Browsing by Author "Koyuncu, Ayhan"

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Factors affecting breast cancer treatment delay in Turkey: A study from Turkish Federation of Breast Diseases Societies
(Oxford University, 2015-02-01) Ozmen, Vahit; Boylu, Sukru; Ok, Engin; Cantürk, Nuh Zafer; Celik, Varol; Kapkac, Murat; Girgin, Sadullah; Tireli, Mustafa; Ihtiyar, Enver; Demircan, Orhan; Başkan, Mazhar Semih; Koyuncu, Ayhan; Dumanli, Esra; Ozdener, Fatih; Zaborek, Piotr; Taşdelen, Ismet; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; 0000-0001-8250-7494; EBN-1186-2022; 9637821500
Background: One of the most important factors in breast cancer (BC) mortality is treatment delay. The primary goal of this survey was to identify factors affecting the total delay time (TDT) in Turkish BC patients. Methods: A total of 1031 patients with BC were surveyed using a uniform questionnaire. The time between discovering the first symptom and signing up for the first medical visit (patient delay time; PDT) and the time between the first medical visit and the start of therapy (system delay time; SDT) were modelled separately with multilevel regression. Results: The mean PDT, SDT and TDT were 4.8, 10.5 and 13.8 weeks, respectively. In all, 42% of the patients had a TDT >12 weeks. Longer PDT was significantly correlated with disregarding symptoms and having age of between 30 and 39 years. Shorter PDT was characteristic of patients who: had stronger self-examination habits, received more support from family and friends and had at least secondary education. Predictors of longer SDT included disregard of symptoms, distrust in success of therapy and medical system and having PDT in excess of 4 weeks. Shorter SDT was linked to the age of >60 years. Patients who were diagnosed during a periodic check-up or opportunistic mammography displayed shorter SDT compared with those who had symptomatic BC and their first medical examination was by a surgeon. Conclusion: TDT in Turkey is long and remains a major problem. Delays can be reduced by increasing BC awareness, implementing organized population-based screening programmes and founding cancer centres.
Factors affecting time to seeking medical advice and start of treatment in breast cancer (BC) patients in Turkey
(Lippincott Williams & Wilkins, 2013-05-20) Özmen, Vahit; Boylu, Şükrü; Ok, Engin; Cantürk, Zafer; Çelik, Varol; Kapkac, Murat; Girgin, Sadullah; Tireli, Mustafa; İhtiyar, Enver; Demircan, Orhan; Başkan, Mazhar Semih; Koyuncu, Ayhan; Taşdelen, İsmet; Dumanlı, Esra; Özdener, Fatih; Taşdelen, İsmet; Uludağ Üniversitesi/Tıp Fakültesi.; EBN-1186-2022
Randomized trial comparing resection of primary tumor with no surgery in stage IV breast cancer at presentation: Protocol MF07-01
(Springer, 2018-10-24) Soran, Atilla; Ozmen, Vahit; Ozbas, Serdar; Karanlık, Hasan; Muslumanoglu, Mahmut; Igci, Abdullah; Canturk, Zafer; Utkan, Zafer; Ozaslan, Cihangir; Uras, Cihan; Aksaz, Erol; Soyder, Aykut; Ugurlu, Umit; Col, Cavit; Cabioglu, Neslihan; Bozkurt, Betül; Uzunkoy, Ali; Koksal, Neset; Gulluoglu, Bahadir M.; Ünal, Bülent; Atalay, Can; Yildirim, Emin; Erdem, Ergun; Salimoglu, Semra; Sezer, Atakan; Koyuncu, Ayhan; Gurleyik, Gunay; Alagol, Haluk; Ulufi, Nalan; Berberoglu, Ugur; Dulger, Mustafa; Cengiz, Omer; Sezgin, Efe; Johnson, Ronald; Evrensel, Türkkan; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; 0000-0002-9732-5340; AAJ-1027-2021; 6603942124
The MF07-01 trial is a multicenter, phase III, randomized, controlled study comparing locoregional treatment (LRT) followed by systemic therapy (ST) with ST alone for treatment-na < ve stage IV breast cancer (BC) patients. At initial diagnosis, patients were randomized 1:1 to either the LRT or ST group. All the patients were given ST either immediately after randomization or after surgical resection of the intact primary tumor. The trial enrolled 274 patients: 138 in the LRT group and 136 in the ST group. Hazard of death was 34% lower in the LRT group than in the ST group (hazard ratio [HR], 0.66; 95% confidence interval [CI], 0.49-0.88; p = 0.005). Unplanned subgroup analyses showed that the risk of death was statistically lower in the LRT group than in the ST group with respect to estrogen receptor (ER)/progesterone receptor (PR)(+) (HR 0.64; 95% CI 0.46-0.91; p = 0.01), human epidermal growth factor 2 (HER2)/neu(-) (HR 0.64; 95% CI 0.45-0.91; p = 0.01), patients younger than 55 years (HR 0.57; 95% CI 0.38-0.86; p = 0.007), and patients with solitary bone-only metastases (HR 0.47; 95% CI 0.23-0.98; p = 0.04). In the current trial, improvement in 36-month survival was not observed with upfront surgery for stage IV breast cancer patients. However, a longer follow-up study (median, 40 months) showed statistically significant improvement in median survival. When locoregional treatment in de novo stage IV BC is discussed with the patient as an option, practitioners must consider age, performance status, comorbidities, tumor type, and metastatic disease burden.
Validation of breast cancer nomograms for predicting the non-sentinel lymph node metastases after a positive sentinel lymph node biopsy in a multi-center study
(Elsevier, 2010-01) Gür, Serhat; Ünal, Bülent; Özbek, Umut; Özmen, Vahit; Aydoğan, Fatih; Güllüoğlu, Bahadır Mahmut; Aksaz, Erol; Özbaş, Serdar Mustafa; Başkan, Semih; Koyuncu, Ayhan; Soran, Atilla; Gökgöz, Şehsuvar; Uludağ Üniversitesi/Tıp Fakültesi/Genel Cerrahi Anabilim Dalı.; 6603238737
Objective: In the study, our aim was to evaluate the predictability of four different nomograms on non-sentinel lymph node metastases (NSLNM) in breast cancer (BC) patients with positive sentinel lymph node (SLN) biopsy in a multi-center study. Methods: We identified 607 patients who had a positive SLN biopsy and completion axillary lymph node dissection (CALND) at seven different BC treatment centers in Turkey. The BC nomograms developed by the Memorial Sloan Kettering Cancer Center (MSKCC), Tenon Hospital, Cambridge University, and Stanford University were used to calculate the probability of NSLNM. Area under (AUC) Receiver Operating Characteristics Curve (ROC) was calculated for each nomogram and values greater than 0.70 were accepted as demonstrating good discrimination. Results: Two hundred and eighty-seven patients (287) of 607 patients (47.2%) had a positive axillary NSLNM. The AUC values were 0.705, 0.711, 0.730, and 0.582 for the MSKCC, Cambridge, Stanford, and Tenon models, respectively. On the multivariate analysis; overall metastasis size (OMS), lymphovascular invasion (LVI), and proportion of positive SLN to total SLN were found statistically significant. We created a formula to predict the NSLNM in our patient population and the AUC value of this formula was 0.8023. Conclusions: The MSKCC, Cambridge, and Stanford nomograms were good discriminators of NSLNM in SLN positive BC patients in this study. A newly created formula in this Study needs to be validated in prospective studies in different patient populations. A nomogram to predict NSLNM in patients with positive SLN biopsy developed at one institution should be used with caution.
Validation of breast cancer nomograms for predicting the non-sentinel lymph node metastases after a positive sentinel lymph node biopsy in a multi-center study (vol 36, pg 30, 2010)
(Elsevier, 2011-05) Gür, Serhat; Ünal, Bülent; Özbek, Umut; Özmen, Vahit; Aydoǧan, Fatih; Güllüoǧlü, Bahadır Mahmut; Aksaz, Erol; Özbaş, Serdar Mustafa; Başkan, Semih; Koyuncu, Ayhan; Soran, Atilla; Gökgöz, Şehsuvar; Uludağ Üniversitesi/Tıp Fakültesi/Genel Cerrahi Anabilim Dalı.; 6603238737