Browsing by Author "Karakas, Hilal"

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Age-Related Differences in E-Health Literacy in People with Multiple Sclerosis
(Sage Publications Ltd, 2025) Yavas, Ipek; Karakas, Hilal; Celik, Rabia Gokcen Gozubatik; Cansiz, Melek; Ertekin, Ozge; Kahraman, Turhan
Cognitive Difficulties, Coping Strategies and Barriers to Participation in Cognitive Rehabilitation in People With Multiple Sclerosis: A Qualitative Study Across Different Disability Levels
(Sage Publications Ltd, 2025) Karakas, Hilal; Yavas, Ipek; Gokcen, Rabia; Celik, Gozubatik; Cansiz, Melek; Ertekin, Ozge; Kahraman, Turhan
Citation - Scopus: 2
Effect of Telerehabilitation-Based Motor Imagery Training on Pain and Related Factors in People with Multiple Sclerosis: Randomized Controlled Pilot Trial
(WB Saunders Co-Elsevier Inc, 2025) Karakas, Hilal; Kahraman, Turhan; Ozdogar, Asiye Tuba; Baba, Cavid; Ozakbas, Serkan
Objectives: To investigate the effect of telerehabilitation-based graded motor imagery (MI, GMI) training on pain and pain-related factors in people with multiple sclerosis (MS). Design: Randomized controlled, assessor-blind pilot trial with repeated-measure design. Setting: Neurology outpatient clinic. Participants: Thirty-two people with MS were randomly allocated to intervention (n=16) and control (n=16) groups. Interventions: During the 8-week GMI training period, the first 2 weeks involved implicit MI training while 6 weeks of explicit MI training were conducted. Main Outcome Measures: The primary outcome was the general pain intensity over the past 2 days, assessed with a visual analog scale, with a minimum clinically important difference (MCID) of 23 mm. Secondary outcomes included general pain and specific body parts' pain intensity over the past 7 days, neuropathic pain intensity, MI ability, fatigue, depression, anxiety, quality of life, sleep quality, daytime sleepiness, and cognitive functions scores. Assessments were conducted at baseline, at weeks 8 (post-treatment) and 12 (follow-up). Results: The intervention group demonstrated a significant reduction in pain intensity over the past 2 days compared with control group (P<.05). Furthermore, at the 8-week assessment, the intervention group surpassed the MCID in pain intensity over the past 2 and 7 days (P<.05), whereas no significant change was observed in the control group (P>.05). Significant effects were observed post-treatment on general pain over the past 7 days, neuropathic pain, MI ability, fatigue, depression, quality of life, processing speed, and visuospatial memory within intervention group compared with control group (P<.05). However, the effect on anxiety, sleep quality, daytime sleepiness, and verbal memory between groups was not significant (P>.05). Conclusions: Telerehabilitation-based GMI training stands out as viable for the management of chronic pain and pain-related psychosocial symptoms for people with MS.
Citation - WoS: 1
Citation - Scopus: 1
Evaluating the Prognostic Role of Glucose-to Ratio in Patients With Metastatic Renal Cell Carcinoma Treated with Tyrosine Kinase Inhibitors in First Line: A Study by the Turkish Oncology Group Kidney Cancer Consortium (TKCC)
(Springer Int Publ AG, 2025) Bolek, Hatice; Kuzu, Omer Faruk; Sertesen Camoz, Elif; Sim, Saadet; Sekmek, Serhat; Karakas, Hilal; Urun, Yuksel
Purpose Identifying prognostic indicators for risk stratification in metastatic renal cell carcinoma (mRCC) is crucial for optimizing treatment strategies and follow-up plans. This study aims to investigate the prognostic role of the glucose-to-lymphocyte ratio (GLR) in patients with mRCC receiving tyrosine kinase inhibitors (TKIs) as first-line therapy. Methods A retrospective cohort study was conducted using data from the Turkish Oncology Group Kidney Cancer Consortium Database. GLR was calculated by dividing the fasting glucose (mmol/L) by the lymphocyte count (x109/L). We categorized patients into two categories based on their median GLR level. Results The analysis included a total of 598 patients. We found that progression-free survival (PFS) was significantly longer in the GLR-low group, with a median PFS of 15.05 months (95% CI 12.7-17.4) compared to 7.79 months (95% CI 6.6-9.0) in the GLR-high group (p < 0.001). Multivariate analysis identified GLR as an independent risk factor for poor PFS (HR 1.39, 95% CI 1.12-1.72; p = 0.003). Overall survival (OS) was also significantly longer in the GLR-low group, with a median OS of 38.47 months (95% CI, 30.9-46.0) compared to 24.15 months (95% CI 18.0-30.2) in the GLR-high group (p = 0.001). GLR was an independent predictor for OS in multivariate analysis (HR 1.45, 95% CI 1.12-1.86; p = 0.004). Conclusion The GLR can be a valuable prognostic marker for glucose metabolism and systemic inflammatory status in this patient population. Our research highlights the potential prognostic value of GLR in patients with mRCC receiving TKIs, indicating its potential as a useful tool for clinical decision-making.
Impact of First-Line Tyrosine Kinase Inhibitor Selection on Survival Outcomes With Second-Line Nivolumab in Metastatic Renal Cell Carcinoma
(BMC, 2025) Kuzu, Omer Faruk; Bolek, Hatice; Camoz, Elif Sertesen; Karakas, Hilal; Sekmek, Serhat; Sim, Saadet; Urun, Yuksel
IntroductionAccess to first-line immune checkpoint inhibitor (ICI) combinations in metastatic renal cell carcinoma (mRCC) remains limited in many low- and middle-income countries. Consequently, tyrosine kinase inhibitors (TKIs) are still widely used. This study investigates the impact of first-line sunitinib versus pazopanib on survival outcomes with second-line nivolumab.MethodsWe conducted a retrospective analysis of 245 patients with mRCC from the Turkish Oncology Group Kidney Cancer Consortium Database. Patients received first-line sunitinib or pazopanib, followed by second-line nivolumab. Primary endpoints were time to treatment failure (TTF) and overall survival (OS). Subgroup analyses were performed based on IMDC risk classification and presence of sarcomatoid features.ResultsA total of 245 patients who were treated with sunitinib or pazopanib monotherapy as first-line treatment followed by nivolumab as second-line treatment were included in this study. Median TTF following nivolumab initiation was similar between prior sunitinib and pazopanib groups (7.79 vs 7.72 months; p = 0.892). Median OS-2 was 27.21 months with prior sunitinib and 18.92 months with prior pazopanib (p = 0.496). In patients with sarcomatoid features (n = 20), those pretreated with pazopanib demonstrated numerically longer OS-2 compared to sunitinib (p = 0.023), although the small sample size limits definitive conclusions.ConclusionNo significant differences in survival outcomes were observed between first-line sunitinib and pazopanib before nivolumab in mRCC. In the small subgroup with sarcomatoid features, pazopanib pre-treatment was associated with a numerically longer survival. These findings warrant cautious interpretation and further prospective validation, especially in resource-constrained settings.
The Impact of Smoking on Nivolumab Outcomes in Renal Cell Carcinoma: Real-World Data From the Turkish Oncology Group Kidney Cancer Consortium
(Oxford Univ Press, 2025) Camoz, Elif Sertesen; Bolek, Hatice; Kuzu, Omer Faruk; Sim, Saadet; Karakas, Hilal; Sekmek, Serhat; Urun, Yuksel
Background: The study aims to evaluate the effect of smoking status on treatment results in patients with metastatic renal cell carcinoma (RCC) treated with nivolumab in the second and following lines of therapy. Materials and Methods: The Turkish Oncology Group Kidney Cancer Consortium (TKCC) database was used to extract retrospective data from patients with metastatic RCC treated with nivolumab in the second line and beyond. Patients were evaluated according to their smoking status. Results: A total of 247 patients were evaluated. The majority of the current smokers were male (93.8%, P = .002). Nivolumab is mainly used in the second-line therapy (84.2%). Median time to treatment failure (TTF) and median overall survival were shorter in patients with currently smoking (10.81 vs. 4.11 months, P < .001 and 32.33 vs. 16.76 months, P < .049, respectively). Multivariate analysis showed that current smoking status was an independent adverse factor on median TTF (HR 2.06 95% confidence interval (CI) = 1.20-3.54, P = .009) and median OS (, HR 2.06, 95% CI = 1.25-3.38, P = .004) in metastatic RCC patients treated with nivolumab in the second line and beyond. Conclusions: Current smoking status is an independent adverse prognostic factor for both TTF and OS in patients with metastatic RCC treated with nivolumab in the second line and beyond.
Prognostic Role of Smoking in Metastatic Renal Cell Carcinoma in Real-World Data From the Turkish Oncology Group Kidney Cancer Consortium (TKCC)
(Nature Portfolio, 2026) Bolek, Hatice; Sertesen Camoz, Elif; Kuzu, Omer Faruk; Karakas, Hilal; Sim, Saadet; Sekmek, Serhat; Urun, Yuksel
Smoking has been implicated as a potential factor influencing cancer progression and outcomes in various malignancies, including metastatic renal cell carcinoma (mRCC). This study aimed to evaluate the effect of smoking status on treatment outcomes in mRCC patients, with a focus on metastatic sites. This retrospective cohort study utilized data from the Turkish Oncology Group Kidney Cancer Consortium (TKCC). The primary endpoint of the study was overall survival (OS) across metastatic sites. A total of 779 patients were included, of whom 464 (58.1%) were former/current smokers. Smoking status did not significantly affect OS in the overall cohort. However, in the bone metastatic subgroup, former/current smokers exhibited worse OS compared to never smokers (33.9 vs. 22.1 months; p = 0.005). Multivariate Cox regression analysis showed that former/current smoking was an independent predictor for OS in patients with bone metastasis (former/current smoker vs never smoker HR 1.44, 95% CI 1.05-1.99; p = 0.026) and bone-only metastasis (former/current smoker vs never smoker HR 4.44; 95% CI 1.27-15.55; p = 0.020) after adjusting for confounding factors. Smoking is an independent predictor of poor survival in mRCC patients with bone metastases, highlighting the organ-specific effects of smoking on cancer progression. Further research is needed to explore underlying mechanisms and evaluate outcomes in the context of modern therapies.
Citation - WoS: 1
Citation - Scopus: 1
Sunitinib in Metastatic Renal Cell Carcinoma: Clinical Outcomes Across Risk Groups in a Turkish Oncology Group Kidney Cancer Consortium
(Wiley, 2025) Bolek, Hatice; Kuzu, Omer Faruk; Sertesen Camoz, Elif; Sim, Saadet; Sekmek, Serhat; Karakas, Hilal; Urun, Yuksel
Uric Acid Level in Metastatic Renal Cell Carcinoma Treated With Nivolumab: a Turkish Oncology Group Kidney Cancer Consortium (TKCC) Study
(Taylor & Francis Ltd, 2025) Sekmek, Serhat; Bolek, Hatice; Kuzu, Omer Faruk; Camoz, Elif Sertesen; Sim, Saadet; Karakas, Hilal; Urun, Yuksel
AimsTo investigate the effect of uric acid level on prognosis in patients with metastatic renal cell carcinoma (mRCC) treated with nivolumab.Materials and methodsThis retrospective study utilized data from the Turkish Oncology Group Kidney Cancer Consortium (TKCC), which is a multicenter registry encompassing 13 cancer centers across T & uuml;rkiye.Results and conclusionsA total of 189 patients were included in the study. The median age was 61 years in all cohort. Univariable analyses revealed longer TTF (17.87 vs. 6.57 months, p = 0.014) and OS (52.01 vs. 25.36, p = 0.032) in the uric acid-high (UAH) group than in the uric acid-low (UAL) group. In multivariable analyses, low uric acid level emerged as an independent risk factor for OS (hazard ratio (HR): 1.82, 95% confidence interval (CI): 1.09-3.05; p = 0.022), whereas no significant association was observed with TTF (HR: 1.24, 95% CI: 0.72-2.13; p = 0.431). While uric acid levels were a significant independent prognostic factor for OS, no association was found with TTF. Our findings underscore the prognostic importance of uric acid in mRCC, suggesting its potential role as a biomarker for risk stratification
Yeni Teşhis Konulan Multipl Sklerozlu Bireylerde Servikal Omurilik Lezyonunun Üst Ekstremite Fonksiyonu Üzerindeki Etkisinin Değerlendirilmesi
(2025) Cinar, Bilge Piri; Ozakbas, Serkan; Kaya, Ergi; Baba, Cavid; Özdoğar, Asiye Tuba; Yapıcı, Nurbanu Aygündüz; Karakas, Hilal
Amaç: Çok erken evre multipl skleroz (MS) hastalarında servikal kord lezyonlarının üst ekstremite fonksiyonları üzerindeki etkisini değerlendirmek ve bu popülasyonda üst ekstremite fonksiyonlarını etkileyen faktörleri tanımlamak. Gereç ve Yöntem: Çalışmaya 245 ilk semptomlardan 24 ay geçmiş ve 378 tanıdan sonraki altı ay içinde hastalık modifiye edici tedaviye (DMT) başlamış MS’li bireyler dahil edilmiştir. Üst ekstremite fonksiyonlarını değerlendirmek için Dokuz Çivi Peg Testi (N-HPT) uygulanmıştır. Servikal kord lezyonunun varlığına göre katılımcılar iki gruba ayrıldı. Bulgular: Gruplar arasında yaş, cinsiyet, hastalık süresi ve atak sayısı açısından anlamlı bir fark bulunmamıştır. Ancak, toplam Genişletilmiş Engellilik Durumu Ölçeği (EDSS) skoru, piramidal ve duyusal fonksiyonel sistem skorları, servikal kord lezyonları olan MS’li bireylerde olmayanlara göre daha yüksek bulunmuştur. Tanıdan sonraki altı ay içinde DMT başlatılan katılımcılarda, dominant ve ortalama N-HPT performans süreleri, servikal kord lezyonu olan MS’li bireylerde olmayanlara göre anlamlı derecede daha uzun bulunmuştur. Ancak, ilk semptomlardan 24 ay sonra tanı konulan katılımcılar arasında gruplar arasında anlamlı bir fark gözlenmemiştir. Yaş, hastalık süresi ve tanıdan tedaviye kadar geçen süre, N-HPT performansını etkileyen önemli faktörler olarak belirlenmiştir. Daha genç, daha kısa hastalık süresine sahip ve tanı sonrası daha erken tedavi alan MS’li bireyler, diğerlerine göre daha iyi performans göstermiştir. Sonuç: Çalışmamız, MS’in erken evrelerinde bile servikal kord lezyonlarının üst ekstremite fonksiyonları üzerindeki etkisini vurgulamakta ve erken tanı ile DMT’lerin hızlı bir şekilde başlatılmasının önemini ortaya koymaktadır.