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  • Küçük Resim Yok
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    The optimal upfront therapy in metastatic hormone-sensitive prostate cancer: A network meta-analysis
    (Wolters Kluwer Medknow Publications, 2023) Mutlu, Hasan; Bozcuk, Hakan
    Background: Prostate cancer (PC) is one of the most common cancer types in men. In addition to androgen-deprivation therapy (ADT), new generation agents have provided survival advantages to patients with metastatic hormone-sensitive PC (mHSPC). In this analysis, we aimed to determine the most effective approach for treating and suppressing mHSPC using network meta-analysis (NMA). Materials and Methods: A total of 10 trials investigating different treatment modalities were conducted using NMA. The analysis was performed for all mHSPC cases as well as for low- and high-volume and docetaxel-naive subgroups. Results: In combination with ADT, abiraterone acetate (AA) in the general-population and high-volume-disease subgroups, and enzalutamide in docetaxel-naive and low-volume-disease subgroups have the highest probability of being the best treatment modalities in terms of overall survival. In addition, in the low-volume and docetaxel-naive settings, enzalutamide was superior to ADT (hazard ratio [HR] = 0.429, 95% CrI: 0.258-0.714 and HR = 0.533, 95% CrI: 0.375-0.756, respectively). In addition, in the high-volume and general-population settings (all trials and cases), AA was superior to ADT (HR = 1.568, 95% CrI: 1.378-1.773 and HR = 1.164, 95%CrI: 1.348-1.924, respectively). Conclusion: The volume status based on the CHAARTED trial should be taken into account to determine an appropriate treatment strategy for mHSPC. AA plus prednisone in high-risk and high-volume-mHSPC patients and enzalutamide in low-volume-mHSPC patients could be favorable options in combination with ADT. Depending on the patient's tolerance, in high-volume mHSPC, docetaxel, or apalutamide in combination with ADT could be alternatives for AA, whereas in the low-volume mHSPC, local radiotherapy plus ADT or ADT alone could be utilized in place of enzalutamide.
  • Küçük Resim
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    Prognostic value of HPV DNA in urothelial carcinoma of the bladder: a preliminary report of 2-year follow-up results
    (2021) Sarıer, Mehmet; Süremen Usta, Sibel; Turgut, Hasan; Öztürk, Sefa Alperen; Soylu, Ahmet; Emek, Mestan; Kukul, Erdal; Bozcuk, Hakan; Sepin, Nevgün
    Purpose: The association between the human papillomavirus (HPV) and anogenital carcinomas is well established. However, despite its anatomic adjacency, the relationship between HPV and urothelial carcinoma of the bladder (UCB) is less clear. Recent meta-analysis and case-control studies demonstrated a significant relationship between the presence of HPV DNA and UCB. The aim of this clinical study was to compare the 2-year follow-up results of HPV-positive and HPV-negative UCB patients to evaluate the prognostic value of HPV DNA positivity in UCB. Methods: The study included patients with stage pTa and pT1 UCB who underwent polymerase chain reaction (PCR) analysis of HPV DNA between January 1 and November 30, 2018. Based on their PCR results, 19 HPV-positive and 38 HPV-negative UCB patients who had regular follow-up in our clinic were evaluated in terms of tumor recurrence and disease progression over a 2-year follow-up period. Results: There was no significant difference between the groups in terms of age, follow-up time, smoking, or tumor grade (P= .576, P= .368, P= .080, and P= .454). Tumor recurrence was observed at least once in 47.3% (n=9) of the 19 HPV-positive patients and 36.8% (n=14) of the 38 HPV-negative patients (P= .445). There was no difference in disease progression between the groups during follow-up. Conclusion: In our sample of UCB patients, the presence of HPV DNA was associated with a trend toward higher recurrence rate during the 2-year follow-up, though the difference was not statistically significant. No difference in disease progression was observed based on HPV DNA positivity.