Person: YUMUK, PERRAN FULDEN
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YUMUK
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PERRAN FULDEN
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Publication Metadata only Differences in PET/CT standardized uptake values involvement and survival compared to histologic subtypes of lung adenocarcinoma(SAGE PUBLICATIONS LTD, 2021) BOZKURTLAR, EMİNE; Ercelep, Ozlem; Alan, Ozkan; Telli, Tugba A.; Tuylu, Tugba B.; Arikan, Rukiye; Demircan, Nazim Can; Simsek, Eda T.; Babacan, Nalan A.; Kaya, Serap; Dane, Faysal; Bozkurtlar, Emine; Ones, Tunc; Lacin, Tunc; Yumuk, Perran FuldenPurpose: Lung adenocarcinoma is histologically diverse but has distinct histologic growth patterns. There is no consensus on the clinical benefit of this histologic model. We aimed to evaluate the differences in the distribution of the preoperative primary tumor positron emission tomography (PET)/computed tomography (CT) standardized uptake values (SUVs) and survival in the lung adenocarcinoma subtypes. Methods: We retrospectively evaluated the data of 107 patients with resected lung adenocarcinoma who had preoperative PET/CT between 2005 and 2017 in a single center. Patients had lepidic, acinar, papillary, micropapillary, and solid histologic subtypes. We compared fluorodeoxyglucose SUVs and survival data of histologic subtypes. Results: The median age of the patients was 62 years (40-75), 76.4% were male, the median SUVmax was 9.4 (1-36.7), and the median follow-up time was 29 months (3-135 months). The median overall survival (OS) was 71 months and the median progression-free survival (PFS) was 33 months. SUVmax was significantly different in histologic subtypes: values for papillary, micropapillary, solid, acinar, and lepidic subtypes were 9.7, 8, 12, 9.1, and 3.9, respectively (p= 0.000). Solid predominant adenocarcinoma had significantly higher SUVmax than the other subtypes (p= 0.001). Lepidic predominant adenocarcinoma had significantly lower SUVmax than the other subtypes (p= 0.000). There was no significant difference in OS between histologic subtypes (p= 0.66), but PFS was significantly different between the groups (p= 0.017), and the solid subtype had a shorter PFS than the other histologic subtypes. Conclusion: Lung adenocarcinoma consists of a diverse group of diseases. Different SUVmax values are seen in different histologic subtypes of nonmetastatic lung adenocarcinoma. Solid predominant types have high SUVmax values while lepidic predominant types have lower SUVmax values. The solid subtype had a shorter PFS than the other histologic subtypes.Publication Metadata only Vascular endothelial growth factor, hypoxia-inducible factor 1 alpha and CD34 expressions in early-stage gastric tumors: Relationship with pathological factors and prognostic impact on survival(KARGER, 2007) ÇELİKEL, ÇİĞDEM; Cabuk, Devrim; Basaran, Gul; Celikel, Cigdem; Dane, Faysal; Yumuk, P. Fulden; Iyikesici, M. Salih; Ekenel, Meltem; Turhal, N. SerdarBackground: Angiogenesis is one of the key steps in solid tumor growth and metastasis. We planned to investigate the prognostic significance of vascular endothelial growth factor (VEGF), hypoxia-inducible factor 1 alpha (HIF-1 alpha) and CD34 expressions as markers of angiogenesis in gastric cancer. Patients and Methods: We retrospectively reviewed the medical records of 51 gastric cancer patients who had total or subtotal gastrectomy at Marmara University Hospital from 1990 to 2004 and evaluated the expression of VEGF, HIF-1 alpha and CD34 by immunohistochemistry in their archival tumor tissues. We recorded the clinical and pathological characteristics of these patients and analyzed their survival outcome. Results: Thirty out of 51 patients were males. The median age was 63 years (range 34-81). The median follow-up was 17 months. Thirty-six patients had node-positive disease. The majority of patients (n = 43) had T2 and T3 disease. Vascular and lymphatic invasions were present in 57 and 77% of tumors, respectively. VEGF and HIF-1 alpha were positive in 65 and 71% of tumors. The median CD34 staining score was 19 (3-68). VEGF, HIF-1 alpha and CD34 expressions were more frequent in tumors without serosal invasion (p = 0.01, p = 0.01 and p = 0.003, respectively). CD34 expression was significantly more frequent in tumors with VEGF and HIF-1 alpha expression (p = 0.00, p = 0.00). HIF-1 alpha expression was more frequent in tumors with VEGF expression (p = 0.00). The 5year overall survival was 45%. VEGF, HIF-1 alpha, CD34 expressions and other pathological characteristics were found to have no impact on survival. Conclusion: VEGF, HIF-1 alpha and CD34 expressions were more common in tumors without serosal invasion. As a future perspective, biological agents targeting VEGF and HIF-1 alpha might be more effective at earlier stages of gastric cancer. Copyright (c) 2007 S. Karger AG, Basel.Publication Metadata only Limited painful mouth opening(W B SAUNDERS CO, 2005) YUMUK, PERRAN FULDEN; Guler, N; Yumuk, PF; Ilguy, D; Gac, V; Greer, JPublication Metadata only Significance of a clinical pharmacist-led comprehensive medication management program for hospitalized oncology patients(SPRINGER, 2020) YUMUK, PERRAN FULDEN; Umar, Rashida Muhammad; Apikoglu-Rabus, Sule; Yumuk, Perran FuldenBackground The use of highly toxic drugs in cancer treatment and supportive care medications exposes patients to an increased number of drug-related problems (DRPs). Clinical pharmacists contribute to the optimal use of medications by intervening in identified drug-related problems. Objective To evaluate the relevance of a comprehensive medication management service in oncology patients. Setting Marmara University Teaching and Research Hospital Medical Oncology Ward, Istanbul, Turkey. Methods This prospective study was carried out between December 2015 and April 2016 with adult patients with confirmed malignancy. Comprehensive medication management was performed by the clinical pharmacist throughout the patient's hospital stay. The medication-related data as well as data regarding demographic and general health status of the patients were reviewed for the presence of drug-related problems. The identified problems, interventions and acceptance rate by physicians were recorded with the help of the Pharmaceutical Care Network Europe V6.0 (PCNE) classification. Main outcome measures Number and causes of drug-related problems, nature and acceptance rate of clinical pharmacist interventions and rate of problems solved. Results The study included 137 patients. The mean (SD) age of the patients was 58 (14.6) years. A total of 481 drug-related problems were recorded. The most frequent drug-related problems were 'adverse drug events [including drug interactions]' (n = 376), 'untreated indications' (n = 59) and 'unnecessary drug treatment' (n = 25). Inappropriate combination of drugs was the cause of 73.2% of the total problems. Interventions were made to stop administration of a suitable drug if the combination with another drug was contraindicated while prescribers were mostly informed about major drug interactions. The prescribers approved 93% of the total intervention proposals. The majority (90.9%) of the identified problems were totally solved. Conclusion Integration of clinical pharmacy services through a comprehensive medication management program in oncology will help to reduce the number of drug-related problems.Publication Metadata only Impact of the Charlson Comorbidity Index on dose-limiting toxicity and survival in locally advanced and metastatic renal cell carcinoma patients treated with first-line sunitinib or pazopanib(SAGE PUBLICATIONS LTD, 2020) ÇİÇEK, FURKAN CUMA; Demircan, Nazim C.; Alan, Ozkan; Tuylu, Tugba Basoglu; Telli, Tugba Akin; Arikan, Rukiye; Cicek, Furkan C.; Ercelep, Ozlem; Ozturk, Mehmet A.; Cetin, Ilknur Alsan; Ergelen, Rabia; Tinay, Ilker; Babacan, Nalan Akgul; Kaya, Serap; Dane, Faysal; Yumuk, Perran F.Background Anti-angiogenic tyrosine kinase inhibitors, sunitinib and pazopanib, have proven efficacy in advanced renal cell carcinoma, with specific adverse events occurring during treatment process. Comorbidities can reflect functional status and have prognostic value in oncology patients. We aimed to assess the association of the Charlson Comorbidity Index with severe toxicities and mortality in renal cell carcinoma cases treated with front-line sunitinib or pazopanib. Methods Files of locally advanced and metastatic renal cell carcinoma patients who received first-line sunitinib or pazopanib were retrospectively examined. Charlson Comorbidity Index of each patient was calculated. Patients were also stratified into Memorial Sloan-Kettering Cancer Center risk groups. Predictors of dose-limiting toxicity were evaluated with binomial logistic regression analysis. Univariate and multivariate Cox regression models were utilized to determine prognostic factors for survival. Results The study included 102 patients, 64 were treated with first-line sunitinib and 38 with pazopanib. In 42 patients (41.9%), Charlson Comorbidity Index was 9 or more. Dose-limiting toxicities were significantly more frequent in Charlson Comorbidity Index >= 9 group (69% vs. 40%, p = 0.004), and Charlson Comorbidity Index independently predicted dose-limiting toxicity (Hazard ratio (HR) = 4.30, p = 0.002). After adjusting for other variables, a Charlson Comorbidity Index of >= 9 is also a significant prognostic factor for progression-free (HR = 1.76, p = 0.02) and overall survival (HR = 1.75, p = 0.03). Conclusions Charlson Comorbidity Index may be a valuable method to estimate prognosis and optimize therapy in patients with advanced renal cell carcinoma receiving first-line sunitinib or pazopanib.Publication Metadata only Outcome of rectal and sigmoid carcinoma patients receiving adjuvant chemoradiotherapy in marmara university hospital(TAYLOR & FRANCIS LTD, 2003) YUMUK, PERRAN FULDEN; Yumuk, PF; Abacioglu, U; Caglar, H; Gumus, M; Sengoz, M; Turhal, NSAdjuvant chemoradiotherapy is the standard treatment in resected stage II/III rectosigmoid carcinoma. We report a retrospective analysis of 33 patients who received adjuvant chemoradiotherapy. Patients received 5-fluorouracil (375mg/m(2)/day x 5days) and calcium leucovorin (20mg/m(2)/day x 5days), q4weeks, two courses before and two courses after radiotherapy. The 5-fluorouracil dose was reduced to 225mg/m(2)/day given continuously as protracted short-term infusion on the first and last 3 days during radiotherapy. Radiotherapy was started at 7th week and 45-50.4 Gy was given to pelvic region. Median age was 63 years. Median follow-up was 38 months starting from the operation date. Four-year local and distant control rates were 78% and 69%, respectively. Four-year disease-free survival and overall survival were 60% and 62%, respectively. Protracted short-term infusion of 5-fluorouracil during pelvic irradiation is a safe treatment modality. Further studies are needed to improve the local control of high-risk rectal and sigmoid carcinomas.