Cancer therapy-related cardiac dysfunction (CTRCD) is still a serious problem. Existing risk scores are insufficient for risk classification, especially in low and medium-risk patients. This study aims to evaluate if arterial stiffness (AS) measurement, which is associated with most of the known risk factors, can be a useful parameter for predicting subsequent CTRCD in patients with breast cancer (BC). Patients with BC were included in the study. All patients’ AS parameters such as pulse wave velocity (PWV), augmentation index (AIx), augmentation pressure (AP), and echocardiographic parameters were obtained before treatment. During treatment, echocardiographic follow-up with routine parameters and left ventricle global longitudinal strain (LVGLS) were measured. Patients were evaluated on whether CTRCD occurred or not. A total of 67 patients were analyzed. The mean age of the study population was 54.9 ± 11 years. Baseline characteristics were similar except for age. No CTRCD diagnosis was obtained according to left ventricle ejection fraction (LVEF) reduction, but 18 patients (26.8

Breast cancer is a hormone-dependent cancer. Hormonal exposure begins in the intrauterine period and continues in later years of life. 2D:4D ratio is accepted as an indicator of this exposure. The aim of this study was to investigate whether there is a difference in 2D:4D ratio between pathological subgroups of breast cancer and healthy control group. In this study, 204 participants, 154 breast cancer patients and 50 healthy control volunteers with similar age distribution, were included. Both hands of all participants were scanned using a digital scanner. The second and fourth finger lengths were measured using a digital measuring ruler with an accuracy of 0.05 mm. The 2D:4D ratio was calculated as the length of the second finger divided by the length of the fourth finger. A total of 204 patients (55 triple negative, 52 luminal B, 33 luminal A, 14 HER2-overexpessing and 50 healthy control volunteers) were subjected to finger scanning. There was no statistically significant difference in mean age between the groups. The right hand 2D:4D ratio was significantly lower in the Luminal A group compared to the other groups (p < 0.048). Although prenatal hormonal exposure is accepted as a risk factor for breast cancer, no study has evaluated patients in pathological subgroups. The 2D:4D ratio may be associated with breast cancer especially in the luminal A group in which hormone receptors are strongly positive and which has a better prognosis compared to the other groups.

INTRODUCTION:Breast-cancer is a common-cause of death in women.(1) We investigated the effects of before/after-NACT on hemoglobin-albumin-lymphocyte-platelet (HALP) scores and of changes therein on clinical/pathological-responses.MATERIALS AND METHODS:One-hundred-twenty-seven breast-cancer-patients receiving-NACT between December 2009 - January 2019 were investigated retrospectively.RESULTS:The mean - age was 50.3±12.3 (min 27 - max 79), and 125 patients (98.4 %) were women. Fifty-four (42.5 %) were premenopausal and 71 (55.9 %) postmenopausal. Invasive-ductal-carcinoma was present in 111 patients (92.5 %). Eighty patients (70.2 %) were ≤ T2 and 34 (29.8 %) > T2. Lymph-node-status was positive in 99 patients (83.2 %) and negative in 20 (16.8 %). Ki-67 was ≤ 10 % in 22 (28.9 %), 11-20 % in 23 (30.3 %), and > 20 % in 31 (40.8 %). Complete clinical response was observed in 27 (21.3 %), partial-response in 76 (59.8 %), stable-disease in 21 (16.5 %), and progressive-disease in 3 patients (2.4 %). The objective-response-rate (ORR) was 103 (81.1 %). Pathological-complete-response (pCR) was observed in 24 patients (18.9 %). ORR was higher in Ki-67 > 20 % compared to ≤ 10 % and 10-20 % (90.3 % vs 59.0 % / 78.3 %, respectively, p: 0.027), but no difference occurred in pCR. Neutrophil-lymphocyte-ratio (NLR), platelet-lymphocyte-ratio (PLR), prognostic-nutritional-index (PNI), and HALP were measured before/after NACT. Associations with ORR and pCR were investigated via changes in these with NACT (excepting-PNI), but no-significant results emerged.CONCLUSIONS:Higher ORR occurred post-NACT in patients with Ki-67 >20 %, while NLR, PLR, PNI, and HALP before/after-NACT and post-NACT-changes (excepting-PNI) had no-effect on ORR/pCR (Tab. 5, Ref. 21). Text in PDF www.elis.sk Keywords: breast cancer, objective response rate (ORR), pathological complete response (pCR), hemoglobin-albumin-lymphocyte-platelet (HALP) score.

Cancer poses a significant global health challenge and ranks as the second leading cause of mortality in the United States of America (USA).Annually, approximately 62,210 individuals in the USA are diagnosed with exocrine pancreatic cancer, making it the fourth most common cause of cancerrelated deaths in the country. 1 The 5-year overall survival (OS) rate for all stages of pancreatic cancer stands at a mere 8%. 2In resectable pancreatic cancer, lymph node status emerges as the most crucial prognostic factor.Even with R0 resection, the five-year OS is only 30% for node-negative cases and drops to 10% for node-positive disease. 3Additional prognostic factors in resectable pancreatic cancer encompass the status of surgical margins, tumor differentiation, the presence of lymphovascular invasion, and preoperative-postoperative serum cancer antibody 19-9 (CA 19-9) levels. 4,5Nevertheless, as approximately 15% of the general population lacks the CA 19-9 secretion phenotype, relying on this parameter for prognosis can be misleading. 6Obstructive jaundice constitutes another vital prognostic factor, as it can lead to alterations in hepatic functions, coagulation and fibrinolysis impairments, cholangitis, hepatic insufficiency, increased surgery-related complications, and, consequently, a poorer prognosis.

Aim: Epirubicin-docetaxel (ET) combination is an unusual and less frequently recommended regimen in the neoadjuvant treatment of breast cancer. In this study, we aimed to evaluate the efficacy of this combination. Material and Methods: The study involved 46 women diagnosed with breast cancer in 2009-2019 who received neoadjuvant therapy. All received epirubicin 80 mg/m2 and docetaxel 75 mg/m2 (on day-1) over a 21-day period, in varying cycles. Results: The mean age of the patients was 49.3 +/- 12.3 years. Twenty-one (45.7%) were premenopausal and 25 (54.3%) postmenopausal, 27 (64.3%) were =T2 at the time of diagnosis and 15 (35.7%) were >T2. Clinical involvement of the lymph nodes was present in 36 (80%). Eleven (28.9%) were luminal-A, 20 (52.6%) luminal-B, 2 (5.3%) HER2-positive, and 5 (13.2) triple-negative. Twenty-six (56.5%) patients had received 3 cycles and 20 (43.5%) had more than 3. In the clinical-response evaluation, complete response was observed in 10 (21.7%) patients, partial response in 24 (52.2%), stable disease in 9 (19.6%), and progressive disease in 3 (6.5%). The objective-response rate (ORR) was 73.9%. Total pathological-complete-response (pCR) was observed in 7 (15.2%) patients. pCR rates were higher in patients without clinical-lymph-node involvement (44.4% vs 8.3%, p:0.022). The median follow-up time was 37.5 months. Discussion: Although the combination of ET in the neoadjuvant treatment of breast cancer is not among the regimens recommended in the guidelines, according to our study, it has a significant contribution to ORR and pCR, especially in node negatives.

Objectives: Tumors of the ampulla-of-Vater are rare, and accurate prognosis is essential. We examined the significance of the hemoglobin-albumin-lymphocyte-platelet (HALP) score and lymph-node-ratio (LNR). Methods: Thirty-four patients in 2003-2018 were examined retrospectively. Results: Twelve women and 22 men were enrolled. Tumors were ≤2 cm in 11 (32.4%) and >2 cm in 17 (50%). Seven (38.9%) were in the LNR 1 (<0.1) group and 11 (61.1%) in the LNR 2 (≥0.1) group. Fifteen (62.5%) of the 24 operated patients received adjuvant-therapy, with recurrence in 12 (50%). Overall survival (OS) was significantly shorter with car-cinoembryonic-antigen (CEA) elevation at diagnosis compared to normal CEA (mean OS 27.1 vs. 89.8 months, p:0.029). OS was longer in stages 1–2 than 3–4 (mean OS 100.5 vs. 46.7 months, p:0.03), but shorter in patients with tumors >2 cm compared to tumors ≤2 cm (mean OS 53.2 vs. 90 months, p:0.059). No significant difference in OS emerged between the LNR 1 and 2 groups (114.8 vs. 82.9 months). No significant difference emerged in OS, disease-free, or progression-free-survival for HALP. Conclusion: Pre-operative CEA elevation, Stages 3–4, and tumor sizes exceeding 2 cm result in poor prognosis. The LNR and HALP have no effect on prognosis.

Regorafenib is a multikinase inhibitor. It is used for metastatic colorectal cancer (mCRC) treatment. It has a mild effect. Regorafenib outcomes, and side effects may vary across patients. This study was aimed to evaluate the factors that affect regorafenib outcomes in mCRC patients. We conducted a single-center and retrospective study. Fifty-six patients were included. All patients had received regorafenib for mCRC. Some clinical and pathological factors and the effects of these factors on overall survival (OS), progression-free survival (PFS), and disease control rates (DCR) were analyzed. Concomitant amlodipine intake with regorafenib improved OS [14.26 vs. 6.97 months; 95% confidence interval, 4.04-20.84; P = 0.031] and DCR at 12th week (90% vs. 46%; P = 0.012). Hepatic metastasis was found as the poorest prognostic factor in both univariate and multivariate analyses. Patients who received chemotherapy after regorafenib had better OS. Good performance status was the strongest indicator of better OS. Patients taking amlodipine for arterial hypertension at the same time with regorafenib had numerically better OS and PFS and statistically better DCR. Amlodipine itself already has anticancer effects, and it has additive anticancer effects with regorafenib. The presence of hepatic metastases was found to be the most important prognostic factor for OS. There were not any predictive factors of side effects to regorafenib.

SUMMARY OBJECTIVES: Black cumin is widely used as a spice and as a traditional treatment. The active ingredient in black cumin seeds is thymoquinone. Thymoquinone has shown anticancer effects in some cancers. We planned to investigate its anticancer effect on pancreatic cancer cell lines. METHODS: Thymoquinone chemical component in various doses was prepared and inoculated on pancreatic cancer cell culture, healthy mesenchymal stem cells, and peripheral blood mononuclear cell culture. IC50 values were calculated by absorbance data and measuring cell viability by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide staining of cells incubated with thymoquinone at 24, 48, and 72 h. RESULTS: There was dose-related cytotoxicity. Maximal cytotoxicity was observed at 24 h and 100 μM thymoquinone concentrations in pancreatic cancer cell culture and mesenchymal stem cells. Any concentration of thymoquinone was not cytotoxic to peripheral blood mononuclear cell. Thymoquinone even caused proliferation at a concentration of 6.25 μM. CONCLUSIONS: Since the cytotoxic concentration of thymoquinone on pancreatic cancer cell culture and mesenchymal stem cells is the same, it is not appropriate to use thymoquinone to achieve cytotoxicity in pancreatic cancer. However, since thymoquinone provides proliferation in peripheral blood mononuclear cell at a noncytotoxic dose, it may have an immune activator effect. Therefore, in vivo studies are needed to investigate the effect of thymoquinone on the immune system.

OBJECTIVE To investigate factors that may affect prognosis in gastrointestinal stromal tumors (GISTs). STUDY DESIGN A descriptive study. PLACE AND DURATION OF STUDY Karadeniz Technical University Hospital, Trabzon, Turkey from 2000 to 2019. METHODOLOGY All the patients diagnosed with GIST and followed-up in this centre were included. Those who were not followed-up in this centre were excluded. The Chi-square test for differences between variables in independent groups; and the Kaplan-Meier method for survival rates were used. RESULTS Median tumor size was larger in patients with recurrence, compared to those without (8cm vs. 5 cm, p <0.001). Recurrence rates were higher with mitosis ≥5 in 50 high-power-fields than with low mitosis (52.6% vs. 23.4%, p = 0.021). Median Ki-67 percentages were higher in patients with recurrence than without (5 vs. 2, p = 0.031). Recurrence rates were higher with necrosis and bleeding than without (57.7% vs. 14.3%, p = <0.001; 50% vs. 13.8%, p = 0.003). Median overall-survival (OS) was shorter in with mitotic counts ≥5 compared to <5 (52.0 vs. 110.0 months, p = 0.051) and with ulceration than without (36.0 vs. 110.0 months, p = 0.017). The groups below (<43.5) and above (>43.5) the median prognostic-nutritional-index (PNI) value were similar in terms of OS and disease-free survival (DFS) (52 vs. 70 months, p = 0.174; 82 vs. 100 months, p = 0.411). Median DFS was shorter with ulceration than without (27 vs. 100 months, p = 0.048). CONCLUSION While necrosis, bleeding, ulceration, mitosis, size, and Ki-67 significantly affect the prognosis in GIST, PNI has no significant effect. Key Words: Gastrointestinal stromal tumors (GIST), Survival, Prognosis, Recurrence, Prognostic Nutrition Index (PNI).