Screening Colonoscopy Participation in Turkish Colorectal Cancer Patients and their First Degree Relatives

Kilickap, Saadettin,Arslan, Cagatay,Rama, Dorina,Yalcin, Suayib Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.6

Background: This study aimed to research the awareness of screening colonoscopy (SC) among patients with colorectal cancer (CRC) and their relatives. Methodology: A questionnaire form including information and behavior about colonoscopic screening for CRCs of patients and their first-degree relatives (FDRs) was prepared. Results: A total of 406 CRC patients were enrolled into the study, with 1534 FDRs (siblings n: 1381 and parents n: 153). Positive family history for CRC was found in 12% of the study population. Previous SC was performed in 11% of patients with CRC. Mean age of the patients whose FDRs underwent SC was lower than the patients whose FDRs did not (52 vs 57 years; p<0,001). The frequency of SC in FDRs was 64% in patients diagnosed CRC under 35 years of age. Persons having a positive family history of CRC had SC more often (51 vs 22%, p<0,001). FDRs of patients having a higher educational level and income had SC more frequently. Conclusions: When screening for CRC is planned, elderly subjects, those with family history for CRC, and those with low educational and lower income should be given esspecial attention in order that they be convinced to undergo screening for CRC.

Higher Ki67 Expression is Associates With Unfavorable Prognostic Factors and Shorter Survival in Breast Cancer

Kilickap, Saadettin,Kaya, Yalcin,Yucel, Birsen,Tuncer, Ersin,Babacan, Nalan Akgul,Elagoz, Sahande Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.3

Background: The prognostic value of the Ki67 expression level is yet unclear in breast cancer. The aim of this study was to investigate the association between Ki67 expression levels and prognostic factors such as grade, Her2 and hormone receptor expression status in breast cancers. Materials and Methods: Clinical and pathological features of the patients with breast cancer were retreived from the hospital records. Results: In this study, 163 patients with breast cancer were analyzed, with a mean age of $53.4{\pm}12.2$ years. Median Ki67 positivity was 20% and Ki67-high tumors were significantly associated with high grade (p<0.001), lymphovascular invasion (p=0.001), estrogen receptor (ER) negativity (p=0.035), Her2 positivity (p=0.001), advanced stage (p<0.001) and lymph node positivity (p<0.003). Lower Ki67 levels were significantly associated with longer median relapse-free and overall survival compared to those of higher Ki67 levels. Conclusions: High Ki67 expression is associated with ER negativity, Her2 positivity, higher grade and axillary lymph node involvement in breast cancers. The level of Ki67 expression is a prognostic factor predicting relapse-free and overall survival in breast cancer patients.

Smoking Habits of Relatives of Patients with Cancer: Cancer Diagnosis in the Family is an Important Teachable Moment for Smoking Cessation

Hayran, Mutlu,Kilickap, Saadettin,Elkiran, Tamer,Akbulut, Hakan,Abali, Huseyin,Yuce, Deniz,Kilic, Diclehan,Turhal, Serdar Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.1

Background: In this study we aimed to determine the rate and habitual patterns of smoking, intentions of cessation, dependence levels and sociodemographic characteristics of relatives of patients with a diagnosis of cancer. Materials and Methods: This study was designed by the Turkish Oncology Group, Epidemiology and Prevention Subgroup. The relatives of cancer patients were asked to fill a questionnaire and Fagerstrom test of nicotine dependence. Results: The median ages of those with lower and higher Fagerstrom scores were 40 years and 42 years, respectively. We found no evidence of variation between the two groups for the remaining sociodemographic variables, including the subject's medical status, gender, living in the same house with the patient, their educational status, their family income, closeness to their cancer patients or spending time with them or getting any help or wanting to get some help. Only 2% of the subjects started smoking after cancer was diagnosed in their loved ones and almost 20% of subjects had quit smoking during the previous year. Conclusions: The Fagerstrom score is helpful in determining who would be the most likely to benefit from a cigarette smoking cessation program. Identification of these people with proper screening methods might help us to pinpoint who would benefit most from these programs.

Serum Levels of Alpha-Tocopherol, Vitamin C, Beta-Carotene, and Retinol in Malignant Pleural Mesothelioma

Emri, Salih,Kilickap, Saadettin,Kadilar, Cem,Halil, Meltem Gulhan,Akay, Hadi,Besler, Tanju Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.7

The aim of this study was to investigate the possible relationship between antioxidant vitamin levels and malignant pleural mesothelioma (MPM). For this purpose, we measured the serum levels of 4 antioxidant vitamins, ${\beta}$-carotene, ${\alpha}$-tocopherol, retinol, and ascorbic acid, in patients with environmentally induced MPM and in healthy controls from one tremolite village (Kureysler), the biggest erionite village (Tuzkoy) and Ankara. A total of 160 subjects were enrolled in the study, 42 (26.3%) diagnosed with MPM and 118 (73.7%) healthy subjects. A comparison was made between the MPM group and three control groups of which two were exposed and one was unexposed to mineral fibers. The study population consisted of 82 males (51%) and 78 females (49%) with a mean of age of $44.8{\pm}14$ years (range; 20-65 years). Lowest levels of ${\beta}$-carotene, ascorbic acid, and ${\alpha}$-tocopherol were found in MPM patients (MPM vs control groups combined, p<0.0001 for each antioxidant vitamin), without any relation to age or sex. There was no significant difference between the antioxidant levels of healthy controls of Tuzkoy and Ankara. In conclusion; our findings suggested an increased risk of MPM being associated with low levels of ${\alpha}$-tocopherol and ascorbic acid in patients with MPM.

Bone Metastasis from Gastric Cancer: The Incidence, Clinicopathological Features, and Influence on Survival

Fatma Paksoy Turkoz,Mustafa Solak,Saadettin Kilickap,Arife Ulas,Onur Esbah,Berna Oksuzoglu,Suayib Yalcin 대한위암학회 2014 Journal of gastric cancer Vol.14 No.3

Purpose: To evaluate the incidence, clinicopathological characteristics, treatment outcomes, prognostic factors, and survival of gastriccancer patients with bone metastases. Materials and Methods: Of 4,617 gastric cancer patients who were treated between 2001 and 2013, 176 patients with bone metastaseswere analyzed. Results: The incidence of bone metastasis was 3.8%. The most common histopathological subtype was adenocarcinoma (79%) withpoor differentiation (60.8%). The median interval from the diagnosis to bone metastasis was 11 months. The median survival time afterbone metastasis was 5.4 months. Factors that were associated with longer median survival times included the following: isolated bonemetastasis (P=0.004), well-differentiated tumors (P=0.002), palliative chemotherapy (P=0.003), zoledronic acid treatment (P<0.001),no smoking history (P=0.007), and no metastatic gastric cancer at the time of diagnosis (P=0.01). On the other hand, high levels oflactate dehydrogenase (LDH) (hazard ratio [HR]: 1.86; P=0.015), carcinoembryonic antigen (CEA) (HR: 2.04; P=0.002), and carbohydrateantigen (CA) 19-9 (HR: 2.94; P<0.001) were associated with shorter survival times. In multivariate analysis, receiving zoledronicacid (P<0.001) and performance status (P=0.013) were independent prognostic factors. Conclusions: Smoking history, poor performance status, poorly differentiated adenocarcinoma, and high levels of LDH, CEA, and CA19-9 were shown to be poor prognostic factors, while receiving chemotherapy and zoledronic acid were associated with prolonged survivalin gastric cancer patients with bone metastases.

Lack of Association between the MTHFR C677T Polymorphism and Lung Cancer in a Turkish Population

Yilmaz, Meral,Kacan, Turgut,Sari, Ismail,Kilickap, Saadettin Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.15

Background: In this case-control study, we aimed to investigate the relationship between the methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism and lung cancer. Materials and Methods: Total 200 individuals including 100 patients with lung cancer and 100 controls were analyzed. Genotyping of MTHFR C677T was performed using PCR and RFLP methods. Results: The majority of the patients were men and 90% were smokers. We found that the risk ratio for development of LC was 13-times higher in smokers compared with non-smokers between patient and control groups in our study (OR:13.5, 95%CI:6.27-29.04, p:0.0001). Besides, the risk ratio for development of LC was nine times higher in individuals with cancer history in their family than those without cancer history (OR:9.65, 95%CI: 2.79-33.36; p:0.0001). When genotype distributions and allele frequencies were analyzed in the study groups, no significant difference was apparent (${\chi}^2$:0.53, p=0.76). In addition, no correlation between genotypes of MTHFRC677T polymorphism and histological type of LC was found (${\chi}^2$:0.99, p=0.60). Conclusions: These results suggest that there was no association between the MTHFR C677T polymorphism and lung cancer in the Turkish population.

Evaluation of Quality of Life in Turkish Patients with Head and Neck Cancer

Akkas, Ebru Atasever,Yucel, Birsen,Kilickap, Saadettin,Altuntas, Emine Elif Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.8

Background: In this study, our aim was to investigate the effect of factors, such as radiotherapy, the dose of radiotherapy, the region of radiotherapy, the age of the patient, performance, co-morbidity, the stage of the disease and the therapy modalities on the quality of life of patients with head and neck cancer. Materials and Methods: Eighty-two patients who were treated by either chemoradiotherapy or radiotherapy, at the Cumhuriyet University Faculty of Medicine, Department of Radiation Oncology, between February 2007 and September 2010, for head and neck cancer were included. The quality of life European Organisation for Research and Treatment of Cancer, Questionnaire module to be used in Quality of Life assessments in Head and Neck Cancer (EORTC QLQ-H&N35) questionnaire was conducted in all patients before starting the radiotherapy, in the middle, at the end, at 1 month and at 6 months after the treatment. Results: According to the questionnaires at the end and at the $6^{th}$ month after the radiotherapy, it was found that the age of the patient, co-morbidity, ECOG performance state, localization, type of treatment, the stage of the disease, the dose and the region of radiotherapy affect some of the symptom scales for quality of life. Conclusions: Quality of life was affected negatively during and after the radiotherapy. However, in the $6^{th}$ month after the therapy, a significant improvement was observed in most symptoms.

Bone Metastasis from Gastric Cancer: The Incidence, Clinicopathological Features, and Influence on Survival

Turkoz, Fatma Paksoy,Solak, Mustafa,Kilickap, Saadettin,Ulas, Arife,Esbah, Onur,Oksuzoglu, Berna,Yalcin, Suayib The Korean Gastric Cancer Association 2014 Journal of gastric cancer Vol.14 No.3

Purpose: To evaluate the incidence, clinicopathological characteristics, treatment outcomes, prognostic factors, and survival of gastric cancer patients with bone metastases. Materials and Methods: Of 4,617 gastric cancer patients who were treated between 2001 and 2013, 176 patients with bone metastases were analyzed. Results: The incidence of bone metastasis was 3.8%. The most common histopathological subtype was adenocarcinoma (79%) with poor differentiation (60.8%). The median interval from the diagnosis to bone metastasis was 11 months. The median survival time after bone metastasis was 5.4 months. Factors that were associated with longer median survival times included the following: isolated bone metastasis (P=0.004), well-differentiated tumors (P=0.002), palliative chemotherapy (P=0.003), zoledronic acid treatment (P<0.001), no smoking history (P=0.007), and no metastatic gastric cancer at the time of diagnosis (P=0.01). On the other hand, high levels of lactate dehydrogenase (LDH) (hazard ratio [HR]: 1.86; P=0.015), carcinoembryonic antigen (CEA) (HR: 2.04; P=0.002), and carbohydrate antigen (CA) 19-9 (HR: 2.94; P<0.001) were associated with shorter survival times. In multivariate analysis, receiving zoledronic acid (P<0.001) and performance status (P=0.013) were independent prognostic factors. Conclusions: Smoking history, poor performance status, poorly differentiated adenocarcinoma, and high levels of LDH, CEA, and CA 19-9 were shown to be poor prognostic factors, while receiving chemotherapy and zoledronic acid were associated with prolonged survival in gastric cancer patients with bone metastases.

Lung Cancer in Women: A Single Institution Experience with 50 Patients

Babacan, Nalan Akgul,Yucel, Birsen,Kilickap, Saadettin,Seker, Mehmet Metin,Kacan, Turgut,Olcas, Ilknur Koc,Eren, Ayfer Ay,Odabas, Hatice Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.1

Background: Lung cancer is the most common cause of cancer-related death worldwide. The incidence of lung cancer is aproximately 7-8 thousand percent in Turkish women. In this study, we aimed to evaluate the clinical, pathological properties and survival data of female patients with lung cancer who were treated in our center. Materials and Methods: From 2007 to 2012, 50 women with lung cancer were enrolled. Patient data were evaluated retrospectively. Results: The median age was 61 (40-81). Forty patients (80%) were diagnosed with non small cell lung cancer (NSCLC), 10 patients (20%) were small cell carcinoma (SCC). Twelve (24%) patients were smokers and 13 of 16 non-smokers had a history of exposure to asbestos. The most common histologic subtype was adenocarcinoma (46%) and this accounted for 71% in patients with exposure to asbestos. The most common initial Eastern Cooperative Oncology Group (ECOG) performance score was 1 (24 patients, 48%) and initial stage was IV (25 patients, 50%) in the study group. During the median 15 months (1-96 months) followup period: 1 year overall survival (OS) was 68%, 2year overall survival was 36% and the median survival time was 19 months. According to univariate analysis, poor ECOG performance status, advanced stage, anemia and weight loss at time of diagnosis were negative prognostic factors. However, adenocarcinoma sub-type was a positive prognostic factor. Conclusions: In this study NSCLC sub-type, poor ECOG performance score, advanced stage, anemia and weight loss were prognostic factors in Turkish women with lung cancer.

Clinical Characteristics, Treatment and Survival Outcomes in Malignant Mesothelioma: Eighteen Years' Experience in Turkey

Berk, Serdar,Dogan, Omer Tamer,Kilickap, Saadettin,Epozturk, Kursat,Akkurt, Ibrahim,Seyfikli, Zehra Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.11

Background: Malignant mesothelioma (MM) is an insidious tumor with poor prognosis, arising from mesothelial surfaces such as pleura, peritoneum and pericardium. We here aimed to evaluate the demographic, clinical, and radiological features of patients with MM followed in our center as well as their survival. Methods: The study included 228 patients (131 male, 97 female) who were followed up in our institution between 1993 and 2010 with the diagnosis of MM. Results: The mean age was 59.1 years in men and 58.7 years in women and the sex ratio was 1.4:1 in favor of males. Environmental asbestos exposure was present in 86% of the patients for a mean duration of $40{\pm}20$ years (range: 3-70). Pleural effusion and thoracic/abdominal pain were the most common presenting signs and symptoms (70.2% and 57.8%, respectively). One hundred-thirteen (66%) patients were treated with platinum-based combination chemotherapy (PBCT) plus supportive care (SC) and 67 (34%) patients received SC alone. The median follow-up time was 10.0 months. The median overall survival was significantly improved with PBCT plus SC compared to SC alone (11.4 vs. 5.1 months; p=0.005). The 6, 12, 18, and 24-month survival rates were significantly improved with PBCT plus SC compared to SC alone (72%, 43%, 19%, and 2% vs. 49%, 31%, 11%, and 1%). Conclusion: The survival of patients with MM improved in patients treated with PBCT. The survival advantage continued 12- and 24-month after the initial time of combination chemotherapy.