Publications by authors named "Vildan Kaya"

28 Publications

  • Page 1 of 1

Reoperation does not provide a survival advantage in patients with recurrent Glioblastoma treated with irinotecan/bevacizumab treatment.

Indian J Cancer 2021 Jan-Mar;58(1):91-95

Department of Medical Oncology, Medicalpark Gaziantep Hospital, Gaziantep, Turkey.

Background: Treatment options for recurrent glioblastoma (GBM) have limited efficacy. Although reoperation is useful for both the confirmation of the diagnosis of recurring disease and the relief of the symptoms, its effect on survival is unknown. The aim of this study was to evaulate the impact of second surgery in recurrent GBM.

Methods: Patients with GBM followed in our center between January 2015 and April 2018 were analyzed retrospectively based on the treatment options.

Results: 25 patients diagnosed with recurrent GBM were analyzed. Ten patients (40%) were treated with chemotherapy following reoperation, and 15 patients (60%) were treated with only chemotherapy. No benefits of reoperation were observed in the univariate analysis.

Conclusion: The second surgery in recurrent GBM has limited effect in clinical course.
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http://dx.doi.org/10.4103/ijc.IJC_758_18DOI Listing
January 2021

A novel diagnostic tool for the detection of bladder cancer: Measurement of urinary high mobility group box-1.

Urol Oncol 2020 08 17;38(8):685.e11-685.e16. Epub 2020 Apr 17.

Bahcesehir University School of Medicine, Department of Internal Medicine, Medical Oncology, Medicalpark Gaziantep Hospital, Gaziantep, Turkey.

Objective: We aimed to investigate the diagnostic value of urinary High Mobility Group Box-1 (HMGB1) level as a noninvasive tool that can be potentially used for diagnosis and during follow-up in patients with bladder cancer patients.

Method: The study was conducted in a total of 121 participants including 61 patients diagnosed with primary bladder cancer, 30 patients with an acute urinary tract infection and 30 healthy controls. Age, gender and urinary HMGB1 levels of the study groups were evaluated. The association of clinical features (tumor diameter, number of foci, pathological grade, muscle invasion) with urinary HMGB1 levels was investigated in patients with bladder cancer.

Results: All 3 groups showed a normal age and gender distribution with no significant difference among them (P = 0.775 and P = 0.967, respectively). A significant difference was detected in urinary HMGB1 levels among the 3 groups (P < 0.001). When urinary HMGB1 levels were compared between patients with high grade vs. low grade tumors, the mean HMGB1 level was 44.39 pg/ml (12.1-505.2) in patients with low grade tumors and 280 pg/ml (18.7-2685.3) in patients with high grade tumors (P < 0.001). Patients with a greater number of tumor foci had higher HMGB1 levels in comparison to patients with a single tumor focus (P = 0.008). Urinary HMGB1 levels were higher in patients with a tumor diameter of ≥3 cm than in patients with a tumor diameter less than 3 cm (P = 0.001). Patients with muscle-invasive bladder cancer exhibited higher urinary HMGB1 levels compared to patients with non-muscle-invasive bladder cancer (P = 0.033). The cut-off values derived from the ROC analysis were 63.30 pg/ml for distinguishing bladder cancer from urinary tract infection, 30.94 pg/ml for urinary tract infection versus control group and 38.70 pg/ml for bladder cancer vs. control group, respectively. Sensitivity was 59% and specificity was found 77%.

Conclusion: In future controlled studies involving larger patient groups, urinary HMGB1 levels can be used for diagnostic and screening purposes in bladder cancer patients.
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http://dx.doi.org/10.1016/j.urolonc.2020.03.025DOI Listing
August 2020

Effectiveness of Platinum-Based Treatment for Triple Negative Metastatic Breast Cancer: a Meta-Analysis

Asian Pac J Cancer Prev 2018 May 26;19(5):1169-1173. Epub 2018 May 26.

Medstar Antalya Hospital, Department of Radiation Oncology, Antalya Education and Research Hospital, Antalya,Turkey. Email:

Background: Triple-negative breast cancer (TNBC) is a sub-group of breast cancers with a particularly poor prognosis. The results of studies investigating the role of platinum-based chemotherapy (PBC) in metastatic TNBC (mTNBC) have been conflicting. In this meta-analysis, our aim was to assess the effectiveness of PBCs for mTNBCs. Methods: The PubMed, Cochrane Controlled Trials Register Databases, and EBSCOhost databases were accessed. The English language was used as the search language and only human studies were included. The Newcastle–Ottawa Quality Assessment Scale and the Jadad scoring system were used to evaluate the quality of the included randomized controlled studies. Results: Seven studies and 1,571 patients were included in this meta-analysis. The pooled hazard ratio (HR) for overall survival (OS), evaluated on the basis of six studies, showed the use of PBC regimes to be related to OS in mTNBCs (HR 0.620; 95% CI 0.513-0.749; p:<0.001). Four studies containing HR and abstract statistics used for HR calculation were included in the meta-analysis for progression-free survival (PFS). The pooled HR again indicated a significant relation (HR, 0.628; 95% CI, 0.501-0.786; p:<0.001). Conclusions: In this meta-analysis, we confirmed that PBC regimes provide OS and PFS advantages compared to non-PBC regimes. The use of PBC regimes could be a good choice in mTNBC patients for better quality of life and survival.
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http://dx.doi.org/10.22034/APJCP.2018.19.5.1169DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6031818PMC
May 2018

Prognostic Significance of Indicators of Systemic Inflammatory Responses in Glioblastoma Patients

Asian Pac J Cancer Prev 2017 Dec 29;18(12):3287-3291. Epub 2017 Dec 29.

Medstar Antalya Hospital, Department of Radiation Oncology, Antalya, Turkey. Email:

Background: High-grade gliomas, with glioblastomas as the most frequently observed histologic subtype, are the most common primary brain tumours in adults. It is considered that inflammatory responses play a major role in malignancies, including tumour progression. This study aimed to determine the prognostic significance of the neutrophil to lymphocyte ratio (NLR) and the thrombocyte to lymphocyte ratio (PLR) as indicators of systemic inflammatory response (SIR) in glioblastoma patients. Methods: A total of 90 patients treated for glioblastoma were retrospectively evaluated. Absolute counts were used to generate NLR and PLR. A SIR was considered to be present with an NLR ≥5 and/or PLR ≥150. Results: Median follow-up time was 11.3 months (range: 1-70 months). The 1-year and 2-year overall survival rates were 55.2% and 19.5%, respectively. Univariate analysis showed that there was no correlation between overall survival and gender (p=0.184), comorbid disease (p = 0.30), clinical presentation (p = 0.884), or tumour lateralization (p = 0.159). Multivariate analysis showed that overall survival was significantly correlated with SIR based on NLR (HR: 2.41), and ECOG performance status (HR: 1.53). The prognostic factors that affected survival, other than SIR, were Eastern Cooperative Oncology Group (ECOG) performance status (p = 0.003), and tumour localization (p = 0.006). Conclusion: The present findings confirm that NLR based on peripheral blood counts prior to treatment can be used as a prognostic factor in patients with glioblastoma. Since tumour aggression increases and survival decreases as the NLR value rises, choice of treatment modality is facilitated for glioblastoma patients.
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http://dx.doi.org/10.22034/APJCP.2017.18.12.3287DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980885PMC
December 2017

Expression of claudin 1, 4 and 7 in thyroid neoplasms.

Oncol Lett 2017 May 27;13(5):3722-3726. Epub 2017 Mar 27.

Department of Pathology, University of Health Sciences, Antalya Education and Research Hospital, Antalya 07050, Turkey.

The distinction of thyroid carcinoma from benign thyroid neoplasm, as well as the subtyping of papillary carcinoma (PC) and follicular carcinoma (FC), may be performed histopathologically in the majority of cases. However, in certain cases, it is difficult to histopathologically distinguish between PC and FC, as well as follicular adenoma (FA), FC and the dominant nodule of multinodular goiter (MNG-DN). The present study aimed to determine the roles of the expression levels of the tight junction proteins claudin 1, 4 and 7 in the differential diagnosis of PC, FC, FA, MNG-DN, medullary carcinoma (MC) and anaplastic carcinoma (AC). The current study included 114 cases of histopathologically diagnosed thyroid neoplasia, which were distributed as follows: 29 FA, 18 MNG-DN, 47 PC, 10 FC, 5 MC and 5 AC. The expression levels of claudin 1, 4 and 7 were examined using immunohistochemical methods. The results revealed a significant difference in claudin 1 expression between malignant and benign thyroid neoplasms (P<0.001). Claudin 1 expression was not detected in any of the MNG-DN cases, and no significant difference in claudin 1 expression levels was identified between FA and FC (P=0.653). However, a statistically significant difference was observed between FC and PC (P<0.001). Claudin 4 expression did not differ between malignant and benign thyroid neoplasms, neither between MNG-DN, FA and FC, nor between FC and PC (P=0.068, P=0.502 and P=0.481, respectively). Claudin 7 exhibited positive immunohistochemical staining in 107 patients (94%); however, no significant difference in claudin 7 expression §levels was identified between malignant and benign thyroid neoplasms among MNG-DN, FA and FC (malignant, P=0.135; benign, P=0.470). Claudin 7 exhibited positive staining in all PC and FC cases. Therefore, claudin 1 expression levels may be useful in distinguishing cases of FC and PC with overlapping histopathological features, and provide a novel immunohistochemical marker for the subtyping of thyroid carcinoma.
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http://dx.doi.org/10.3892/ol.2017.5916DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5431601PMC
May 2017

Effects of pacifier use on transition to full breastfeeding and sucking skills in preterm infants: a randomised controlled trial.

J Clin Nurs 2017 Jul 21;26(13-14):2055-2063. Epub 2017 Mar 21.

Department of Child Health Nursing, Faculty of Health Science, Ataturk University, Erzurum, Turkey.

Aims And Objectives: To determine the effects of pacifier use on transition to full breastfeeding and sucking skills in preterm infants.

Background: Feeding problems in preterm infants cause delays in hospital discharge, extend mother-infant reunification and increase medical cost. Nutritive sucking skills of preterm infants may develop by improving non-nutritive sucking skills and increasing sucking experiences.

Design: A prospective, randomised controlled trial conducted in the Eastern Turkey.

Methods: Seventy infants were randomised into two groups: a pacifier group (n = 34) and a control group (n = 36). Pacifier use was applied in the preterm infants in the pacifier group, up to switching to full breastfeeding. The infants in the control group did not use pacifiers. Data were collected by a researcher using the Preterm Infant Introductory Information Form, the Preterm Infant Monitoring Form and the LATCH Breastfeeding Assessment Tool. For the study, ethics committee approval, official permission and written informed consents of the families were obtained.

Results: The time to transition to full breastfeeding (123·06 ± 66·56 hours) and the time to discharge (434·50 ± 133·29 hours) in the pacifier group were significantly shorter compared to the control group (167·78 ± 91·77 and 593·63 ± 385·32 hours, respectively) (p < 0·05). The weight at transition to full breastfeeding (1944·12 ± 275·67 g) and the weight of discharge (1956·45 ± 268·04 g) in the pacifier group were significantly lower compared to the control group (2155·58 ± 345·57 and 2159·75 ± 341·22 g, respectively) (p < 0·05). Sucking skills of the infants in the pacifier group at 48 hours after transition to oral feeding and before the discharge was better than in the control group (p < 0·05).

Conclusion: Pacifier use improved the sucking skills and shortened the time to transition to full breastfeeding and to discharge in preterm infants receiving complementary feeding.

Relevance To Clinical Practice: Pacifier use may be recommended to accelerate transition to full breastfeeding and to improve the sucking skills in preterm infants who were fed by both oral route and complementary feeding in the neonatal intensive care units.
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http://dx.doi.org/10.1111/jocn.13617DOI Listing
July 2017

Effects of Definitive Chemoradiotherapy on Respiratory Function Tests and Quality of Life Scores During Treatment of Lung Cancer.

Asian Pac J Cancer Prev 2015 ;16(15):6779-82

Department of Radiation Oncology, Antalya Education and Research Hospital, Antalya, Turkey E-mail :

Background: Chemoradiotherapy is an important treatment modality for lung cancers. The aim of this study was to investigate alterations in, as well as the interrelationship between, lung function and quality of life of patients receiving chemoradiotherapy due to locally advanced non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) limited to the thorax.

Materials And Methods: The study included patients receiving definitive chemoradiotherapy for lung carcinoma. The respiratory function of the patients was assessed by measuring forced expiratory volume in 1 s per unit (FEV1) and forced expiratory volume in 1s per unit of vital capacity (FEV1/VC) before, in the middle of and after treatment. During the study, EORTC QLQ C30 and LC13 questionnaires developed by the Committee of the European Organization for Research and Treatment of Cancer (EORTC) were employed to evaluate the quality of life on the same day as respiratory function tests (RFT).

Findings: The study included 23 patients in total: 19 (82.6%) diagnosed with NSCLC and 4 (17.4%) with SCLC. The average percentage FEV1 was 55.6±21.8% in the pre-treatment period, 56.2±19.2% in the middle of treatment and 60.4±22% at the end of treatment. The improvement in functional scores, symptom scores and general health scores during treatment was not statistically significant (P=0.568, P=0.734, P=0.680, P=0.757 respectively).

Conclusions: Although this study showed an improvement in respiratory function and quality of life of patients during treatment with thoracic chemoradiotherapy, no statistically significant results were obtained. While evaluating the effectiveness of treatments for lung carcinoma, the effects of treatment on respiratory function and quality of life should be considered.
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http://dx.doi.org/10.7314/apjcp.2015.16.15.6779DOI Listing
July 2016

The role of gender in patients with diffuse large B cell lymphoma treated with rituximab-containing regimens: a meta-analysis.

Arch Med Sci 2015 Aug 11;11(4):708-14. Epub 2015 Aug 11.

Department of Medical Oncology, Medical Faculty, Cukurova University, Adana, Turkey.

Introduction: Diffuse large B cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma (NHL). Although gender has not been included in prognostic systems, male gender has been found as a bad prognostic indicator in Hodgkin lymphoma, follicular lymphoma and chronic lymphocytic leukemia. The relationship between gender and prognosis is not clear in patients with DLBCL treated with rituximab-containing regimens. The aim of this meta-analysis is to determine the prognostic/predictive role of gender in patients with DLBCL treated with rituximab-containing regimens.

Material And Methods: We systematically searched for studies investigating the relationships between gender and prognosis in DLBCL treated with rituximab-containing regimens. After careful review, survival data were extracted from eligible studies. A meta-analysis was performed to generate combined hazard ratios for overall survival, disease-free survival (DFS) and event-free survival (EFS).

Results: A total of 5635 patients from 20 studies were included in the analysis. Our results showed that male gender was associated with poor prognosis in terms of overall survival (OS) (hazard ratio (HR) = 1.155; 95% confidence interval (CI): 1.037-1.286; p < 0.009). The pooled hazard ratio for DFS and EFS showed that male gender was not statistically significant (HR = 1.219; 95% CI: 0.782-1.899; p = 0.382, HR = 0.809; 95% CI: 0.577-1.133; p = 0.217).

Conclusions: The present meta-analysis indicated male gender to be associated with a poor prognosis in patients with DLBCL treated with rituximab-containing regimens.
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http://dx.doi.org/10.5114/aoms.2015.53289DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4548028PMC
August 2015

Expression patterns of claudins 1, 4, and 7 and their prognostic significance in nasopharyngeal carcinoma.

J BUON 2015 Jan-Feb;20(1):212-7

Antalya Education and Research Hospital, Department of Pathology, Antalya, Turkey.

Purpose: Tight junction (TJ) proteins in the cells organize paracellular permeability, and they have a critical role in apical cell-to-cell adhesion and epithelial polarity. In our study, the expression patterns of claudins 1, 4, and 7 and their relationship with prognosis were determined in patients with nasopharyngeal carcinoma.

Methods: Claudins 1, 4, and 7 were stained immunohistochemically in 18 biopsy samples of nasopharyngeal carcinomas that included non-neoplastic surface epithelium and dysplastic epithelium in addition to the tumor tissue. The files of these patients were scanned and the stage of disease and treatment received were obtained along with demographic data such as age and gender.

Results: Overexpression of claudins 1, 4, and 7 in non-neoplastic surface epithelium was found in 14 (77.7%), 16 (88.8%), and 10 (55.5%) cases respectively; in dysplastic surface epithelium overexpression was found in 8 (44.4%), 13 (72.2%), and 4 (22.2%) cases, respectively; and in invasive tumor areas overexpression was found in 13 (72.2%), 9 (50%), and 10 (55.6%) cases respectively. Increased claudin 4 expression was related to advanced stage (p=0.014). There was a significant relationship determined between claudin 4 and 7 expression and decreased survival (p=0.018, p=0.024, respectively).

Conclusion: The fact that a statistically significant relationship was found between claudin 4 expression and advanced stage, and similarly a statistically significant relationship was found between claudin 4 & 7 expression and decreased survival gives rise to thoughts that especially claudin 4 and 7 could have different tumorigenic effects on nasopharyngeal carcinoma besides their known adhesion characteristics.
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April 2015

Expression of Cox-2 and Bcl-2 in Paget's disease of the breast.

Asian Pac J Cancer Prev 2015 ;16(3):1041-5

Department of Pathology, Antalya Education and Research Hospital, Antalya, Turkey E-mail :

Background: Paget's disease (PD) is a rare form of intraepithelial adenocarcinoma that involves breast and extramammarian tissues. It is often associated with ductal carcinoma in situ and/or invasive ductal cancer. Molecular pathways that play a role in development of Paget's disease are stil unclear. Expression patterns of Cox-2 and bcl-2 were therefore assessed.

Materials And Methods: Patients with a histopathological diagnosis of Paget's disease were included in this study. Patient files were analysed retrospectively.

Results: Invasive cancer was diagnosed in 35 (76.1%) of the patients, 7 (15.2%) had ductal carcinoma in situ and 4 (8.7%) patients had no associated neoplasm. Twenty four (52.2%) patients showed COX-2 expression in Paget cells whereas no expression was seen in 22 (47.8%) patients. No relation was found between COX-2 expression and the lesion underlying Paget's disease (p=0.518). Bcl-2 expression in Paget cells was found positive in 12 (26.1%) and negative in 27 (58,7%) cases. There was no relation between Bcl-2 expression and the lesion accompanying Paget's disease (p=0.412). No relation was observed between COX-2 expression and Bcl-2 expression (p=0.389).

Conclusions: In breast cancer, COX-2 expression is associated with poor prognostic factors. As COX-2 expression increases the tendency to metastasize also increases. In our study we found a significantly high COX-2 expression in Paget's disease of the breast. We suggest that COX-2 expression and inflammatory processes may play a role in pathogenesis of the Paget's disease of the breast.
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http://dx.doi.org/10.7314/apjcp.2015.16.3.1041DOI Listing
December 2015

Prognostic significance of p53 in gastric cancer: a meta- analysis.

Asian Pac J Cancer Prev 2015 ;16(1):327-32

Department of Medical Oncology, Ministry of Health Batman Regional Government Hospital, Batman, Turkey E-mail :

Background: Gastric cancer is one of the frequently seen cancers in the world and it is the second most common reason for death due to cancer. The prognostic role of expression of p53 detected by immunohistochemistry in gastric cancer remains controversial. This meta-analysis aimed to explore any association between overexpression and survival outcomes.

Materials And Methods: We systematically searched for studies investigating the relationships between expression of p53 detected by immunohistochemistry and prognosis of gastric cancer patients. Study quality was assessed using the Newcastle-Ottawa Scale. After careful review, survival data were extracted from eligible studies. A meta-analysis was performed to generate combined hazard ratios for overall survival and disease-free survival.

Results: A total of 4.330 patients from 21 studies were included in the analysis. Our results showed tissue p53 overexpression in patients with gastric cancer to be associated with poor prognosis in terms of overall survival (HR, 1.610; 95% CI, 1.394 -5.235; p: <0.001). Pooled hazard ratio for disease free survival showed that p53 positivity or negativity were not statitistically significant (HR, 1.219; 95%CI, 0.782-1.899; p:0.382).

Conclusions: The present meta-analysis indicated overexpression of p53 detected by immunohistochemistry to be associated with a poor prognosis in patients with gastric cancer.
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http://dx.doi.org/10.7314/apjcp.2015.16.1.327DOI Listing
October 2015

Mandible bone metastases secondary to pulmonary adenocarcinoma.

Med Arch 2014 Oct 15;68(5):356-8. Epub 2014 Oct 15.

Department of Medical Oncology, Isparta State Hospital, Isparta, Turkey.

Objective: Metastatic tumors of the mandible are rare and usually present clinically as growths. The prognosis of lung cancer patients with bone metastases is poor.

Case Report: This article shows a metastasis from adenocarcinoma of the lung affecting the mandible of a 75-year-old female patient where the metastatic lesion was detected before primary tumor. The patient were treated with radiation therapy with palliative and antalgic intent. But the patient died 8 weeks after the diagnosis.

Conclusion: Radiation therapy was effective and well tolerated in the case. Bone metastases particularly mandible metastasis of lung cancer has poor prognosis. Palliative and supportive therapy may be firstly chose because of poor prognosis.
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http://dx.doi.org/10.5455/medarh.2014.68.356-358DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4269538PMC
October 2014

Roles for paraoxonase but not ceruloplasmin in peritoneal washing fluid in differential diagnosis of gynecologic pathologies.

Asian Pac J Cancer Prev 2014 ;15(15):6233-7

Department of Medical Oncology, Ministry of Health Batman Regional Govermant Hospital, Batman, Turkey E-mail :

Background: Intraperitoneal spread of gynecologic cancers is a major cause of mortality and morbidity and often presents with malignant ascites. Microscopic tumor spread can be demonstrated by a peritoneal wash cytology and help assess the prognosis of the disease. In our study, the roles of paraoxonase and ceruloplasmin, measured in peritoneal washing fluid of patients operated for gynecologic pathologies in differential diagnosis was investigated.

Materials And Methods: Patients operated for malign or benign gynecologic pathologies in Antalya Education and Research Hospital Gynecology Clinic between 2010-2012 were included in the study. Samples were obtained during surgery.

Results: A statistically significant difference was detected between patients with benign and malign diseases with regards to PON1 levels measured in peritoneal washing fluid (p:0.044), the average values being 64.2±30.8 (Range 10.8-187.2) and 41.4±21.4 (Range 10.4-95.5), respectively. No significant variation was evident for ceruloplasmin.

Conclusions: Paraoxonase levels measured in peritoneal washing fluid may contribute to the differentiation of malign-benign diseases in gynecologic pathologies.
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http://dx.doi.org/10.7314/apjcp.2014.15.15.6233DOI Listing
January 2017

The clinical and pathological features of 133 colorectal cancer patients with brain metastasis: a multicenter retrospective analysis of the Gastrointestinal Tumors Working Committee of the Turkish Oncology Group (TOG).

Med Oncol 2014 Sep 10;31(9):152. Epub 2014 Aug 10.

Department of Medical Oncology, Faculty of Medicine, Medical School of Sitki Kocman University, Mugla, 48000, Turkey,

Brain metastasis in colorectal cancer is highly rare. In the present study, we aimed to determine the frequency of brain metastasis in colorectal cancer patients and to establish prognostic characteristics of colorectal cancer patients with brain metastasis. In this cross-sectional study, the medical files of colorectal cancer patients with brain metastases who were definitely diagnosed by histopathologically were retrospectively reviewed. Brain metastasis was detected in 2.7 % (n = 133) of 4,864 colorectal cancer patients. The majority of cases were male (53 %), older than 65 years (59 %), with rectum cancer (56 %), a poorly differentiated tumor (70 %); had adenocarcinoma histology (97 %), and metachronous metastasis (86 %); received chemotherapy at least once for metastatic disease before brain metastasis developed (72 %), had progression with lung metastasis before (51 %), and 26 % (n = 31) of patients with extracranial disease at time the diagnosis of brain metastasis had both lung and bone metastases. The mean follow-up duration was 51 months (range 5-92), and the mean survival was 25.8 months (95 % CI 20.4-29.3). Overall survival rates were 81 % in the first year, 42.3 % in the third year, and 15.7 % in the fifth year. In multiple variable analysis, the most important independent risk factor for overall survival was determined as the presence of lung metastasis (HR 1.43, 95 % CI 1.27-4.14; P = 0.012). Brain metastasis develops late in the period of colorectal cancer and prognosis in these patients is poor. However, early screening of brain metastases in patients with lung metastasis may improve survival outcomes with new treatment modalities.
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http://dx.doi.org/10.1007/s12032-014-0152-zDOI Listing
September 2014

Lack of any prognostic role of insulin-like growth factor-1 receptor in non-small cell lung cancer.

Asian Pac J Cancer Prev 2014 ;15(14):5753-7

Department of Medical Oncology, Antalya Education and Research Hospital, Antalya, Turkey E-mail :

Background: The purpose of this study is to determine whether the IGF1R expression has a prognostic role in non-small cell lung cancer.

Materials And Methods: Forty-seven patients histopathologically diagnosed with small cell lung cancer upon bronchoscopic biopsy or resection materials were included in the study. IGF1R expression was examined via immunohistochemical methods. In samples, >10% staining were assessed as positive and ≤10% as negative. Information about demographic datas and treatments was obtained by retrospective searches of patient files.

Results: IGF1R expression was determined as positive in 38 (80.9%) and as negative in 9 (19.1%) patients. There was no significant relation between IGF1R expression and histological sub-type, local invasion, lymph node and metastasis status (p=0.842, p=0.437, 0.064, 0.447, respectively). There was also no correlation with IGF1R expression and survival (p=0.141).

Conclusions: There are conflicting results between IGF1R and its prognostic effects in the various studies. It has been claimed in some studies it is not related to prognosis as in our study, and in some studies it has been claimed that it is a good prognostic factor whereas in some studies it has been claimed as being a factor for worse prognosis. We think that IGF1R expression in non-small cell lung carcinoma patients deserves further analysis, because of its potential prognostic and predictive roles.
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http://dx.doi.org/10.7314/apjcp.2014.15.14.5753DOI Listing
June 2015

Loss of tight junction proteins (Claudin 1, 4, and 7) correlates with aggressive behavior in colorectal carcinoma.

Med Sci Monit 2014 Jul 20;20:1255-62. Epub 2014 Jul 20.

Department of Pathology, Antalya Education and Research Hospital, Antalya, Turkey.

Background: Tight junction proteins in the cell organize paracellular permeability and they play a critical role in apical cell-to-cell adhesion and epithelial polarity. Claudins are major integral membrane proteins of tight junctions, especially Claudin 1, 4, and 7, which are known as the impermeability Claudins. In this study, we investigated the importance of loss of Claudin 1, 4, and 7 expression, and their relation to tumor progression in colorectal cancer patients.

Material/methods: Loss of Claudin 1, 4, and 7 expression was examined by immunohistochemical method in 70 patients diagnosed with colorectal cancer. Cases with loss of Claudin expression in <1/3 of tumor cells were classified as mild loss, whereas cases with loss of Claudin expression ³1/3 of tumor cells were classified as moderate-to-marked loss in order to evaluate the relation between loss of Claudin 1, 4, and 7 expression and clinicopathologic data.

Results: The severe suppression of Claudin 1, 4, and 7 expression was found to be significantly related to the depth of tumor invasion, positive regional lymph nodes, histological grade, lymphovascular invasion, perineural invasion, and lymphocytic response. Additionally, severity of loss in Claudin 4 expression was found to have a relation with distant metastasis.

Conclusions: Claudin 1, 4, and 7 are important building blocks of paracellular adhesion molecules. Their decreased expression in colorectal cancer seems to have critical effects on cell proliferation, motility, invasion, and immune response against the tumor.
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http://dx.doi.org/10.12659/MSM.890598DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113573PMC
July 2014

Clinical prognostic factors of adjuvant radiation therapy for low-grade gliomas: results of 10 years survival.

Int J Clin Exp Med 2014 15;7(5):1336-43. Epub 2014 May 15.

Department of Radiation Oncology, Akdeniz University School of Medicine Antalya, Turkey.

Objective: Low-grade gliomas compose 5-20% of all glial tumors. The prognosis of the disease can be anticipated by specific clinical factors determined during diagnosis. For this purpose, our study investigated the clinical prognostic factors for low-grade gliomas.

Methods: Patients diagnosed with histopathologically confirmed low-grade glioma, followed by Akdeniz University and Süleyman Demirel University School of Medicine, Department of Radiation Oncology between 1999 and 2013 were included in the study. The examination of survival by single variable analyses were performed by log rank test. For the multivariate analysis, independent factors for the prediction of survival by using possible factors determined by previous analyses were examined by using Cox regression analysis.

Results: Fifty-five patients were included in the study. The mean follow-up period was determined as 60 ± 57 (4.5-168.1) months. Five-year overall survival was determined as 69% and 10-year overall survival was determined as 40%. When the potential prognostic factors were studied in Cox regression model, pre-radiotherapy age below 40 and gross-total excision were determined as good prognostic factors.

Conclusion: We demonstrated that the aggressive surgical resection provided a better survival advantage both in single variable analyses and multivariate analyses. Consequently, although the low number of patients was the most important limitation in our study, we consider that patient age and extent of resection are the most important clinical prognostic factors in low-grade gliomas.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4073753PMC
July 2014

Expression of cyclooxygenase-2 and Bcl-2 in breast cancer and their relationship with triple-negative disease.

J BUON 2014 Apr-Jun;19(2):430-4

Antalya Education and Research Hospital, Department of Pathology, Antalya, Turkey.

Purpose: Carcinogenesis is a multistep process with many factors being involved. The aim of this study was to investigate the role of cyclooxygenase-2 (COX-2) and Bcl-2 expression in patients with triple-negative breast cancer (TNBC) and, also whether any differences exist between TNBC and non-TNBC patients in relation with these two parameters.

Methods: This study included 50 patients with pathologically diagnosed TNBC and followed up at the Medical Oncology Clinic of Antalya Education and Research Hospital between 2008 and 2010. Thirty non-TNBC patients composed the control group. COX-2 and Bcl-2 expression was immunohistochemically investigated in both patient groups.

Results: COX-2 expression was positive in 26 (86.7%) of non-TNBC and 18 (90%) of TNBC patients (p=0.722). Compared with non-TNBC, TNBC correlated with higher Bcl-2 expression (p=0.005). Of the non-TBNC patients 86.7% and 50% of TNBC patients showed Bcl-2 expression. When Bcl-2 and COX-2 expression were considered together, a significant difference was found between the two groups (p=0.021).

Conclusion: This study showed that increased COX-2 expression correlated with Bcl-2 expression both in TNBC and non-TNBC patients. Analysis of coexpression of Bcl- 2 and COX-2 may be meaningful for deciding treatment strategies for TNBC. Treatment strategies targeting Bcl-2 and COX-2 seem to be promising for this aggressive disease with no specific treatment.
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September 2014

Lack of relation of AKAP12 with p53 and Bcl-2 in colorectal carcinoma.

Asian Pac J Cancer Prev 2014 ;15(8):3415-8

Pathology, Antalya Education and Research Hospital, Antalya, Turkey E-mail :

Background: AKAP12 inhibits oncogenic proliferation, invasion, chemotaxis and neovascularization. Bcl-2 and p53 are two important apoptotic markers that play roles in apoptotic processes. It has been found that AKAP12 blocks the cell cycle and induces apoptosis in fibrosarcoma cells. In our study we assessed the relationship of AKAP12 with apoptotic markers, Bcl-2 and p53.

Materials And Methods: Our study included 45 cases that were histopathologically diagnosed with colorectal carcinoma from the tissue samples acquired by surgical resection. AKAP 12, Bcl-2, and p53 expression was examined by immunohistochemistry.

Results: A total of 45 colorectal adenocarcinoma patients - 17 (37.8%) females and 28 (62.2%) males - were included in this study. AKAP12 expression was found to be negative in 8 patients (17.8%), and positive in 37 patients (82.2%). Bcl-2 was found positive in 6 patients (13.3%) and p53 in 29 patients (55.6%). AKAP12 expression had no significant relation with Bcl-2 and p53 expression (p:0.939, p:0.079, respectively).

Conclusions: Although various studies have pointed to apoptotic activity of AKAP12, the literature is limited regarding relations with p53 or Bcl-2 expression. In the present study, we found no relation in colorectal carcinomas.
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http://dx.doi.org/10.7314/apjcp.2014.15.8.3415DOI Listing
January 2015

Esophageal cancer, gastric cancer and the use of pesticides in the southwestern of Turkey.

Asian Pac J Cancer Prev 2014 ;15(6):2821-3

Department of Medical Oncology, Ministry of Health Batman Regional Govermant Hospital, Batman, Turkey E-mail :

Background: Esophageal and gastric cancer generally have a poor prognosis and may share common risk factors. It has been demonstrated that the pesticide usage may contribute to development of many cancer types. In this study, the relation between amount of pesticides used in agriculture and esophageal and gastric cancer incidence was researched.

Materials And Methods: Findings from the data bank of the Ministry of Health Provincial Health Directorate Cancer Records Center between the years of 1998-2010 were used. All patients who were diagnosed with gastric and esophageal cancer histopathologically were included. Data for annual pesticide usage were obtained from Provincial Agriculture Directorate for the same time period. Statistical analysis was performed using the Spearman test.

Results: One thousand eight hundred and ninety-six patients were involved in the study, 1,233 males (65%) and 663 females (35%), 230 with esophageal cancer (12.1%) and 1,666 with gastric cancer (87.9%). No statistically significant relation was apparent between pesticide amount used and esophageal cancer (p: 0.87).

Conclusions: In our study, there was no relationship between pesticide usage and esophageal or gastric cancer. However, the time between pesticide usage and cancer development was not known, qualifying the comparison.
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http://dx.doi.org/10.7314/apjcp.2014.15.6.2821DOI Listing
January 2015

The role of high mobility group box 1 (HMGB1) in colorectal cancer.

Med Sci Monit 2014 Mar 31;20:530-7. Epub 2014 Mar 31.

Department of Pathology, Antalya Education and Research Hospital, Antalya, Turkey.

Background: HMGB1, the most important member of the high mobility group box protein family, is a nuclear protein with different functions in the cell; it has a role in cancer progression, angiogenesis, invasion, and metastasis development. We studied the expression of HMGB1 and whether it is a prognostic factor in colorectal carcinoma.

Material And Methods: The study included 110 cases that were histopathologically diagnosed with colorectal carcinoma from the tissue samples acquired by surgical resection and biopsy in Antalya Education and Research Hospital between 2008 and 2012. HMGB1 expression was examined via immunohistochemical method.

Results: HMGB1 expression was evaluated as negative in 32 (44.4%) of the patients and as positive in 40 (55.6%) patients. There was no relation between the HMGB1 expression and sex, age, tumor invasion depth, and histological type. However, a significant relation was detected between the HMGB1 expression and lymph node status, metastasis status, and stage (p:<0.001, p:<0.001, p:<0.001, respectively). Similar results were obtained for the relations between the HMGB1 and histological grade, perineural invasion, lymphovascular invasion, and lymphocytic response (p<0.001, p<0.001, p<0.001, and p<0.001, respectively).

Conclusions: The results of our study demonstrate that HMGB1 overexpression has a significant role in tumor progression (especially migration of tumor cells) and tumor ability to metastasize in colorectal cancers; thus, it corroborates the idea that it might be an important prognostic factor.
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http://dx.doi.org/10.12659/MSM.890531DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3976146PMC
March 2014

The role of high mobility group box 1 (HMGB1) in colorectal cancer.

Med Sci Monit 2014 Mar 31;20:530-7. Epub 2014 Mar 31.

Department of Pathology, Antalya Education and Research Hospital, Antalya, Turkey.

Background: HMGB1, the most important member of the high mobility group box protein family, is a nuclear protein with different functions in the cell; it has a role in cancer progression, angiogenesis, invasion, and metastasis development. We studied the expression of HMGB1 and whether it is a prognostic factor in colorectal carcinoma.

Material And Methods: The study included 110 cases that were histopathologically diagnosed with colorectal carcinoma from the tissue samples acquired by surgical resection and biopsy in Antalya Education and Research Hospital between 2008 and 2012. HMGB1 expression was examined via immunohistochemical method.

Results: HMGB1 expression was evaluated as negative in 32 (44.4%) of the patients and as positive in 40 (55.6%) patients. There was no relation between the HMGB1 expression and sex, age, tumor invasion depth, and histological type. However, a significant relation was detected between the HMGB1 expression and lymph node status, metastasis status, and stage (p:<0.001, p:<0.001, p:<0.001, respectively). Similar results were obtained for the relations between the HMGB1 and histological grade, perineural invasion, lymphovascular invasion, and lymphocytic response (p<0.001, p<0.001, p<0.001, and p<0.001, respectively).

Conclusions: The results of our study demonstrate that HMGB1 overexpression has a significant role in tumor progression (especially migration of tumor cells) and tumor ability to metastasize in colorectal cancers; thus, it corroborates the idea that it might be an important prognostic factor.
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http://dx.doi.org/10.12659/MSM.890531DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3976146PMC
March 2014

The relation of radiation-induced pulmonary fibrosis with stress and the efficiency of antioxidant treatment: an experimental study.

Med Sci Monit 2014 Feb 21;20:290-6. Epub 2014 Feb 21.

Department of Radiation Oncology, Süleyman Demirel University School of Medicine, Isparta, Turkey.

Background: Radiation-Induced Lung Injury has 2 components: radiation pneumonitis and radiation fibrosis. The pulmonary fibrosis has no known efficient treatment. The purpose of this study was to study the relationship between the oxidant/antioxidant status and pulmonary fibrosis in rats having radiation induced pulmonary fibrosis and to study the antioxidant effects of pentoxifylline, vitamin E, and vitamin C in the treatment of pulmonary fibrosis.

Material And Methods: The study rats were divided into 5 groups: Thoracic RT + vitamin E+ Pentoxifylline for group 1, Thoracic RT + vitamin C + Pentoxifylline for group 2, Thoracic RT + vitamin C + vitamin E + Pentoxifylline for group 3, and Thoracic RT + Pentoxifylline for group 4, and group 5 was the control group.

Results: When groups are evaluated in pairs, significant differences between group 1 and 2, group 1 and 4, and group 1 and 5 were determined (p: 0.002, p: 0.002, p<0.001, respectively). No significant difference was determined between group 1 and 3 (p: 0.161). No significant difference was determined between group 2 and group 3, 4, and 5 (p: 0.105, p: 0.645, p: 0.234, respectively). There was no significant difference between group 4 and 5 (p: 0.645).

Conclusions: The combination of vitamin E and pentoxifylline is efficient in preventing radiation-induced lung fibrosis. The additional benefit of vitamin C, which is added to this combination to increase the antioxidant activity, cannot be shown. It would be useful to investigate the combination of vitamin E, pentoxifylline, and other non-enzymatic antioxidants.
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http://dx.doi.org/10.12659/MSM.890334DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3937037PMC
February 2014

Prognostic significance of basic laboratory methods in non- small-cell-lung cancer.

Asian Pac J Cancer Prev 2013 ;14(9):5473-6

Department of Radiation Oncology, Suleyman Demirel University School of Medicine, Isparta, Turkey E-mail :

Background: In our study, the LDH, albumin, hemoglobin, neutrophile, thrombocyte, lymphocyte counts and prognostic significance of neutrophile-lymphocyte and thrombocyte-lymphocyte ratios in NSCLC derived from these counts obtained during regular examinations of patients were examined.

Materials And Methods: Histopathologically diagnosed non-small-cell-lung cancer patients between 2008 and 2010 were included in the study. Before the treatment, full blood count including routine lymphocyte count, blood biochemistry examinations including liver (AST, ALT, total protein, Albumin), LDH and kidney (BUN, Cre) function tests were performed.

Results: A total of 156 patients, 76 of whom (48.7%) were female and 80 of whom (51.3%) were male were included. Mean hemoglobin level was determined as 12. Overall survival was found to be significantly dependent on whether patients were anemic or not (p: 0.005). Mean LDH level was determined as 233.4. There was nosurvival difference between patients with and without high LDH (p: 0.532). In patients where NLR showed systemic inflammatory response, overall survival was 10.8 months whereas this duration was 19.6 months in patients where the systemic inflammatory response was negative (p: 0.012). In patients where TLR showed systemic inflammatory response, overall survival was 13.6 months whereas this duration was 21.9 months in patients where the systemic inflammatory response was negative (p: 0.04).

Conclusions: Molecular methods have been changing rapidly in today's world and they manage the treatment besides defining the prognosis of patients. However, easily accessible and cheap laboratory parameters should be considered in the prognosis of patients besides these new methods.
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http://dx.doi.org/10.7314/apjcp.2013.14.9.5473DOI Listing
June 2014

Non-Hodgkin lymphoma and pesticide exposure in Turkey.

Asian Pac J Cancer Prev 2013 ;14(6):3461-3

Department of Medical Oncology, Ministry of Health Batman Regional Govermant Hospital, Batman, Turkey.

Background: Non-Hodgkin lymphoma (NHL) is a solid tumour of lymphocytes, important elements in the immune system. According to 2006 data, in Turkey the incidence was 6.5 per 100,000 in males, and 4.4 in females. The relationship between the use of pesticides and development of NHL has been extensively investigated in many studies, and it has been demonstrated that the risk of NHL is increased by exposure to such compounds. Antalya is a region of intensive agricultural activity. In this study, the relationship between the incidence of lymphoma in Antalya and the amount of pesticides employed was investigated.

Materials And Methods: The study used data from 1995 to 2010 on the patients from the databank of TR Ministry of Health, Antalya Provincial Health Directorate, Cancer Registration Center and the patients who were histopathologically diagnosed with NHL during these years.

Results: The relationship between the amount of pesticide used and the incidence was studied with the Spearman correlation analysis and the p value was found as 0.05. The correlation coefficient was 0.497. An increase in the NHL incidence over the years was identified, with a 2.42-fold increment found from 1995 to 2005 and a 2.77 fold elevation from 1995 to 2010. The use of pesticides increased 1.89 fold over the same period.

Conclusions: Our study investigated the relationship of the pesticides used with NHL patients diagnosed during the same year. Since the time elapsing after exposure to pesticides until the development of cancer is not clear, no comparison can be made at present. We believe that the increase in use of pesticides since 1995 may be associated with the increase in the incidence of NHLand therefore that further studies on the issue including measurements of serum pesticide levels, are required.
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http://dx.doi.org/10.7314/apjcp.2013.14.6.3461DOI Listing
February 2014

Isolated and solitary splenic metastasis detected by positron emission tomography in a patient with malignant melanoma: case report and review of the literature.

Contemp Oncol (Pozn) 2013 29;17(2):214-7. Epub 2013 Apr 29.

Denizli State Hospital, Department of Radiation Oncology, Denizli, Turkey.

Splenic metastasis from malignant melanoma is an extremely rare occurrence and is most often reported during autopsy. As in other solid tumors, splenic metastasis is usually part of multiple organ metastases in melanoma and is rarely an isolated or solitary mass. As the use of positron emission tomography /computed tomography and imaging techniques become more common, splenic metastases are seen more often than before. Even though it is a commonly known fact that positron emission tomography/computed tomography is no help during primary staging and patient relations in malignant melanoma, several studies and meta-analyses have proven that it is more specific, sensitive and accurate to identify metastases than raditional methods. Therefore, using techniques with high specificity and accuracy rates such as positron emission tomography/computed tomography in the diagnosis of splenic metastasis in patients with malignant melanoma will increase the survival rate with an earlier splenectomy. We report the case of a 35-year-old male patient with cutaneous malignant melanoma whose splenic metastasis was detected with positron emission tomography/computed tomography. This article describes, with reference to the literature, a malignant melanoma case, which presented with splenomegaly and solitary mass lesion and was diagnosed as metastasis by splenectomy after positron emission tomography/computed tomography.
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http://dx.doi.org/10.5114/wo.2013.34627DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3685360PMC
June 2013

Tumour markers in peritoneal washing fluid - contribution to cytology.

Asian Pac J Cancer Prev 2013 ;14(2):1027-30

Department of Medical Oncology, Ministry of Health Batman Regional Govermant Hospital, Batman, Turkey.

Background: Peritoneal washing cytology (PWC) that shows the microscopic intra-peritoneal spread of gynaecologic cancers is not used in staging but is known as prognostic factor and effective in planning the intensity of the therapy. False negative or false positive results clearly affect the ability to make the best decision for therapy. In this study we assessed levels of tumour markers, carcinoembryonic antigen (CEA), cancer antigen 125 (CA-125) and carbohydrate antigen (CA19-9), in peritoneal washing fluid to establish any possible contribution to the peritoneal washing cytology in patients operated for gynaecologic cancer.

Materials And Methods: Preoperative tumour markers were studied in serum of blood samples obtained from the patients for preoperative evaluation of a gynaecologic operation. In the same group peritoneal tumour markers were studied in the washing fluid obtained for intraoperative cytological evaluation.

Results: This study included a total of 94 patients, 62 with malignant and 32 with benign histopathology. The sensitivity of the cytological examination was found to be 21% with a specificity of 100%. When evaluated with CEA the sensitivity of the cytological examination has increased to 37%.

Conclusions: In addition to examination of PWC, the level of CEA, a tumour marker, in peritoneal washing fluid can make a diagnostic contribution. Determining the level of CEA in peritoneal washing fluid will be useful in the management of gynaecologic cancers.
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July 2014

Presacral and intrathoracic extramedullary hematopoiesis: a case report.

Clin Imaging 2012 Jul-Aug;36(4):406-8. Epub 2012 Jun 8.

Pamukkale University Hospital, Department of Pediatric Hematology, Turkey.

Extramedullary hematopoiesis (EMH) refers to the location of hematopoietic elements in locations other than the bone marrow and peripheral blood. It may be seen as a compensatory condition in many hematological conditions including thalassemia, or it may occur as an incidental finding. Intrathoracic EMH commonly develops in the posteroinferior mediastinum. Presacral EMH is an extremely rare condition, and there are a limited number of case reports published in the literature. We are reporting a case of EMH that involves the posterior mediastinum and presacral region on computed tomography and magnetic resonance imaging in a patient with thalassemia intermedia.
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http://dx.doi.org/10.1016/j.clinimag.2011.10.017DOI Listing
November 2012