Person: YUMUK, PERRAN FULDEN
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YUMUK
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PERRAN FULDEN
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Publication Open Access Newly diagnosed breast cancer in a patient receiving imatinib mesylate(2014) YUMUK, PERRAN FULDEN; Toptas, Tayfur; Yumuk, Fulden; Firatli-Tuglular, Tulin; Bayik, Mahmut; Kaygusuz-Atagunduz, IsikPublication Open Access Adoption of pleurectomy and decortication for malignant mesothelioma leads to similar survival as extrapleural pneumonectomy(MOSBY-ELSEVIER, 2016-02) YILDIZELİ, BEDRETTİN; Batirel, Hasan Fevzi; Metintas, Muzaffer; Caglar, Hale Basak; Ak, Guntulu; Yumuk, Perran Fulden; Yildizeli, Bedrettin; Yuksel, MustafaObjective: We changed our surgical approach to malignant pleural mesothelioma (MPM) in August 2011 and adopted pleurectomy and decortication (PD) instead of extrapleural pneumonectomy (EPP). In this study, we analyzed our perioperative and survival results during the 2 periods. Methods: All patients who underwent surgical intervention for MPM during 2003-2014 were included. Data were retrospectively analyzed from a prospective database. Before August 2011, patients underwent evaluation for EPP and adjuvant chemoradiation (group 1). After August 2011, patients were evaluated for PD and adjuvant chemotherapy and/or radiation (group 2). Demographic characteristics, surgical technique, histology, side, completeness of resection, and types of treatments were recorded. Statistics was performed using Student t test, chi(2) tests, uni- and multivariate regression, and Kaplan-Meier survival analysis. Results: The same surgical team operated on 130 patients. Median age was 55.7 years (range, 26-80 years) and 76 were men. EPP and extended PD was performed in 72 patients. Ninety-day mortality was 10%. Median survival was 17.8 months with a 5-year survival rate of 14%. Uni- and multivariate analyses showed that epithelioid histology, stage N0, and trimodality treatment were associated with better survival (P=.039, P=.012, and P<.001, respectively). Demographic variables and overall survival (15.6 vs 19.6 months, respectively) were similar between the groups, whereas nonepithelioid histology, use of preoperative chemotherapy, and incomplete resections were more frequent in group 2 (P<.001, P<.001, and P=.006, respectively). Follow-up was shorter in group 2 (22.5 +/- 20.6 vs 16.4 +/- 10.9 months; P<.001). Conclusions: Adoption of PD as the main surgical approach is not associated with survival disadvantage in the surgical treatment of MPM.Publication Metadata only Effect of PET/CT standardized uptake values on complete response to treatment before definitive chemoradiotherapy in stage III non-small cell lung cancer(SPRINGER INTERNATIONAL PUBLISHING AG, 2019) DANE, FAYSAL; Ercelep, O.; Alan, O.; Sahin, D.; Telli, T. A.; Salva, H.; Tuylu, T. B.; Babacan, N. A.; Kaya, S.; Dane, F.; Ones, T.; Alkis, H.; Adli, M.; Yumuk, F.PurposeThe standard treatment for patients with stage III non-small cell lung cancer (NSCLC), unsuitable for resection and with good performance, is definitive radiotherapy with cisplatin-based chemotherapy. Our aim is to evaluate the effect of the maximum value of standardized uptake values (SUVmax) of the primary tumor in positron emission tomography-computed tomography (PET/CT) before treatment on complete response (CR) and overall survival.MethodsThe data of 73 stage III NSCLC patients treated with concurrent definitive chemoradiotherapy (CRT) between 2008 and 2017 and had PET/CT staging in the pretreatment period were evaluated. ROC curve analysis was performed to determine the ideal cut-off value of pretreatment SUVmax to predict CR.ResultsMedian age was 58years (range 27-83years) and 66 patients were male (90.4%). Median follow-up time was 18months (range 3-98months); median survival was 23months. 1-year overall survival (OS) rate and 5-year OS rate were 72 and 19%, respectively. Median progression-free survival (PFS) was 9months; 1-year PFS rate and 5-year PFS rate were 38 and 19%, respectively. The ideal cut-off value of pretreatment SUVmax that predicted the complete response of CRT was 12 in the ROC analysis [AUC 0.699 (0.550-0.833)/P<0.01] with a sensitivity of 83%, and specificity of 55%. In patients with SUVmax<12, CR rate was 60%, while, in patients with SUV12, it was only 19% (P=0.002). Median OS was 26months in patients with pretreatment SUVmax<12, and 21months in patients with SUVmax12 (HR=2.93; 95% CI 17.24-28.75; P=0.087). CR rate of the whole patient population was 26%, and it was the only factor that showed a significant benefit on survival in both univariate and multivariate analyses.ConclusionPretreatment SUVmax of the primary tumor in PET/CT may predict CR in stage III NSCLC patients who were treated with definitive CRT. Having clinical CR is the only positive predictive factor for prolonged survival.Publication Metadata only Weight gain after adjuvant chemotherapy in patients with early breast cancer in Istanbul Turkey(HUMANA PRESS INC, 2011) DANE, FAYSAL; Basaran, Gul; Turhal, Nazim Serdar; Cabuk, Devrim; Yurt, Nevin; Yurtseven, Gul; Gumus, Mahmut; Teomete, Mehmet; Dane, Faysal; Yumuk, Perran FuldenWeight gain is a well-known and unwanted complication of adjuvant chemotherapy in breast cancer. We observed that the female Turkish cancer patients frequently gain weight with adjuvant treatment of breast cancer and planned to examine the magnitude of this problem in early breast cancer patients treated at our hospital. A total of 176 early breast cancer patients who received their adjuvant systemic therapy in Marmara University Hospital between 2003 and 2007 are included in the study. We recorded their weight before and after chemotherapy and also a year after chemotherapy to find out whether the change with weight is transitory. We have also recorded demographic information, including the educational level, menopausal status, the type of chemotherapy or hormonal treatment administered stage of disease, marital status, occupation and the underlying diseases to analyze the relationship between change in weight and these parameters. Median age of patients was 53 and 72% of patients were postmenopausal. Educational level was equally distributed for primary education (27%), high school (40%), and university (33%). The majority of the patients (76%) was married, had two children (69%) and was housewife (60%). Family history of any cancer was high (32%). Most of the patients had stage II cancer (56%), received anthracyclines+/- taxane based chemotherapy (98%) and had no underlying disease (68%). The majority also did not smoke (73%) or drink alcohol (93%). A total of 67% and 72% patients gained weight upon completion and one year after completion of chemotherapy. Mean weight before the chemotherapy, upon completion of chemotherapy and one year after completion of chemotherapy were 68.9 kg, 70.6 kg (P = 0.000) and 71.9 kg (P = 0.000) respectively. Mean body mass index was 27.1 at baseline, 27.8 upon completion of chemotherapy (P = 0.000) and 28.3 one year after completion of chemotherapy (P = 0.000). Age, menopausal status, multiparity and presence of comorbid diseases had statistically significant impact on weight gain following adjuvant therapy in breast cancer patients (P = 0.000, P = 0.008, P = 0.015 and P = 0.017 respectively). This study shows that Turkish women with early breast cancer gain weight after adjuvant systemic therapy, in line with European and American counterparts. This increase in weight is maintained at least one year after adjuvant therapy. Given the adverse consequences of weight gain in terms of both breast cancer prognosis and general health, it is necessary to inform patients about this change and to develop strategies for weight maintenance during and after systemic therapy.Publication Open Access Is Laboratory Prognostic Index a Valuable Prognostic Index for Malignant Pleural Mesothelioma?(ELSEVIER SCIENCE INC, 2019-10) BOZKURTLAR, EMİNE; Tuylu, T. Basoglu; Demircan, N. C.; Arikan, R.; Telli, T. Akin; Alan, O.; Ercelep, O.; Bozkurtlar, E.; Kocakaya, D.; Kaya, S.; Babacan, N.; Lacin, T.; Dane, F.; Ahiskali, R.; Batirel, H.; Yumuk, P. F.Publication Open Access Chordoma: a case series and review of the literature(2018-12) YUMUK, PERRAN FULDEN; Alan, Ozkan; Akin Telli, Tugba; Ercelep, Ozlem; Tanrikulu Simsek, Eda; Basoglu Tuylu, Tugba; Mutis, Aydan; Hasanov, Rahib; Kaya, Serap; Akgül Babacan, Nalan; Dane, Faysal; Yumuk, Perran FuldenPublication Metadata only Efficacy of protracted dose-dense temozolomide in patients with recurrent high-grade glioma(SPRINGER, 2011) ATASOY, BESTE MELEK; Abacioglu, Ufuk; Caglar, Hale B.; Yumuk, Perran F.; Akgun, Zuleyha; Atasoy, Beste M.; Sengoz, MericThe current standard therapy for newly diagnosed glioblastoma is multimodal, comprising surgical resection plus radiotherapy and concurrent temozolomide, then adjuvant temozolomide for 6 months. This has been shown to provide survival benefits; however, the prognosis for these patients remains poor, and most relapse. The objective of this prospective Phase II study was to evaluate the efficacy and tolerability of protracted, dose-dense temozolomide therapy (100 mg/m(2) for 21 consecutive days of a 28-day cycle) in patients with recurrent glioblastoma or grade 3 gliomas who had previously received standard therapy. Of the 25 patients included (median age 50 years), 20 were evaluable for radiologic response. Two patients had partial responses and 10 had stable disease (60% overall clinical benefit); 8 patients (40%) progressed after the first treatment cycle. Five patients were not assessed for radiologic response due to early clinical progression but were included in the progression-free survival (PFS) and overall survival (OS) analyses. The median follow-up time was 7 months (range, 1-14 months). The median PFS was 3 months (95% confidence interval, CI, 1.8-4.2) and the median OS was 7 months (95% CI 5.1-8.9). The 6-month PFS rate (primary endpoint) was 17.3% (95% CI 1.7-32.2) and the 1-year OS rate was 12% (95% CI -1-25). This regimen was well tolerated. The most frequent adverse event was lymphopenia (grade 3-4 in 20 patients); no opportunistic infections were reported. Treatment was discontinued due to toxicity in 2 patients (grade 4 hepatic toxicity and thrombocytopenia). These data suggest that protracted, dose-dense temozolomide had modest activity with manageable toxicity in patients with recurrent high-grade glioma previously treated with temozolomide.Publication Open Access 5-Flourouracil-Induced Encephalopathy in Parkinson's Disease(AKAD DOKTORLAR YAYINEVI, 2012-03-31) DANE, FAYSAL; Korkmaz, Taner; Seber, Selcuk; Basaran, Gul; Yumuk, P. Fulden; Dane, Faysal; Kocar, Muharrem; Telli, Ferhat; Turhal, N. SerdarA 59 year-old male with Parkinson's disease developed encephalopathy during adjuvant treatment of rectal cancer. Acute neurotoxicity related to high dose 5-Flourouracil infusion is well described, but encephalopathy with low dose bolus 5-Flourouracil is rare. The advanced Parkinson's disease patients may be more prone to hyperammonemia associated encephalopathy caused by 5-Flourouracil. The prompt recognition of the symptoms is key to diagnosis and treatment.Publication Metadata only CECOG experts' recommendations on the use of denosumab in the prevention of skeletal-related events in bone metastases of lung cancer(2013) YUMUK, PERRAN FULDEN; Hilbe W., Abacioglu U., Aebersold D.M., Bachouchi M., Brodowicz T., Gaafar R., Holzer G., Mohn-Staudner A., Kalev D., Kalinka-Warzocha E., Kovac V., Siano M., Yumuk F., Tamasi L.Purpose: Skeletal-related events represent a substantial burden for patients with advanced cancer. Randomized, controlled studies suggested superiority of denosumab over zoledronic acid in the prevention of skeletal-related events in metastatic cancer patients, with a favorable safety profile. Experts gathered at the 2012 Skeletal Care Academy in Istanbul to bring forward practical recommendations, based on current evidence, for the use of denosumab in patients with bone metastases of lung cancer. Recommendations: Based on current evidence, use of denosumab in lung cancer patients with confirmed bone metastases is recommended. It is important to note that clinical judgment should take into consideration the patient's general performance status, overall prognosis, and live expectancy. Currently, the adverse event profile reported for denosumab includes hypocalcemia and infrequent occurrence of osteonecrosis of the jaw. Therefore, routine calcium and vitamin D supplementation, along with dental examination prior to denosumab initiation are recommended. There is no evidence for renal function impairment due to denosumab administration. At present, there is no rationale to discourage concomitant use of denosumab and surgery or radiotherapy. © 2013 Springer-Verlag Wien.Publication Metadata only Clinical outcome of breast cancer patients with N3a (>= 10 positive lymph nodes) disease: has it changed over years?(HUMANA PRESS INC, 2011) DANE, FAYSAL; Basaran, Gul; Devrim, Cabuk; Caglar, Hale B.; Gulluoglu, Bahadir; Kaya, Handan; Seber, Selcuk; Korkmaz, Taner; Telli, Ferhat; Kocak, Muharrem; Dane, Faysal; Yumuk, Fulden P.; Turhal, Serdar N.It has been shown that breast cancer patients with N3a (10 positive lymph nodes) had a poor prognosis. We planned to investigate the clinical outcome BC patients who presented with N3a disease and had no evidence of systemic metastasis at the time of diagnosis. We made a retrospective chart review of breast cancer patients who had a parts per thousand yen10 positive lymph nodes and received adjuvant systemic therapy in Marmara University Hospital between 1998 and 2008. We recorded clinical, pathologic and treatment characteristics of the patients and analyzed the survival outcome. We identified 73 patients with N3a disease who were treated in Marmara University Hospital between 1998 and 2008. The median age was 52. Most (75%) of the patients had invasive ductal histology, 75% had T2/T3 tumors, 36% had grade 3 tumors. The median number of metastatic lymph nodes was 15. Estrogen and progesterone receptors were both positive in 61% and both negative in 16+ tumors. Her-2/neu status was assessed in 68% of the tumors; 18% of patients had 3+ and 50% had negative scores. Six patients had triple negative tumors. All patients except one received adjuvant chemotherapy and radiotherapy. Seventy-four percent of patients received anthracycline/taxane-based chemotherapy. Fifty-nine patients received adjuvant endocrine therapy, 42% them received aromatase inhibitors. Five of the 13 Her-2 positive patients received adjuvant trastuzumab. With a median follow-up of 47 months, 5-year disease and overall survival rates were 66 and 81%, respectively. Twenty-four patients had relapsed and 14 patients died. Her-2 status and the number of lymph nodes (< 20 vs. a parts per thousand yen20) had significant impact on disease-free survival in the univariate analysis (P = 0.03 and 0.05, respectively) and Her-2 retained its significant impact on disease-free survival in the multivariate analysis (P = 0.05). The prognosis of BC patients with N3a disease has changed favorably in the past decade with the current standards of care.