GÝRÝÞ ve AMAÇ: Bu çalýþma genç mide kanseri (GC) hastalarýnýn clinicopathologic özelliklerini deðerlendirmek ve sað kalýma (OS) etki eden faktörleri araþtýrmayý amaçladý.
YÖNTEM ve GEREÇLER: Bu çalýþmada, hastane kayýtlarýnýn retrospektif olarak deðerlendirilmesi ile 40 yaþ altý taný almýþ 55 hastanýn verileri elde edilmiþtir. Bu hasta grubunun klinikopatolojik özellikleri ve bazý laboratuvar parametreleri ile bu parametrelerden elde edilen yeni inflamatuar prognostik belirteçler (IPM) deðerlendirildi.
BULGULAR: Çalýþmamýzda hastalarýn ortalama yaþý 33’tü. Erkek hastalarýn sayýsý çoðunluktaydý. Hastalar C-erbB2 pozitifliðine göre de deðerlendirildi. Pozitif olarak saptanan hastalar, tüm hastalarýn sadece %7’siydi. Hastalar ayný zamanda platin duyarlýlýðý açýsýndan da deðerlendirildi. Hastalarýn %30’unun platin tedavilerine karþý duyarlý olarak saptandý. Hastalarýn SK süreleri inflamatuar prognostik belirteçler eþliðinde de deðerlendirildi. Nötrofil-lenfosit oraný (NLR), ortalama platelet volümü/platelet sayýsý (MPV/platelet sayýsý), C-reaktif protein/albümin oranlarý (CAR) ayrý ayrý hesaplandý. Her 3 prognostik belirtecin de ortalama deðerleri baz alýnarak SK sonuçlarý incelendi. Bu deðerler ve SK arasýnda rakamsal olarak belirgin farklýlýk olmasýna raðmen istatistiksel bir anlamlýlýk saptanmadý.
TARTIÞMA ve SONUÇ: Bu çalýþma genç mide kanseri hastalarýnýn klinikopatolojik özelliklerini ve SK sürelerini incelemek için yapýlmýþtýr. Çalýþmamýz sonucunda bu hasta grubunda düþük C-erbB2 pozitiflik oraný ve yüksek platin direnci olduðu saptanmýþtýr. Ayrýca çoðu kanserde saðkalýmla iliþkili olduðu saptanan inflamatuar prognostik belirteçlerin, çalýþmamýzda da SK açýsýndan belirgin rakamsal farklýlýk oluþturduðu görülmüþtür.

INTRODUCTION: This study aimed to evaluate the clinicopathologic features of young gastric cancer (GC) patients and to investigate the factors affecting survival (OS).
METHODS: In this study, the data of 55 patients diagnosed under the age of 40 were obtained by retrospective evaluation of hospital records. Clinicopathological features and some laboratory parameters of this patient group and new inflammatory prognostic markers (IPM) obtained from these parameters were evaluated.
RESULTS: The mean age of the patients in this study was 33 years. The majority of the patients were male. Patients were evaluated according to human C-erbB2 positivity too. The identified patients as positive were only 7% of all patients. Also, the patients were evaluated for platinum sensitivity too. It was found that 30% of the patients were sensitive to platinum treatments. Also, survival times of the patients were evaluated with IPM. Neutrophil-lymphocyte ratio (NLR), mean platelet volume/platelet count, C-reactive protein/albumin ratios were calculated separately. Survival results were analyzed based on the mean values of all 3 prognostic markers. Even though there was a significant numerical difference, no statistical significance was found.
DISCUSSION AND CONCLUSION: This study was conducted to examine the clinicopathological features and survival time of young GC patients. Low C-erbB2 positivity and high platinum resistance were found among this patient population. In addition, inflammatory prognostic markers, which were found to be associated with survival in most cancers, were found to cause significant numerical differences in terms of survival in our study.

GÝRÝÞ ve AMAÇ: Bu çalýþmada patolojik tam yanýtlý (pTY) meme kanseri hastalarýnda neoadjuvan kemoterapi (NAK) sonrasý yanlýþ-pozitif MRG bulgularýný ortaya koymayý ve tümör yanýt paternleri ile insan epidermal büyüme faktörü reseptörü 2 (HER2) pozitifliði ile arasýndaki iliþkiyi deðerlendirmeyi amaçladýk.
YÖNTEM ve GEREÇLER: Bu retrospektif çok merkezli çalýþmaya, Ocak 2016 ile Eylül 2020 tarihleri arasýnda NAK alan ve pTY elde eden meme kanseri tanýlý118 hasta dahil edildi. Hastalarýn NAK öncesi ve sonrasý MRG bulgularý kayýt edildi. Tümör yanýt paternleri kategorilere ayrýldý. HER2 pozitifliði ile post-NAK MRG bulgularý ve tümör yanýt paternleri arasýndaki iliþki istatistiksel olarak analiz edildi.
BULGULAR: Post-NAK MRG bulgularý HER2+ ve HER2− gruplarý arasýnda istatistiksel olarak anlamlý farklýlýk gösterdi (p=0.02). HER2+ tümörlerinde en sýk yanlýþ-pozitif MRG bulgusu odak kontrast tutulumu iken, HER2− grubunda kitle dýþý kontrastlanma (KDK) idi. Cerrahi patolojide duktal karsinoma in situ (DKÝS) ve fibrozis varlýðý ile post-NAK MRG'de KDK anlamlý olarak iliþkili bulundu (p<0,001). Aksiller pTY, HER2+ grubunda anlamlý derecede daha yüksek elde edildi (p=0.04).
TARTIÞMA ve SONUÇ: MRG, NAK sonrasý tümör yanýtýný deðerlendirmede en güvenilir yöntem olarak kabul edilse de, yanlýþ-pozitif ve yanlýþ-negatif sonuçlar elde edilebilmektedir. Bu çalýþma, tümör yanýt paternlerinin HER2 durumuna göre farklýlýk gösterdiðini ortaya koymuþtur. Bu alanda yapýlacak yeni çalýþmalarýn tümör biyolojisini anlamaya yardýmcý olacaðý ve NAK sonrasý MRG'nin tanýsal doðruluðunu arttýrmaya yardýmcý olacaðý düþünülmektedir.

INTRODUCTION: To demonstrate false-positive MRI findings after neoadjuvant chemotherapy (NAC) in patients with pathologic complete response (pCR) and investigate the correlation between post-NAC MRI findings and tumor response patterns based on human epidermal growth factor receptor 2 (HER2) status.
METHODS: This retrospective multicenter study enrolled 118 patients with breast cancer who received NAC and achieved pCR. Tumors were evaluated with MRI pre- and post-NAC. MRI evaluation included lesion characteristics, kinetic curve analysis, background parenchymal enhancement (BPE), and post-NAC changes of MRI features. Tumor response patterns were also assessed and categorized based on MRI findings. Tumor response patterns and post-NAC MRI findings were correlated with HER2 status.
RESULTS: The residual MRI findings following NAC differed significantly between HER2+ and HER2− groups (p=0.02). The most frequent false-positive MRI finding was focus and foci in HER2+ tumors, whereas non-mass enhancement (NME) in HER2− group. The presence of ductal carcinoma in situ (DCIS) and fibrosis in surgical pathology is significantly associated with NME on post-NAC MRI (p<0.001). Axillary pCR was achieved significantly higher in the HER2+ group (p=0.04).
DISCUSSION AND CONCLUSION: Although MRI is considered the most reliable method for evaluating tumor response after NAC, over and underestimation is still possible. This study revealed that tumor response patterns and post-NAC MRI findings differ according to HER2 status. The diagnostic accuracy of post-NAC MRI is evolving by understanding the underlying mechanisms and tumor biology.

GÝRÝÞ ve AMAÇ: Azaltýlmýþ yoðunluklu hazýrlama (RIC) rejimi, yaþlý hastalarda nakille iliþkili morbidite ve mortalite oranýný azaltmak için allojenik hematopoietik kök hücre naklinde (allo-HCT) önemli faydalar göstermiþtir. Biz de bu çalýþmada 60 yaþ ve üzerindeki hematolojik malignitesi olan hastalarda allo-HSCT deneyimini ve sonuçlarýný sunmayý amaçladýk.

YÖNTEM ve GEREÇLER: 2017-2021 yýllarý arasýnda allo-HSCT uygulanan 60 yaþ ve üstü 35 hasta retrospektif olarak analiz edildi. Hastalarýn nakil anýndaki demografik ve klinik özellikleri ile nakil sonuçlarý incelendi.
BULGULAR: Ortanca yaþ 63 (60-74) ve 25'i (%77,1) erkekti. Yirmi yedi (%60) hasta AML, 20 (%20) hasta MDS tanýlýydý. Yirmi üç (%65,8) hastada orta, 6 (%17,1)’ sonda yüksek hematopoietik hücre transplantasyonu spesifik komorbidite indeks skoru vardý. 15 (%42,9) hastada Karnofsky performans durumu ≥%90 olarak saptandý. Busulfan, fludarabin ve anti-timosit globulin kombinasyonu en sýk kullanýlan RIC rejimiydi ve 18 (%51,4) hastada kullanýldý. Ortanca nötrofil ve trombosit engraftman süresi sýrasýyla 18 (11-27) ve 18 (11-33) gündü. Ortanca takip süresi 4 aydý (aralýk, 0-51), toplam saðkalým oraný %14,2. Allo-HSCT' den sonraki ilk 30 gün içinde transplanta baðlý ölüm oraný enfeksiyon ve/veya GvHD nedeniyle 10 hastada (%28,6) tespit edildi. Nakil sonrasý 25 (%71,4) hastada yanýt deðerlendirmesi yapýlabildi. Yanýt deðerlendirmesi yapýlan hastalarda PFS süresi 6 (daðýlým, 1-51) aydý. PFS oraný 12 ayda %72 idi. Son kontrolde 5 (%14,2) hasta tam yanýtla halen yaþýyordu.
TARTIÞMA ve SONUÇ: Azaltýlmýþ yoðunluklu þartlandýrma rejimi, özellikle AML ve MDS gibi hematolojik maligniteleri olan yaþlý hastalarda allo-HSCT' de önemli bir avantaj saðlamýþtýr.

INTRODUCTION: In this study, we aimed to present allogeneic hematopoietic stem cell transplantation (allo-HCT) experience in elderly patients with hematological malignancy.
METHODS: Thirty-five patients aged 60 years and older who underwent allo-HSCT between 2017 and 2021 were retrospectively analyzed. Patient's demographic/clinical features, and the outcomes of transplantation were reviewed.
RESULTS: The median age was 63 (range, 60-74) years and 25 (77,1%) were male. Twenty-seven (60%) were diagnosed with AML, followed by MDS (n: 7, 20%). Twenty-three (65,8%) patients had intermediate, and 6 (17,1%) patients had a high hematopoietic cell transplantation-specific comorbidity index score. Karnofsky performance status of ≥ 90% was detected in 15 (42,9%) patients. Busulfan plus fludarabine plus anti-thymocyte globulin was used mainly as a reduced-intensity conditioning regimen, which was used in 18 (51,4%) patients. The median duration of neutrophil and platelet engraftments were 18 (range, 11-27) and 18 (range, 11-33) days, respectively. The median follow-up time was 4 months (range, 0-51), with the OS rate %14,2. The transplant-related mortality rate within the first 30 days after allo-HSCT was detected in 10 patients (28,6%) due to infection and/or GvHD. Response assessment could be performed in 25 (71,4%) patients after transplantation. The duration of PFS was 6 (range, 1-51) months in patients with response evaluation. The rate of PFS was 72% in 1 years and 5 (14,2%) patients were still alive with complete response at the last visit.
DISCUSSION AND CONCLUSION: Reduced-intensity conditioning regimen has provided the important advantage in allo-HSCT, for elderly patients with hematological malignancies such as AML and MDS.

GÝRÝÞ ve AMAÇ: Miyelodisplastik sendrom (MDS) tanýlý hastalarda en yaygýn olarak kabul edilen prognostik sýnýflandýrma sistemlerinin doðruluðunu deðerlendirmeyi ve MDS progresyonu ile iliþkisine göre çeþitli parametreleri araþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: MDS tanýsý konan 55 hasta (Ocak 1999-Aralýk 2012) geriye dönük olarak incelendi. Demografik özellikler, komorbiditeler, laboratuvar ve patolojik sonuçlar, MDS tanýsýnda risk sýnýflamalarý (patolojik ve prognostik), tedavi özellikleri, hasta saðkalýmý ile ilgili veriler ve akut miyeloid lösemi (AML) dönüþümü incelendi.
BULGULAR: Otuz beþ erkek ve 20 kadýn hasta (ortalama yaþ: 70.95±9.80 yýl) dahil edildi. Yirmi dört (%43.46) hastada progresyon olduðu belirlendi. Sadece ECOG-PS skorunun ≥2 olmasý (OR: 6.939, %95 GA: 1.527-31.526; p=0.012) ve WPSS'ye göre 'yüksek' veya 'çok yüksek' riskli olarak sýnýflandýrmanýn (OR: 10.115, %95) GA: 2.293-44.614; p=0.002), MDS progresyonu ile baðýmsýz olarak iliþkili faktörler olduðu belirlendi.
TARTIÞMA ve SONUÇ: Çeþitli parametreler için tek deðiþkenli farklýlýklar gözlemlenmesine raðmen, MDS progresyonu baðýmsýz olarak ECOG-PS ve WPSS sýnýflandýrmasý ile iliþkilendirilmiþtir. Sýnýflandýrma sistemlerinin tek baþýna MDS progresyonunu tahmin etmede yetersiz olduðu görülmektedir.

INTRODUCTION: We aimed to assess the accuracy of the most widely-accepted prognostic classification systems in patients with myelodysplastic syndromes (MDS), and to investigate various parameters with respect to their association with MDS progression.
METHODS: Fifty-five patients diagnosed with MDS (January 1999 to December 2012) were reviewed retrospectively. Demographic characteristics, comorbidities, laboratory and pathological results, risk classifications (pathological and prognostic) at MDS diagnosis, treatment features, data regarding patient survival, and acute myeloid leukemia (AML) conversion were examined.
RESULTS: Thirty-five male and 20 female patients (mean age: 70.95±9.80 years) were included. Twenty-four (43.46%) patients were defined to have had progression. Having an ECOG-PS score of ≥2 (OR: 6.939, 95% CI: 1.527-31.526; p=0.012) and being classified as ‘high’ or ‘very high’ risk according to the WPSS (OR: 10.115, 95% CI: 2.293-44.614; p=0.002) were found to be the only factors independently associated with MDS progression.
DISCUSSION AND CONCLUSION: Although univariate differences were observed for various parameters, MDS progression was independently associated with ECOG-PS and WPSS class. It appears that singular classification systems are insufficient to predict MDS progression.

GÝRÝÞ ve AMAÇ: Mukozit, myeloablatif hazýrlama rejimiyle allojeneik kök hücre nakli yapýlan hastalarda geliþebilen önemli komplikasyonlardan biridir. Kök hücre nakil alýcýlarýnda aðrý palyasyonu saðlamak ve yaþam kalitesini artýrmak için farklý yöntemler geliþtirilmiþtir. Bu çalýþmanýn amacý, hasta kontrollü analjezi (HKA) yöntemi eþliðinde uygulanan opioid tedavisinin erken dönem nakil komplikasyonlarýyla iliþkisini araþtýrmaktýr.
YÖNTEM ve GEREÇLER: Toplam 452 hastanýn [ortanca yaþ: 35(15-67) yýl, erkek/kadýn: 285/167] verileri geriye dönük olarak incelendi.
BULGULAR: Hasta kontrollü analjezi 157 hastada (%34.7) ortanca 9(1-24) gün süreyle uygulandý. HKA+ grupta myeloablatif rejim uygulanan hasta sayýsý anlamlý yüksekti (p<0.001). HKA gereksinimi olan hastalarda aðýr mukozit geliþiminin daha sýk olduðu gözlendi (p<0.001). Tüm beden ýþýnlamasý (p<0.001) ve metotreksat kullanýmý (p<0.001) HKA+ grupta daha sýktý. Hipoksi, kanama, sinuzoidal obstrüksiyon sendromu, invaziv fungal enfeksiyonlar, nörotoksisite, hepatotoksisite ve nefrotoksisite HKA+ grupta daha sýk görüldü. Hastanede kalýþ süresi HKA+ grupta anlamlý uzun saptandý (p<0.001).
TARTIÞMA ve SONUÇ: Bu çalýþmada, myeloablatif hazýrlama rejimi uygulanan ve aðýr mukozit geliþen hastalarda daha sýk kullanýlan HKA eþliðinde opioid uygulamasýnýn erken dönem nakil komplikasyonlarýyla iliþkili olduðu gösterildi.

INTRODUCTION: Mucositis is one of the major complications of allogeneic hematopoietic stem cell transplantation with myeloablative conditioning. Several measures have been developed to improve pain palliation and quality of life in transplant recipients. This study was performed to evaluate the association of opioid administration using patient controlled analgesia (PCA) method with early posttranplant complications.
METHODS: Medical records of 452 patients [median age: 35(15-67) years, male/female: 285/167] were retrospectively reviewed.
RESULTS: PCA was used in 157 patients (34.7%) for median 9(1-24) days. The proportion of patients who received myeloablative conditioning regimen was significantly higher in PCA+ group (p<0.001). Severe mucositis was more common in patients who required PCA administration (p<0.001). Total body irradiation (p<0.001) and methotreaxate prophylaxis (p<0.001) were more frequently used in PCA+ patients. Hypoxia, bleeding, sinusoidal obstruction syndrome, invasive fungal infections, neurotoxicity, hepatotoxicity and nephrotoxicity were significantly more common in PCA+ patients. Duration of hospitalization was significantly longer in PCA+ group (p<0.001).
DISCUSSION AND CONCLUSION: Opioid administration with PCA, which was more frequently used in patients who had myeloablative conditioning and mucositis, was found to be associated with the development of early posttransplant complications.

GÝRÝÞ ve AMAÇ: Taný anýnda metastatik meme kanserinde evreleme FDG PET/BT bulgularýnýn metastaz daðýlýmlarý ve tümör histopatolojik özellikleri ile iliþkisini araþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: Meme kanseri tanýsýyla bölümümüzde evreleme FDG PET/BT görüntülemesi yapýlan 80 hasta çalýþmaya dahil edildi. Daha önce tedavi almamýþ hastalar çalýþmaya alýndý. Yaþ, primer tümörün histopatolojik özellikleri geriye dönük olarak kaydedildi. Uzak metastaz alanlarý, metastaz odak sayýlarý, aksilla-aksilla dýþý metastatik lenf nodlarýi PET/BT görüntülerinden tarandý. Standart maksimum tutulum (SUVmaks) deðerleri hesaplandý.
BULGULAR: Tüm hastalar (n: 80, ort. Yaþ 58.0±14.4) invaziv meme kanseri tanýlý idi. Hasta yaþý akciðer metastazý ile iliþkiliydi(p=0.006, ort yaþlar 54, 64). Uzak metastaz alanlarýndan sadece karaciðer metastazýnýn primer tümör SUVmaks deðeri ve tümör moleküler profili ile iliþkisi olduðu gösterildi. Karaciðer metastaz sýklýðý HR+/HER2- olan hastalarda (7/60, %11.7) diðer tümör subtipleri (9/20, %45) olanlara göre daha düþüktü. Primer tümör (p=0.001), aksilla lenf nodu(p=0.02) ve karaciðer metastaz(p=0.02) SUVmaks deðerleri ile tümör subtipleriarasýnda anlamlý iliþki gözlendi.Uzak metastaz alan sayýsý ile metastatik aksiller lenf nodu sayýsý (p=0.02) ve en yüksek uzak metastaz SUVmaks deðeri (p=0.001) arasýnda anlamlý iliþki gözlendi.
TARTIÞMA ve SONUÇ: Meme kanserinde taný anýnda metastaz varlýðýnýn doðru olarak saptanmasýnýn tedavi planý ve hastalýðýn seyri açýsýndan önemi büyüktür. FDG PET/BT uzak metastazý ve hatta daðýlýmýný belirlemede oldukça güvenilir bir modalite olup, çalýþamamýz sonunda FDG PET/BT bulgularýnýn prognostik öneme sahip faktörleri öngörebileceðini düþünmekteyiz.

INTRODUCTION: We aimed to investigate the relationship between staging FGD PET/CT findings and metastasis distribution and histopathological features of primary tumor in patients with metastatic breast cancer at diagnosis time.
METHODS: Eighty patients with breast cancer who underwent F-18 FDG PET/CT for staging were included. The patients with newly diagnosed metastatic disease were included. Age and histopathological features of the primary tumor were recorded. The distant metastases sites, the numbers of metastasis and metastatic axillary/non-axillary lymph nodes were reviewed from PET/CT. The maximum standardized uptake(SUVmax) values were measured.
RESULTS: All patients(n: 80,mean age 58.0±14.4) had invasive breast carcinoma. Age was significantly related to the presence of lung metastases(p=0.006, mean ages 54y vs 64y).Only liver metastasis had a significant relationship with primary tumor SUVmax values and tumor molecular profile. The patients with HR+/HER2- (7/60patients, 11.7%) had relatively less liver metastasis than with the other subtypes (9/20patients, 45%). There were significant associations between SUVmax of axillary lymph node(p=0.02), primary tumor(p=0.001), liver metastasis(p=0.02) and tumor subtypes. The numbers of distant metastasis were related with the numbers of axillary lymph node metastasis(p=0.02) and the highest SUVmax of distant metastasis(p=0.001).
DISCUSSION AND CONCLUSION: Accurate detection of distant metastases in breast cancer at the time of diagnosis is of great importance in terms of treatment planning and prognosis of the disease. FDG PET/CT is a very reliable modality in determining distant metastasis and their distribution, and as a result of our study, we suggest that PET/CT findings can predict factors with prognostic importance.

GÝRÝÞ ve AMAÇ: BRCA2 geni, homolog rekombinasyon ile çift sarmallý DNA hasarýnýn onarýmýnda yer alan bir tümör baskýlayýcý gendir. Þimdiye kadar, BRCA2 geninin kanserle ilgili birçok varyantý rapor edilmiþtir. Bu genin K3326X varyantýnýn kanserdeki olasý etkisine iliþkin çalýþmalarda çeliþkili yayýnlar bulunmaktadýr. Bu çalýþmada meme ve yumurtalýk kanseri tanýsý almýþ Türk hastalarýn K3326X BRCA2 gen varyantý ve kanser patogenezindeki rolü araþtýrýlmýþtýr.
YÖNTEM ve GEREÇLER: Çalýþmaya BRCA1 ve BRCA2 genetik analizi için kanser tanýsý konan 1957 hasta ve kanser öyküsü olmayan 432 saðlýklý birey dahil edildi. Bireylerden elde edilen genomik DNA örneðinden yeni nesil dizileme yöntemi kullanýlarak K3326X varyantý araþtýrýldý.
BULGULAR: 1957 kanser hastasýnýn 54'ünde (%2.75) K3326X varyantý tespit edildi. Kanserli olmayan grup için 432 hastanýn 11'i (%2,5) K3326X varyantýný taþýyordu. Her iki grup K3326X varyant taþýyýcýlýðý açýsýndan karþýlaþtýrýldýðýnda, bireyler için istatistiksel olarak anlamlý bir sonuç elde edilemedi (p=0,934).
TARTIÞMA ve SONUÇ: Çalýþmamýzda BRCA2 K3326X varyantýnýn kanser etyopatogenezine anlamlý etkisi tespit edilememiþtir. Sonuç olarak, klinik önemi henüz tam olarak anlaþýlamayan bu varyant, ilk kez Türk popülasyonu için araþtýrýlmýþtýr. Sonuçlarýmýz, varyantýn benign bir varyant olabileceðini düþündürmektedir.

INTRODUCTION: The BRCA2 gene is a tumor suppressor gene involved in the repair of double-stranded DNA damage by homologous recombination. Until now, many cancer-related variants of the BRCA2 gene have been reported. There are conflicting publications in studies of the possible effect of the K3326X variant of this gene in cancer. This study investigates the K3326X BRCA2 gene variant and its role in the cancer pathogenesis of Turkish patients diagnosed with breast and ovarian cancer.
METHODS: In the study, 1957 patients with cancer diagnosis for BRCA1 and BRCA2 genetic analysis and 432 healthy individuals without a history of cancer were included. The K3326X variant was investigated using the next-generation sequencing method from the genomic DNA sample obtained from the individuals.
RESULTS: K3326X variant was detected in 54 of 1957 (2.75%) cancer patients. For the non-cancerous group, 11 of 432 (2.5%) patients were carrying the K3326X variant. When both groups were compared in terms of K3326X variant carriage, a statistically significant result could not be obtained for the individuals (p=0.934).
DISCUSSION AND CONCLUSION: BRCA2 K3326X variant did not have a significant role in cancer etiopathogenesis. As a result, the variant whose clinical significance is not still been fully understood, was investigated for the first time for Turkish population. Our results suggest that the variant could be a benign variant.

GÝRÝÞ ve AMAÇ: Sikline baðýmlý kinaz 4/6 inhibitörlerinin endokrin terapi ile birleþtirilmesi, hormon reseptörü pozitif, HER2 negatif ilerlemiþ veya metastatik meme kanseri için birinci veya ikinci basamak tedavi olarak endikedir. Tümörleri farklý derecelerde endokrin duyarlýlýða sahip olabilecek hastalarda endokrin tedaviye CDKI'lerin eklenmesinin etkinliðini ve güvenliðini araþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: CDK4/6 inhibitörü ve hormon tedavisi alan HR+, HER2-, ABC'li toplam 99 hasta dahil edildi. Hastalarýn klinikopatolojik özellikleri ve progresyonsuz (PFS) ve genel saðkalým (OS) sonuçlarý analiz edildi. Toksisite, kombine ilaçlar ve saðkalýmý öngörebilecek faktörler de deðerlendirildi.
BULGULAR: Ortanca yaþý 51 (31-80) olan bu çalýþmada hastalarýn moleküler alt tipleri þöyleydi; 51 hasta (%51,5) lümen A grubunda, 48 hasta (%48,5) lüminal B HER2-grubunda.CDK 4/6 inhibitör tedavisi öncesi sýrasýyla 48 ve 46 hastada visseral ve visseral olmayan metastaz görüldü. Medyan 13,7 aylýk takip süresinde (daðýlým: 3-48 ay), medyan OS 38,5 aydý, medyan PFS 5.2 aydý. Tek deðiþkenli analiz, CDK 4/6 ajaný seçiminin PFS ile önemli ölçüde iliþkili olduðunu gösterdi. Ribosiklib ile 6 aylýk PFS oraný %42,3, palbosiklib ile %63,6, abemaciclib ile NA idi (p=0,01). Tek deðiþkenli analiz tümörün lüminal tipi (p=0,002), ilk taný anýndaki ileri evre hastalýk (p<0,001) ve visseral metastaz varlýðýnýn (p=0,006) OS için anlamlý faktörler olduðunu ortaya koydu.
TARTIÞMA ve SONUÇ: Bu çalýþmada, her üç ajan için de saðkalým yararý olduðunu ve özellikle birinci ve ikinci basamak kullaným arasýnda anlamlý bir fark olduðunu gösterdik.

INTRODUCTION: Combining cyclin-dependent kinases 4/6 inhibitors with endocrine therapy are indicated as first or second-line treatment for hormone receptor-positive, HER2-negative advanced or metastatic breast cancer.We aimed to investigate the efficacy and safety of adding CDKIs to endocrine therapy in patients whose tumors might have differing degrees of endocrine sensitivity.
METHODS: Totally, 99 patients with HR+, HER2-, ABC who received CDK4/6 inhibitor
and hormonotherapy were included.Clinicopathological features of patients and progression-free survival (PFS) and overall survival (OS) outcomes were analyzed.The toxicity, combine drugs and the factors that may predict survival were also evaluated.


RESULTS: This study with a median age of 51 years (range;31-80).The molecular subtypes of the patients were as follows;51 patients (51.5%) were in the luminal A group, and 48 patients (48.5%) were in the luminal B HER2- group. Before CDK 4/6 inhibitor therapy, visceral and non-visceral metastasis were seen in 48 and 46 patients, respectively.At the median follow-up time of 13.7 months (range: 3-48 months), the median OS was 38.5 months, the median PFS was 5.2 months. Univariate analysis demonstrated that the choice of CDK 4/6 agent was significantly associated with PFS. 6-months PFS rate with ribociclib was 42.3%, in palbociclib, it was 63.6%, in abemaciclib it was NA (not aplicable) (p=0.01).Univariate analysis revealed that the luminal type of tumor (p=0.002), advanced stage disease at the initial diagnosis (p<0.001), and presence of visceral metastasis (p=0.006) were significant factors for OS.
DISCUSSION AND CONCLUSION: In this study we demonstrated that there is a survival benefit for all three agents and there is a significant difference especially between first and second-line usage.

GÝRÝÞ ve AMAÇ: Meme kanserinin en sýk görülen alt tiplerinden biri olan lobüler meme kanserlerinin; taný, tedavi ve takip açýsýndan önem taþýyacak, klinik ve immünohistopatolojik özelliklerini analiz etmektir.
YÖNTEM ve GEREÇLER: Araþtýrma retrospektif olarak yapýlmýþtýr. Ocak 2019 – Aðustos 2022 tarihleri arasýnda meme kanseri tanýsý alan ve tedavisi yapýlan hastalar çalýþmaya dahil edilmiþtir.
BULGULAR: Çalýþmaya dahil edilen hastalarýn yaþlarý 28-81 (yýl) aralýðýnda olup medyan yaþ 53,04’tü. Hastalarýn 26’sý (%35,6) premenapozal iken 47’si (%64,4) postmenapozaldýr. Unilateral özellikteki hasta sayýsý 71’dir (%97.3). Bilateral invaziv lobüler karsinomlu hasta sayýsý 2’dir (%2,7). 38 hasta ile en sýk üst dýþ kadran lokalizasyonunda tümörlü hasta bulunmaktadýr (%44,3). Üst dýþ kadraný sýrasý 11 hasta alt dýþ kadran ve 8 hasta ile santral lokalizyon da tümörlü hastalar takip etmektedir (%15,1 ve %11). Hastalarýn 42’sine (%57,5) meme koruyucu cerrahi, 31’ine (%42)mastektomi uygulandý. Hastalarýn 51’ ine (%69,9) sentinal lenf nodu biyopsisi uygulandý. Aksiller diseksiyon uygulanan hasta sayýsý 22’dir (%30,1).
TARTIÞMA ve SONUÇ: Ýnvaziv lobüler karsinom histopatolojik olarak bilateral ve multisentrik özelliklere sahip olsa da cerrahi olarak invaziv lobüler karsinomlar ile benzer þekilde sadece mastektomi deðil meme koruyucu cerrahiyle de tedavi edilebilen bir hastalýktýr

INTRODUCTION: Analyze the clinical and immunohistopathological characteristics of lobular breast cancers, which are one of the more common subtypes of breast cancer among a wide range, which are important in terms of diagnosis, treatment, and monitoring.
METHODS: Our study was conducted retrospectively. Patients diagnosed with and treated for breast cancer between January 2019 and August 2022 were included in the study after obtaining the necessary ethics committee permissions.
RESULTS: Patients included in the study were between 28 and 81 years of age, and the median age was 53.04. While 26 (35.6%) of the patients were premenopausal, 47 (64.4%) were postmenopausal. The number of patients with unilateral characteristics was 71 (97.3%). The number of patients with bilateral ILC was 2 (2.7%). There were 38 patients with tumors (44.3%) in the upper outer quadrant (UOQ). Patients with tumors in the UOQ were followed by 11 patients with tumors in the lower outer quadrant (LOQ) and 8 patients in the central location (15.1% and 11%). Among the patients, 42 (57.5%) had undergone breast-conserving surgery and 31 (42%) had undergone mastectomy. Sentinel lymph node biopsy (SLNB) was performed in 51 (69.9%) of the patients.
DISCUSSION AND CONCLUSION: Although invasive lobular carcinoma has histopathologically bilateral and multicentric features, it is a disease that can be treated surgically not only with mastectomy but also with breast-conserving surgery, similar to invasive lobular carcinomas.

GÝRÝÞ ve AMAÇ: Pankreas kanseri prognozu en kötü olan kanserler arasýnda yer alýr ve bu nedenle adjuvan tedavi mortaliteyi azaltmak için çok önemlidir. Bu çalýþmanýn amacý, gerçek dünya pratiðinde pankreas kanserinin adjuvan tedavisinde altýn standart mFolfirinox rejimini diðer tedavi rejimleriyle karþýlaþtýrmaktýr.
YÖNTEM ve GEREÇLER: Pankreas kanseri rezeksiyonu yapýlan ve en az bir doz adjuvan kemoterapi alan hastalar mFolfirinox ve Diðerleri (1: 2 oranýnda) olmak üzere iki grup olarak çalýþmaya alýndý. Birincil sonlaným noktasý hastalýksýz saðkalýmdý (DFS). Ýkincil sonlaným noktalarý, genel saðkalým (OS), prediktif faktörler ve güvenlik olarak belirlendi.
BULGULAR: 5 onkoloji merkezinden 166 hastanýn verileri toplandý. Ortanca 30,3 aylýk (24,6 - 35,9) takipte, tahmini ortanca DFS, mFolfirinox grubunda 17,9 ay (%95 GA, 10,3 - 25,6) ve diðerleri grubunda 12,5 ay (%95 GA, 9,7 - 15,3) olarak saptandý (p = 0.088). Tahmini ortanca OS, mFolfirinox grubunda 30,7 ay (%95 GA, 15,7 - 45,7), diðerleri grubunda 22 aydý (%95 GA, 16 - 27,9) (p = 0,464). Daha iyi ECOG performans durumu, tümörün baþ ve ampulla dýþýnda yerleþimi, evre 1 ve 2B, adjuvan kemoradyoterapi (CRT) almama ve perinöral invazyon, mFolfirinox lehine hastalýksýz saðkalým avantajý saðladý.
TARTIÞMA ve SONUÇ: Rezeke edilmiþ pankreas kanserinin adjuvan tedavisinde, mFolfirinox rejimi istatistiksel olarak önemsiz, ancak klinik olarak anlamlý bir DFS ve OS faydasý saðladý.

INTRODUCTION: Pancreatic cancer is among the cancers with the worst prognosis and therefore adjuvant treatment is very important for reducing mortality. The aim of this study is to compare the gold standard mFolfirinox regimen with other treatment regimens in the adjuvant treatment of pancreatic cancer in real-world practice.
METHODS: Patients who underwent pancreatic cancer resection and received at least one dose of adjuvant chemotherapy were included in the study as two groups, mFolfirinox and Others (at a ratio of 1: 2). The primary endpoint was disease-free survival (DFS). Secondary endpoints were determined as overall survival (OS), predictive factors, and safety.
RESULTS: Data of 166 patients were collected from 5 oncology centers. With a median follow-up of 30.3 months (24.6 - 35.9), the estimated median DFS was detected 17.9 months (95% CI, 10.3 - 25.6) in the mFolfirinox group and 12.5 months (95% CI, 9.7 - 15.3) in the others group (p = 0.088). The estimated median OS was 30.7 months (95% CI, 15.7 - 45.7) in the mFolfirinox group and 22 months (95% CI, 16 - 27.9) in the others group (p = 0.464). Better ECOG performance status, tumor location outside the head and ampulla, stage 1 and 2B, not receiving adjuvant chemoradiotherapy (CRT), and perineural invasion provide a disease-free survival advantage in favor of mFolfirinox.
DISCUSSION AND CONCLUSION: In the adjuvant treatment of resected pancreatic cancer, the mFolfirinox regimen provided a statistically insignificant, but clinically significant DFS and OS benefit.

Tamoksifen kullanýmý uterin sarkomlar gibi jinekolojik tümörlere yol açabilir. Ancak tamoksifen kullanýmýnýn yetiþkin granüloza hücreli tümör (AGCT) etiyolojisindeki yeri kesin deðildir. Biz burada, hormon pozitif meme kanseri nedeniyle adjuvan tamoksifen tedavisi almakta olan 57 yaþýndaki bir hastada geliþmiþ olan AGCT vakasýný bildirmek istiyoruz. Hastamýz evre 1a AGCT tanýsý aldýðýnda 22 aydýr tamoksifen kullanmaktaydý. Bildiðimiz kadarýyla, tamoksifen kullanýmý altýnda geliþen AGCT’ ler ile ilgili daha önce yayýmlanmýþ 4 adet vaka bildirimi mevcuttur. Bu tip vakalarýnýn çok nadir olmasý nedeniyle AGCT geliþimini tamoksifen kullanýmý ile iliþkilendirmenin oldukça zor olduðunu söylemek isteriz.

Tamoxifen use can cause gynecologic tumors like uterine sarcomas. However, the relationship between tamoxifen use and adult granulosa cell tumors (AGCTs) is uncertain. Here we report a case of AGCT in a 57-year old patient with antecedent tamoxifen use for hormone-receptor positive breast cancer. After 22 months of tamoxifen use, the patient had diagnosed with a stage 1a granulosa tumor. To our knowledge, there are only four cases previously published about the relationship between the development of granulosa cell tumors and the use of tamoxifen. It is very difficult to say that there is a certain relationship between tamoxifen use and AGCT because of the rarity of the condition.

Adrenokortikal karsinom (AKK) nadir görülen, agresif bir tümördür. AKK’de yaygýn olarak kullanýlan mevcut tedavi seçeneklerine raðmen prognoz kötüdür. Genetik yatkýnlýk dýþýnda herhangi bir risk faktörü tanýmlanmamýþtýr. Prognozu etkileyen en önemli faktörler, taný anýndaki evre ve primer tümörün rezektabilitesidir. Bu yazýda, üç aydýr ayaklarda þiþlik, karýnda çizgilenme ve hafif karýn aðrýsý þikayetleri ile baþvuran 29 yaþýndaki kadýn hastada metastatik AKK olgusu sunulmaktadýr. Bilgisayarlý tomografide sað böbreküstü bezinde karaciðer ve sað böbrekten ayýrt edilemeyen 14 cm'lik kitle saptandý. Tedavi seçenekleri kýsýtlý olan primer AKK; ödem, obezite, stria gibi bulgularýn varlýðýnda ayýrýcý tanýda düþünülmelidir.

Adrenocortical carcinoma (ACC) is an uncommon and aggressive tumor. Despite the current treatment options commonly used in ACC, the prognosis is poor. No risk factors have been identified except for genetic predisposition. The most important factors affecting the prognosis are the stage at the time of diagnosis and the resectability of the primary tumor. Here, we present a metastatic ACC case of a 29-year-old woman presented with symptoms of swelling in her feet, abdominal striae, and mild abdominal pain for three months. The abdominal computed tomography scan revealed a 14 cm mass in the right adrenal gland, indistinguishable from the liver and right kidney. Clinicians should consider primary ACC, which has limited treatment options, in the differential diagnosis in the presence of findings such as edema, obesity, and striae.