases were reviewed to determine whether any male with ADH developed breast cancer.ResultsNineteen males were diagnosed with ADH from June 2003 to September 2018. All had gynecomastia. Surgical procedure was mastectomy in 8 patients and excision/reduction in 11. One patient had their nipple areola complex removed, and 1 required a free nipple graft. Median patient age at ADH diagnosis was 25years (range 18-72years). of the 14 patients with bilateral gynecomastia, 10 had bilateral ADH and 4 had unilateral. Five cases of ADH were described as severe, bordering on ductal carcinoma in situ. No patient reported a family history of breast cancer. No patient took tamoxifen. At a mean follow-up of 75months (range 4-185months), no patient developed breast cancer.Conclusion Our study is the first to provide follow-up information for males with ADH. With 6years of mean follow-up, no male in our series has developed breast cancer. This suggests that either ADH in men does not pose the same risk as ADH in women or that surgical excision of symptomatic gynecomastia in men effectively reduces the risk of breast cancer.Publication Metadata only Automated detection and classification of oral lesions using deep learning to detect oral potentially malignant disorders(Mdpi, 2021) Soluk Tekkeşin, Merva; Ergen, Onur; Tanrıver, Gizem; Master Student; Graduate School of Sciences and Engineering; N/AOral cancer is the most common type of head and neck cancer worldwide, leading to approximately 177,757 deaths every year. When identified at early stages, oral cancers can achieve survival rates of up to 75–90%. However, the majority of the cases are diagnosed at an advanced stage mainly due to the lack of public awareness about oral cancer signs and the delays in referrals to oral cancer specialists. As early detection and treatment remain to be the most effective measures in improving oral cancer outcomes, the development of vision-based adjunctive technologies that can detect oral potentially malignant disorders (OPMDs), which carry a risk of cancer development, present significant opportunities for the oral cancer screening process. In this study, we explored the potential applications of computer vision techniques in the oral cancer domain within the scope of photographic images and investigated the prospects of an automated system for detecting OPMD. Exploiting the advancements in deep learning, a two-stage model was proposed to detect oral lesions with a detector network and classify the detected region into three categories (benign, OPMD, carcinoma) with a second-stage classifier network. Our preliminary results demonstrate the feasibility of deep learning-based approaches for the automated detection and classification of oral lesions in real time. The proposed model offers great potential as a low-cost and non-invasive tool that can support screening processes and improve detection of OPMD.Publication Open Access Autophagy and cancer dormancy(Frontiers, 2021) Akçay, Arzu; Akkoç, Yunus; Peker, Nesibe; Gözüaçık, Devrim; Faculty Member; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine; N/A; N/A; 40248Metastasis and relapse account for the great majority of cancer-related deaths. Most metastatic lesions are micro metastases that have the capacity to remain in a non-dividing state called "dormancy" for months or even years. Commonly used anticancer drugs generally target actively dividing cancer cells. Therefore, cancer cells that remain in a dormant state evade conventional therapies and contribute to cancer recurrence. Cellular and molecular mechanisms of cancer dormancy are not fully understood. Recent studies indicate that a major cellular stress response mechanism, autophagy, plays an important role in the adaptation, survival and reactivation of dormant cells. In this review article, we will summarize accumulating knowledge about cellular and molecular mechanisms of cancer dormancy, and discuss the role and importance of autophagy in this context.