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    The association of anemia and high neutrophil-lymphocyte ratio with decreased survival in patients with laryngeal cancer treated with radiotherapy
    (2023) Soykut, Ela Delikgöz; Kemal, Yasemin; Kaplan, Serkan; Karaçin, Cengiz; Odabaşı, Eylem; Unal, Asude; Er, Zehra
    Aims: We aimed to examine the prognostic value of inflammatory markers such as neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and anemia on oncological outcomes in patients with laryngeal squamous cell carcinomas (LSCC) treated with radiotherapy. Methods: 213 LSCC patients analyzed retrospectively. Inflammatory markers were established by examining blood samples taken within 7 days before treatment. Patients were categorized into two groups: low and high according to NLR, PLR, and SII threshold values. In addition, to evaluate the effect of hemoglobin (Hb) level, the threshold value of each inflammatory marker and Hb level were combined, and 3 groups were formed (3 groups for NLR, 3 groups for PLR, and 3 groups for SII). The relationship between inflammatory markers and overall survival (OS), disease-free survival (DFS), and local regional recurrence-free survival (LRRFS) was investigated. Results: In univariate analysis, high NLR, PLR, SII, and low Hb (<13 g/dl) level were associated with worse survival (all p<0.022), except for PLR and Hb for LRRFS. OS and DFS were significantly better in patients in each group A with a low inflammatory index and high Hb (all p<0.013). In the multivariate analysis, high NLR and group CNLR (high NLR with low Hb) were statistically significant predictors of decreased OS (HR 1.85, 95% CI 1.05-3.28, p=0.033; HR 2.61, 95% CI 1.14-5.97, p=0.022) and DFS (HR 1.81, 95% CI 1.11-2.96, p=0.017; HR 3.32, 95% CI 1.20-9.16, p=0.028). Conclusion: NLR may serve as a potential prognostic biomarker in LSCC, and its predictive ability is further enhanced when NLR is combined with Hb level.
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    Major and minor salivary gland cancers: A multicenter retrospective study
    (2023) Hacıoğlu, Muhammet Bekir; Erdoğan, Bülent; Bardakçı, Murat; Algın, Efnan; Gülbağcı, Burcu; Hacıbekiroğlu, İlhan; Hamdard, Jamshid; Ölmez, Ömer Fatih; Akkuş, Hadi; Öksüzoğlu, Berna; Göksu, Sema Sezgin; Dae, Shute Ailia; Sümbül, Ahmet Taner; Uğraklı, Muzaffer; Karaağaç, Mustafa; Şahin, Elif; Çabuk, Devrim; Özer, Özden; Yavuzşen, Tuğba; Arıkan, Rukiye; Köstek, Osman; Atcı, Muhammed Mustafa; Sakin, Abdullah; Deligönül, Adem; Bayır, Duygu; Dinçer, Murat; Ünsal, Oktay; Yazıcı, Ozan; Zeynelgil, Esra; Gülmez, Ahmet; Harputluoğlu, Hakan; Erol, Cihan; Şendur, Mehmet Ali Nahit; Aytekin, Aydın; Akagündüz, Baran; Öner, İrem; Er, Özlem; Öztosun, Buğra; Gümüş, Mahmut; Biricik, Fatih Selçuk; Aykan, Musa Barış; Karadurmuş, Nuri; Değerli, Ezgi; Demirci, Nebi Serkan; Türkmen, Esma; Şakalar, Teoman; Seçmeler, Şaban; Tanrıverdi, Özgür; Alkan, Ali; Kemal, Yasemin; Çil, İbrahim; Ünal, Çağlar; İriağaç, Yakup; Alan, Özkan; Ballı, Sevinç; Ürün, Yüksel; Özcan, Erkan; Turhal, Nazım Serdal; Çiçin, İrfan
    Background: Most of the studies on salivary gland cancers are limited for various reasons such as being single-center, small number of patients, including only major or minor SGCs, or only including epidemiological data. Methods: A total of 37 medical oncology clinics from different regions of Turkey participated in this retrospective-multicenter study. The analyzed data included clinical and demographical features, primary treatment, metastasis localizations, and treatments and includes certain pathologic features. Results: The study included data from a total of 443 SGCs. 56.7% was in major salivary glands and 43.3% was in minor salivary glands. Distant metastasis in the major SGCs was statistically significantly more common than in the minor SGCs, locoregional recurrence was statistically significantly more common in the minor SGCs than in the major SGCs (p = 0.003). Conclusions: Epidemiological information, metastasis and recurrence patterns, treatment modalities, and survival analysis of the patients over 20 years of follow-up are presented.
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    MANDIBULAR METASTASIS OF RENAL CELL CARCINOMA: AN UNCOMMON CASE
    (2024) Demirel, Emre; Kemal, Özgür; Kemal, Yasemin; Gün, Seda
    Among the masses seen in the oral cavity, distant metastases constitute 1% of all oral cavity neoplasms. Within this 1%, renal cell carcinoma is the third most common cancer that metastasises to the oral cavity after lung cancer and breast cancer, respectively. Although thyroid, salivary glands, skull base, sinuses, pharynx, tonsils, tongue, lips and skin metastases have been reported in the literature in order of incidence, very few renal cell carcinoma mandibular metastases have been reported in the literature in the last 25 years. A patient referred to our clinic by a dentist presented with swelling on the left side of the face and a 2x3 cm radiolucent lesion in the left mandibular corpus on orthopantomogram. The patient had previously been diagnosed with renal cell carcinoma and had received chemotherapy followed by targeted therapy for one year. After advanced radiological examinations, the pathology of the biopsy taken under general anaesthesia was reported as renal cell carcinoma. By sharing this experience with clinicians, the aim is to raise awareness that metastasis of an existing malignancy should be considered in the preliminary diagnosis of patients with known malignancies other than in the head and neck region who present with swelling in areas such as the mandible where distant metastasis is uncommon.
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    Neoadjuvant pembrolizumab plus chemotherapy in early-stage triple-negative breast cancer: a nationwide retrospective Turkish oncology group study
    (2024) Karcı, Ebru; Bilici, Ahmet; Bayram, Buket; Celayir, Melisa; Özyurt, Neslihan; Oyan Uluc, Başak; Eken, Aynur; Başaran, Gül; Demirci, Umut; Kemal, Yasemin; Oruncu, Mehmet Berk; Ölmez, Ömer Fatih; Selçukbiricik, Fatih; Korkmaz, Taner; Ertürk, İsmail; Bilgetekin, İrem; Çelik, Serkan; Türkel, Alper; Alkan, Ali; Sakin, Abdullah; Can, Orçun; Günaldı, Meral; Esin, Ece; Yıldız, Özcan
    Background/Objectives: Following the results of the phase 3 KEYNOTE-522 trial, the U.S. Food and Drug Administration approved pembrolizumab, a humanized IgG4 kappa monoclonal antibody, in combination with neoadjuvant chemotherapy as a new standard of care for high-risk early-stage triple-negative breast cancer (TNBC). This retrospective, multicenter study in Türkiye assessed the real-world efficacy and safety of neoadjuvant pembrolizumab combined with chemotherapy in early-stage TNBC. Methods: The study included 108 patients treated between 2021 and 2023 across 14 oncology centers. Three distinct neoadjuvant regimens incorporating pembrolizumab were administered at the discretion of the treating physicians. The primary outcomes were the pathological complete response (pCR) rate after neoadjuvant therapy and the 2-year event-free survival (EFS) and overall survival (OS) rates. Results: The observed pCR rate was 63.9%, closely mirroring the 64.8% reported in the KEYNOTE-522 trial. At the two-year mark, the EFS rate was 87.2% and the OS rate was 92.3%. Multivariable analysis identified pCR as the sole independent predictor of both EFS and OS. The safety profile was consistent with previous clinical trial data, with most adverse events being of grade 1-2 in severity. Conclusions: These findings provide valuable real-world confirmation of the efficacy and safety of neoadjuvant pembrolizumab-chemotherapy in early-stage TNBC, complementing evidence from randomized trials.
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    Real-world evaluation of nivolumab in patients with non-nasopharyngeal recurrent or metastatic head and neck cancer: a retrospective multi-center study by the Turkish Oncology Group (TOG)
    (2024) Akyıldız, Arif; Güven, Deniz Can; Köksal, Barış; Karaoğlan, Beliz Bahar; Kıvrak, Derya; Ismayilov, Rashad; Aslan, Fırat; Sütçüoğlu, Osman; Yazıcı, Ozan; Kadıoğlu, Ahmet; Alan, Özkan; Majidova, Nargiz; Erciyestepe, Mert; Özcan, Erkan; Akdağ, Goncagül; Taban, Hakan; Kaya, Ali Osman; Guliyev, Murad; Yıldırım, Nilgün; Sakalar, Teoman; Yazılıtaş, Doğan; Ünal, Çağlar; On, Sercan; Biter, Sedat; Demirci, Nebi Serkan; Şenler, Filiz Çay; Kemal, Yasemin; Halil, Ömer Diker; Güllü, İbrahim; Aksoy, Sercan
    Objectives: Head and neck cancers (HNCs) represent a significant global health concern due to high morbidity and mortality rates. Despite therapeutic advances, the prognosis for advanced or recurrent cases remains challenging. Nivolumab obtained approval for recurrent or metastatic HNC based on the Phase III CheckMate 141 trial. This study aimed to evaluate the real-world outcomes of nivolumab in patients with non-nasopharyngeal HNC. Design: In this multicenter retrospective study, we analyzed 124 patients with recurrent or metastatic non-nasopharyngeal HNC who received nivolumab in the second-line setting and beyond. Data were collected from 20 different cancer centers across Turkey. The effectiveness and safety of the treatment and survival outcomes were evaluated. Results: Nivolumab exhibited favorable clinical responses, yielding an objective response rate of 29.9% and a disease control rate of 55.7%. Safety assessments revealed a generally well-tolerated profile, with no instances of treatment discontinuation or mortality due to side effects. Survival analysis disclosed a median overall survival (OS) of 11.8 (95% CI 8.4-15.2) months. Multivariate analysis revealed that ECOG-PS ≥ 1 (HR: 1.64, p = 0.045), laryngeal location (HR: 0.531, p = 0.024), and neutrophil-to-lymphocyte ratio > 3.5 (HR: 1.97, p = 0.007) were independent predictors of OS. Conclusions: Nivolumab is an effective and safe treatment option for patients with recurrent or metastatic non-nasopharyngeal HNC in real-world settings. Further studies are needed on factors affecting response to treatment and survival outcomes.