Person: ŞİMŞEK, MELİH
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Publication Diagnostic performance of apparent diffusion coefficient values for the differentiation of intrahepatic cholangiocarcinoma from gastrointestinal adenocarcinoma liver metastases(2021-12-22T00:00:00Z) Yilmaz, TEMEL FATİH; Gultekin, Mehmet Ali; Turk, Hacı Mehmet; Cesme, Dilek Hacer; Besiroglu, Mehmet; Simsek, Melih; Toprak, Huseyin; Alkan, ALPAY; YILMAZ, TEMEL FATİH; TÜRK, HACI MEHMET; ÇEŞME, DİLEK HACER; ŞİMŞEK, MELİH; ALKAN, ALPAY; TOPRAK, HÜSEYİNBackground: We aimed to investigate whether there is a difference between intrahepatic cholangiocarcinoma (IHCC) and liver metastases of gastrointestinal system (GIS) adenocarcinoma in terms of apparent diffusion coefficient (ADC) values. Patients and methods: From January 2018 to January 2020, we retrospectively examined 64 consecutive patients with liver metastases due to gastrointestinal system adenocarcinomas and 13 consecutive IHCC in our hospital's medical records. After exclusions, fifty-three patients with 53 liver metastases and 10 IHCC were included in our study. We divided the patients into two groups as IHCC and liver metastases of GIS adenocarcinoma. For mean apparent diffusion coefficient (ADCmean) values, the region of interests (ROI) was placed in solid portions of the lesions. ADCmean values of groups were compared. Results: The mean age of IHCC group was 62.50 ± 13.49 and mean age of metastases group was 61.15 ± 9.18. ADCmean values were significantly higher in the IHCC group compared to the metastatic group (p < 0.001). ROC curves method showed high diagnostic accuracy (AUC = 0.879) with cut-off value of < 1178 x 10-6 mm2/s for ADCmean (Sensitivity = 90.57, Specificity = 70.0, positive predictive value [PPV] = 94.1, negative predictive value [NPV] = 58.3) in differentiating adenocarcinoma metastases from IHCC. Conclusions: The present study results suggest that ADC values have a potential role for differentiation between IHCC and GIS adenocarcinoma liver metastases which may be valuable for patient management.Publication Relationship between 18-FDG-PET/CT and Clinicopathological Features and Pathological Responses in Patients with Locally Advanced Breast Cancers(2019-06-01T00:00:00Z) Yildirim, Nilgun; Simsek, MELİH; Aldemir, Mehmet Naci; BİLİCİ, Mehmet; TEKİN, Salim Başol; ŞİMŞEK, MELİHObjective: We investigated the relationship between the maximum standardized uptake value (SUVmax) of whole-body positron emission tomography/computed tomography (PET/CT) performed before treatment and the demographical and histopathological features in locally advanced breast cancer (LABC), as well as the role of PET/CT in the evaluation of pathological complete response (pCR) after neoadjuvant chemotherapy (NAC).Publication Evaluation of 22 Primary Gastrointestinal Lymphoma Patients(2019-02-01T00:00:00Z) Yildirim, Nilgun; Turkeli, Mehmet; Akdemir, Mehmet Naci; Simsek, MELİH; TEKİN, Salim Başol; ŞİMŞEK, MELİHObjective: Primary gastrointestinal non-hodgkin lymphomas (PGI-NHL) are uncommon diseases with treatment modalities including chemotherapy, surgery, and radiotherapy. Our aim is to analyze the demographic and clinical features and treatment results of PGI-NHL.Publication Are We Late in the Diagnosis of Malignities Occurring in Solid Organ Transplant Patients? 11 Years- Experience(2016-02-01T00:00:00Z) Turkeli, Mehmet; Simsek, MELİH; Aldemir, Mehmet Naci; Yildirim, Nilgun; ÇANKAYA, Erdem; ERDEMCİ, Burak; BİLİCİ, Mehmet; TEKİN, Salim Başol; Arslan, Sukru; KORKUT, Ercan; ŞİMŞEK, MELİHObjective: Our aim is to evaluate the frequency and characteristics of cancer in the population of patients with solid organ transplant who are under immunosuppressive medication. In this study we aimed to emphasize the importance of early diagnosis of cancer in solid organ transplant recipients. An aging population began to receive solid organ transplantation and survival times prolonged. But this had a cost and new problems came forward. Especially de novo cancers because of immunosuppressive therapy took notice. Risk of malignancy increases after organ transplantation and cancer incidence was about 2.3-3.1% in these patients including skin cancer, lung cancer, malign lymphoma, cervix cancer, kaposi sarcoma, and hepatobiliary cancer.Publication Immunological Agents Used in Cancer Treatment(2019-02-01T00:00:00Z) Simsek, MELİH; TEKİN, Salim Başol; BİLİCİ, Mehmet; ŞİMŞEK, MELİHImmune checkpoint inhibitors (ICI) are monoclonal antibodies targeting cytotoxic T lymphocyte antigen-4 (CTLA-4), programmed cell death protein-1 (PD-1), or PD-1 ligand (PD-L1). ICI are approved for the treatment of malign melanoma, non-small cell lung cancer, classical Hodgkin lymphoma, head and neck squamous cell carcinoma, urothelial carcinoma, and renal cell carcinoma. They can lead to long-term anti-tumor responses by deactivating the brake mechanism in the immune system. Ipilimumab, tremelimumab, pembrolizumab, nivolumab, atezolizumab, durvalumab, and avelumab are examples of ICI. CTLA-4 is a brake mechanism in immune response. Ipilimumab and tremelimumab are antibodies against CTLA-4. PD-1 is another important immune checkpoint co-inhibitor receptor that is expressed by activated T cells in the peripheral tissue. As a result of blockage of the PD-1/PD-L1 pathway, local tumor-specific immune response augments, and long-term tumor control can be achieved. In recent years, ICI are approved for the treatment of various malignities. They may be responsible for specific toxicities called immune-related adverse events (irAEs). irAEs are a consequence infiltration of normal tissues by activated T lymphocytes that are responsible for autoimmunity. Corticosteroids and anti-tumor necrosis factor agents, such as infliximab and mycophenolate mofetil, are effective in the treatment of irAEs. Immune checkpoint inhibition with monoclonal antibodies against CTLA-4 and/or PD-1/PD-L1 by single agent or combination treatments became a new option in various solid tumors. However, ICI have unique adverse events, and these adverse events should be considered in any new onset clinical situation and should be managed properly. Future prospective randomized clinical trials will clarify recent questions.Publication Breast Cancer Patients with Brain Metastases: A Cross-Sectional Study.(2022-08-19T00:00:00Z) Simsek, MELİH; Aliyev, Altay; Baydas, Tuba; Besiroglu, Mehmet; Demir, Tarik; Shbair, Abdallah Tm; Seker, Mesut; Turk, H Mehmet; ŞİMŞEK, MELİH; TÜRK, HACI MEHMETThe prognosis of breast cancer patients with brain metastasis is poor. It was aimed to define the clinicopathological features of breast cancer patients with brain metastases and to determine the risk factors and survival outcomes associated with brain metastasis. This is a single-center, retrospective, cross-sectional study. A total number of 127 patients diagnosed with breast cancer and who developed brain metastasis between January 2011 and March 2021 were retrospectively analyzed. The survival and clinicopathological data of these patients according to 4 biological subtypes were evaluated (luminal A, luminal B, HER-2 overexpressing, and triple-negative). The median overall survival for all patients was 45.6 months. The median time from the diagnosis of breast cancer to the occurrence of brain metastasis was 29.7 months, and the median survival time after brain metastasis was 7.2 months. The time from the diagnosis of breast cancer to brain metastasis development was significantly shorter in HER-2 overexpressing and triple-negative subtypes than in luminal A and B subtypes. The median time from breast cancer diagnosis to brain metastasis was 33.5 months in luminal A, 40.6 months in luminal B, 16.8 months in HER-2 overexpressing, and 22.8 months in the triple-negative groups (p=0.003). We found the worst median survival after brain metastasis in the triple-negative group with 3.5 months. Early and close surveillance of high-risk patients may help early diagnosis of brain metastasis and may provide to perform effective treatments leading to longer overall survival times for this patient population.Publication Efficacy and safety of trastuzumab emtansine in Her2 positive metastatic breast cancer: real world experience.(2021-05-20T00:00:00Z) Bahçeci, Aykut; Paydaş, Semra; Ak, Naziye; Ferhatoğlu, Ferhat; Saip, Pınar Mualla; Seydaoğlu, Gülşah; Bilici, Mehmet; Şimşek, MELİH; Tekin, Salim Başol; Çalikuşu, Züleyha; Yavuz, Sinan; Şahin, Ahmet Bilgehan; Çubukçu, Erdem; Evrensel, Türkkan; Değirmencioğlu, Serkan; Demiray, Atike Gökçen; Yumuk, Perran Fulden; Alan, Özkan; Çikman, Duygu İlke; Demirelli, Fuat Hulusi; Köstek, Osman; Gökyer, Ali; Doğan, Mutlu; Bal, Öznur; Çakar, Burcu; Gökmen, Erhan; Yamaç, Deniz; Korkmaz, Taner; Aliyev, Altay; Keskin, Özge; Urvay, Semiha; Büyükşimşek, Mahmut; Karadeniz, Cemile; Yildiz, Birol; Yeşil Çinkir, Havva; Demir, Hacer; Beypinar, İsmail; Karaçin, Cengiz; Eser, Kadir; Baykara, Meltem; Kiliçkap, Saadettin; Okutur, Kerem; Bulut, Gülcan; Alkan, Ali; Arpaci, Erkan; Pilanci, Kezban Nur; Demir, Atakan; Işik, Deniz; Yildirim, Nilgün; ŞİMŞEK, MELİHPublication Serum IL-23, E-selectin and sICAM levels in non-small cell lung cancer patients before and after radiotherapy(2020-05-01T00:00:00Z) Ozmen, Hilal Kiziltunc; Simsek, MELİH; ŞİMŞEK, MELİHObjectivePublication Metastatic Breast Carcinoma Mimicking Urothelial Carcinoma(2022-06-01T00:00:00Z) Shbair, Abdallah T. M.; YASİN, Ayşe İrem; TOPÇU, Atakan; ÇOBAN, GANİME; UZUNOĞLU, GÖKÇE DENİZ; ŞİMŞEK, MELİH; YASİN, AYŞE İREM; TOPÇU, ATAKAN; ÇOBAN, GANİME; UZUNOĞLU, GÖKÇE DENİZ; ŞİMŞEK, MELİHBesides being the most frequently diagnosed cancer in women, breast cancer is the main cause of cancer-related deaths in this group of patients. Breast cancer frequently metastasizes to bone, lung, brain, and liver. Renal metastasis from the breast is extremely rare. Here we aimed to report a case of breast cancer with metastasis to bone and left renal pelvis. A 58-year old woman with a mass lesion in the left renal pelvis that mimicked urothelial carcinoma was referred to our clinic. The left nephroureterectomy procedure was performed, and the pathology revealed that a renal pelvis metastasis secondary to breast cancer.Publication A case report of fulminant hepatitis due to ribociclib with confirmed by liver biopsy in breast cancer(2021-06-01T00:00:00Z) TOPÇU, Atakan; YASİN, Ayşe İrem; SHBAIR, ABDALLAH T.M.; BEŞİROĞLU, MEHMET; ŞİMŞEK, MELİH; SUCUOĞLU İŞLEYEN, ZEHRA; YURTSEVER, İSMAİL; GÜCİN, ZÜHAL; ŞEKER, Mesut; TÜRK, HACI MEHMET; TOPÇU, ATAKAN; YASİN, AYŞE İREM; SHBAIR, ABDALLAH T.M.; BEŞİROĞLU, MEHMET; ŞİMŞEK, MELİH; SUCUOĞLU İŞLEYEN, ZEHRA; YURTSEVER, İSMAİL; GÜCİN, ZÜHAL; ŞEKER, MESUT; TÜRK, HACI MEHMETIntroduction Breast cancer is the most frequently diagnosed cancer in women worldwide. Ribociclib is now frequently used in the treatment of metastatic hormone-positive and human epidermal growth factor receptor 2 (HER 2)-negative breast cancer. Case Report A 54-year-old woman with breast cancer presented at a clinic in November 2017 with multiple lung and bone metastases. After receiving multiple lines of treatment due to disease progression, ribociclib and fulvestrant were initiated. Grade 4 toxicity was observed due to ribociclib during follow-up, and ribociclib was discontinued permanently. Management & Outcome: Given that liver transaminases and bilirubin elevation persisted despite discontinuation of the treatment, other reasons for liver toxicity were investigated. Abdominal MRI showed no liver metastases, although there was acute hepatitis. A liver biopsy was performed to determine the etiology. The pathology result was compatible with drug-induced acute fulminant toxic hepatitis. After liver biopsy, prednisolone treatment was initiated, after which the laboratory findings normalized. Discussion Although there are reported cases showing improvement in liver enzymes after ribociclib discontinuation, in our case, no recovery from hepatotoxicity was noticed. The treatment was changed to another hormonal pathway therapy option, exemestane. To the best of our knowledge, this is the first case in the literature reporting this rare side effect of ribociclib, which is a liver biopsy-proven fulminant hepatitis.
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