Person: ŞİMŞEK, MELİH
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Publication Open Access 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 Metadata only 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.Publication Metadata only The importance of the glucose-to-lymphocyte ratio in patients with hepatocellular carcinoma treated with sorafenib(2021-08-01T00:00:00Z) YILMAZ, Ali; ŞİMŞEK, MELİH; HANNARİCİ, Zekeriya; Buyukbayram, Mehmet E.; BİLİCİ, Mehmet; Tekin, Salim B.; ŞİMŞEK, MELİHAim: To show the prognostic significance of the glucose-to-lymphocyte ratio (GLR) in hepatocellular carcinoma (HCC). Patients & methods: A total of 150 patients with advanced HCC who were treated with sorafenib in our center between January 2011 and December 2019 were included in the study retrospectively. Neutrophil-to-lymphocyte ratio, systemic immune-inflammation index, lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio, prognostic nutritional index and GLR were analyzed to assess their prognostic value using Kaplan-Meier and Cox regression analysis before and after propensity score matching (PSM). Results: In univariate analysis before and after PSM, albumin-bilirubin grade, neutrophil-to-lymphocyte ratio, systemic immune-inflammation index, lymphocyte-to-monocyte ratio, prognostic nutritional index, AFP level and GLR were found to be significantly associated with both progression-free and overall survival. In multivariate analysis before and after PSM, GLR, albumin-bilirubin grade and AFP were determined to be independent prognostic factors for progression-free and overall survival. Conclusion: The GLR prior to sorafenib treatment is a new prognostic biomarker that may predict survival in advanced HCC.Publication Metadata only 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, MELİH