Esen, Selin Aktürk; Ergun, Yakup; Erol, Cihan; Arikan, Rukiye; Er, Muhammed Muhiddin; Atci, Muhammed Mustafa; Topçu, Atakan; Uçar, Gökhan; Akagündüz, Baran; Aykan, Musa Bariş

Fluoropyrimidine+cisplatin/oxaliplatin+trastuzumab therapy is recommended for the first-line treatment of human epidermal growth factor receptor 2 (HER2)-positive metastatic gastric adenocarcinoma. However, there is no comprehensive study on which plati-num-based treatment should be preferred. This study aimed to compare the treatment response and survival characteristics of patients with HER2-positive metastatic gastric or gastroesophageal junction (GEJ) cancer who received f luorouracil, oxaliplatin, and leucovo-rin (mFOLFOX)+trastuzumab or cisplatin and f luorouracil (CF)+trastuzumab as first-line therapy. It was a multicenter, retrospective study of the Turkish Oncology Group, which included 243 patients from 21 oncology centers. There were 113 patients in the mFOLF-OX+trastuzumab arm and 130 patients in the CF+trastuzumab arm. The median age was 62 years in the mFOLFOX+trastuzumab arm and 61 years in the CF+trastuzumab arm (p = 0.495). About 81.4% of patients in the mFOLFOX+trastuzumab arm and 83.1% in the CF+trastuzumab arm had gastric tumor localization (p = 0.735). The median progression-free survival (PFS) was significantly higher in the mFOLFOX+trastuzumab arm (9.4 months vs. 7.3 months, p = 0.024). The median overall survival (OS) was similar in both groups (18.4 months vs. 15.1 months, p = 0.640). Maintenance trastuzumab was continued after chemotherapy in 101 patients. In this subgroup, the median OS was 23.3 months and the median PFS was 13.3 months. In conclusion, mFOLFOX+trastuzumab is similar to CF+trastuzumab in terms of the median OS, but it is more effective in terms of the median PFS in the first-line treatment of HER2-positive metastatic gastric and GEJ cancer. The choice of treatment should be made by considering the prominent toxicity findings of the chemotherapy regimens.

Demirelli, Selami; Degirmenci, Hüsnü; Bilen, Handan; Ermis, Emrah; Duman, Hakan; Arisoy, Arif; Murat Bakirci, Eftal; Ipek, Emrah; Askin, Lutfu

Although cardiac involvement is rarely seen in Behcet’s disease (BD), it is essential to detect subclinical left ventricular (LV) dysfunction for prognostic purposes. Herein we aimed to show the role of two dimensional (2D) speckle tracking echocardiography (STE) in determination of subclinical LV dysfunction in patients with BD. 30 patients diagnosed as BD due to International Study Group Behcet’s diagnostic criteria and 25 control subjects underwent Doppler echocardiography including pulsed tissue Doppler of the mitral annulus and speckle-tracking echocardiography. LV peak longitudinal strain and strain rate (SR) was calculated in four-chamber (4C), apical long-axis (LAX), and two-chamber (2C) views, and values of the three views were averaged LV global longitudinal strain (LV-GLS) and SR. LV torsion was determined as the net difference in the mean rotation between the apical and basal levels. There was not any significant difference in age and gender between groups. Patients with BD had significantly lower LV longitudinal strain and Sr measurements than the control group. Although LV basal rotation (LVR) basal values were similar in both groups, LVR-apical and LV torsion (LVTR) values were significantly higher in patient group. LVR-apical and LV-GLS were found to have a good positive corelation (r: 0.44, p<0.001) (r: -0.56, r: -0.65, respectively. p<0.001). There was a weak positive correlation between LVTR and LV-GLS (r: 0.29, p<0.05). We demonstrated that combined assessment of LV-GLS, LV-GLSR, LVTR and LVRapical values detected by STE can be useful in determination of subclinical left ventricular dysfunction in BD.

Demirelli, Selami; Degirmenci, Husnu; Ermis, Emrah; Inci, Sinan; Nar, Gokay; Ayhan, Mehmet Emin; Fırtına, Serdar; Hamur, Hikmet; Durmaz, Senay Arikan

Polycystic ovary syndrome (PCOS) is characterized by hormonal and metabolic abnormalities and is thought to increase a risk for cardiovascular diseases. In this study we use speckle tracking echocardiography (STE) to evaluate left ventricular (LV) dysfunction in the early period of the disease. We enrolled 31 patients with PCOS and 32 healthy volunteers as a control group. The participants’ ages ranged between 18 and 40 years. PCOS was diagnosed according to the Rotterdam criteria. LV strain (LS) and strain rate (SR) were evaluated using apical two-chamber (2C), three-chamber (3C), and four-chamber (4C) imaging. Global LS and SR were calculated as average of three apical views. The waist-to-hip ratio, homeostasis model assessment-insulin resistance (HOMA-IR), and fasting insulin and triglyceride levels were higher in the PCOS group than in the controls (p = 0.001, p = 0.001, p = 0.001, and p = 0.005, respectively). In the PCOS group, the mitral A wave, deceleration time (DT), and isovolumetric relaxation time (IVRT) were significantly higher than in the controls (all p < 0.05). The LV global longitudinal strain (GLS) and global longitudinal SR systolic (GLSRS) were significantly lower in the PCOS patient group (both p = 0.001). There were strong negative correlations between GLS and both fasting insulin (r = −0.64) and DT (r =-0.62) (both p < 0.05). The study demonstrated that PCOS patients had decreased LV function using STE. Therefore, STE imaging appears to be useful for the early detection of subclinical LV dysfunction in patients with PCOS.