Person: GÜNDÜZ, FEYZA
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GÜNDÜZ
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FEYZA
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Publication Open Access Surveillance Strategies for Hepatocellular Carcinoma: Recent Advances and the Shifting Paradigm(SPRINGER, 2021-12) DEMİRTAŞ, COŞKUN ÖZER; Demirtas, Coskun Ozer; Gunduz, Feyza; Ozdogan, Osman CavitCurrently, international liver societies recommend screening at-risk individuals for HCC (patients with cirrhosis regardless of etiology, and/or chronic hepatitis B virus, and/or advanced liver fibrosis) with biannual abdominal ultrasound (USG) with or without alpha-fetoprotein (AFP). The global acceptance of USG in surveillance relies on the absence of risks, non-invasiveness, and lower costs. However, the suboptimal performance of USG +/- AFP in reaching direct and indirect goals of HCC surveillance highlights the need for alternative surveillance strategies. Several studies targeted contrast-enhanced magnetic resonance imaging techniques, but the main barriers for their entrance to surveillance programs have been concerns about cost-effectivity and long scan times. Overall, the HCC risk stratification appears at hand by several validated multiple score systems, but their optimal performance is obtained only in populations who show highly homogenous clinical, pathological, epidemiologic, etiologic, and therapeutic characteristics, and this limitation poses a major drawback to their sustainable use in clinical practice. We need globally validated and molecular integrated risk stratification tools to shape the future tailored HCC surveillance decision algorithms. A dynamic process for HCC surveillance algorithms awaits us owing to the expected further prospective studies focusing on risk-stratified screening strategy.Publication Open Access Practicality and potential restrictions of unresectable hepatocellular carcinoma prognostic index(2022-09-01) DEMİRTAŞ, COŞKUN ÖZER; ÖZDOĞAN, OSMAN CAVİT; BALTACIOĞLU, FEYYAZ; ÖNEŞ, TUNÇ; YUMUK, PERRAN FULDEN; DULUNDU, ENDER; GÜNDÜZ, FEYZA; DEMİRTAŞ C. Ö. , Ricco G., ÖZDOĞAN O. C. , BALTACIOĞLU F., ÖNEŞ T., YUMUK P. F. , DULUNDU E., Uzun S., Colombatto P., Oliveri F., et al.Publication Open Access Proposal and Validation of a Novel Scoring System for Hepatocellular Carcinomas Beyond Curability Borders(JOHN WILEY & SONS LTD, 2022-03) DEMİRTAŞ, COŞKUN ÖZER; Demirtas, Coskun Ozer; Ricco, Gabrielle; Ozdogan, Osman Cavit; Baltacioglu, Feyyaz; Ones, Tune; Yumuk, Perran Fulden; Dulundu, Ender; Uzun, Sinan; Colombatto, Pierro; Oliveri, Filippo; Brunetto, Maurizia Rosanna; Gunduz, FeyzaOptimal scoring system for clinical prognostic factors in patients with unresectable hepatocellular carcinoma (HCC) is currently uncertain. We aimed to develop and externally validate an easy to use tool, particularly for this population, and named it the unresectable hepatocellular carcinoma prognostic index (UHPI). We evaluated the data of patients with treatment-naive unresectable HCC who were diagnosed in the training center from 2010 to 2019 (n = 209). A simple prognostic model was developed by assigning points for each covariate in proportion to the beta coefficients in the Cox multivariable model. Predictive performance and distinction ability of the UHPI were further evaluated in an independent European validation cohort (n = 147) and compared with 11 other available models. A simple scoring system was derived, assigning 0.5/1/2 scores for six independent covariates including, the Child-Pugh score, Eastern Cooperative Oncology Group performance status, maximum tumor size, vascular invasion or extrahepatic metastasis, lymph node involvement, and alpha-fetoprotein. The UHPI score, ranging from 0 to 6, showed superior performance in prognosis prediction and outperformed 11 other staging or prognostic models, giving the highest homogeneity (c-index, 6-month and 1-year area under the receiver operator characteristic curves), lowest Akaike information criterion, and -2 log-likelihood ratio values. The UHPI score allocated well the risk of patients with unresectable HCC for mortality within the first year, using two cut-off values (low-risk, <0.5; intermediate-risk, 0.5-2; high-risk, >2). Conclusion: The UHPI score can predict prognosis better than other systems in subjects with unresectable HCC and can be used in clinical practice or trials to estimate the 6-month and 1-year survival probabilities for this group.Publication Open Access Evaluation of depression, anxiety and quality of life in hepatitis C patients who treated with direct acting antiviral agents(AVES, 2019-09-16) GÜNDÜZ, FEYZA; Kesen, Oguzhan; Kani, Haluk Tarik; Yanartas, Omer; Aykut, Umut Emre; Gok, Bedin; Gunduz, Feyza; Yilmaz, Yusuf; Ozdogan, Osman Cavit; Alahdab, Yesim OzenBackground/Aims: Hepatitis C virus (HCV) infection is known to impair the quality of life (QoL). Increased levels of anxiety and depression have been found in HCV infection with a prevalence of 28% and 33%, respectively. Our aim was to investigate depression, anxiety, and QoL of chronic hepatitis C (CHC) patients before and after treatment with a direct-acting antiviral agent (DAAA). Materials and Methods: In this study, enrolled CHC patients who had undergone DAAA treatment in our out-patient clinic. We administered the Hospital Anxiety and Depression (HAD) questionnaire to measure the severity of the anxiety and depression symptoms and the Short Form-36 (SF-36) questionnaire to measure the QoL at the beginning and at the end of the treatment. Results: Pretreatment anxiety and depression scores showed a statistically significant difference from the post treatment scores (p=0.000 and p=0.029 respectively). When we compared the SF-36 subitems before and after the treatment, a statistical significance was found in physical functioning (p=0.026), physical role limitation (p=0.009), bodily pain (p=0.011), general health (p=0.017), social functioning (p=0.006), and emotional role limitation (p=0.007). Also, an improvement was seen in the vitality (p=0.488) and mental health (p=0.714), which was not statistically significant. Conclusion: Depression got minimally worse in the male group despite an improvement in CHC. Anxiety scores were improved with treatment in the cirrhotic and non-cirrhotic groups significantly. A decrease in anticipatory anxiety may be related to the high treatment success with DAAA. Nearly all the subitems of the QoL scores were improved after treatment and these were more common in the female group. Elimination of HCV may itself decrease the number of patients who need psychiatric treatment.Publication Open Access Characteristics of patients with hepatocellular carcinoma: A multicenter study(2022-09-01) DEMİRTAŞ, COŞKUN ÖZER; KEKLİKKIRAN, ÇAĞLAYAN; GÜNDÜZ, FEYZA; ÖZDOĞAN, OSMAN CAVİT; Guzelbulut F., KARAOĞULLARINDAN Ü., AKKIZ H., ALTINTAŞ E., DEMİRTAŞ C. Ö. , Bahadir O., KEKLİKKIRAN Ç., YILDIRIM A. E. , Gumussoy M., Balci H. R. , et al.Background and Aim: The aim of the present study was to examine the etiology of hepatocellular carcinoma (HCC) by underlying cause and determine the characteristics and clinical features of patients with HCC. Materials and Methods: The study comprised 1802 HCC patients diagnosed and followed up by Liver Diseases Outpatient Clinics in 14 tertiary centers in Turkey between 2001 and 2020. Results: The mean age was 62.3±10.7 years, and 78% of them were males. Of the patients, 82% had cirrhosis. Hepatitis B virus (HBV) infection was the most common etiology (54%), followed by hepatitis C virus (HCV) infection (19%) and nonalcoholic fatty liver disease (NAFLD) (10%). Of the patients, 56% had a single lesion. Macrovascular invasion and extrahepatic spread were present in 15% and 12% of the patients, respectively. The median serum alpha-fetoprotein level was 25.4 ng/mL. In total, 39% of the patients fulfilled the Milan Criteria. When we compared the characteristics of patients diagnosed before and after January 2016, the proportion of NAFLD-related HCC cases increased after 2016, from 6.6% to 13.4%. Conclusion: Chronic HBV and HCV infections remain the main causes of HCC in Turkey. The importance of NAFLD as a cause of HCC is increasing