It has been suggested that type 2 diabetes mellitus may affect breast cancer prognosis, possibly due to increased diabetes-related comorbidity, or direct effects of insulin resistance and/or hyperinsulinemia. The aim of this study was to determine the impact of diabetes on disease-free survival (DFS) following mastectomy for breast cancer patients. The cases included in this retrospective study were selected from breast cancer women who had undergone mastectomy and completed adjuvant chemotherapy from 1998 to 2010. Patients were classified into two groups: diabetic and non-diabetic. Patients' age, sex, menopausal status, body mass index (BMI), histopathological features, tumor size, lymph node involvement, hormone receptor and HER2-neu status, and treatment types were recorded. There were 483 breast cancer patients included in the study. Postmenopausal patients' rate (53.7% vs. 36.8%, P = 0.016) and mean BMI levels were statistically higher (32.2 vs. 27.9, P = 0.007) in diabetic patients. There was no statistical difference for histological subgroup, grade, ER and PR positivity, HER2-neu overexpression rate, and tumor size between the diabetic and non-diabetic group. Lymph node involvements were statistically higher in diabetic patients compared with non-diabetic patients (P = 0.013). Median disease-free survival is 81 months (95% CI, 61.6-100.4) in non-diabetic patients and 36 months (95% CI, 13.6-58.4) in diabetic patients (P < 0.001). The odds ratio of recurrence was significantly increased in those with HER2-neu overexpression and lymph node involvement and decreased with PR-positive tumors. Our results suggest that diabetes is an independent prognostic factor for breast cancer.

In conclusion, DM at the time of diagnosis was associated with the negative prognostic importance for PFS and OS in the advanced stage patients who were receiving first-line platinum-based doublets chemotherapy. In addition poor performance status and advanced stage were identified as negative prognostic factors.

Although this retrospective multicenter study had several limitations, the results suggest that undergoing lapatinib plus capecitabine therapy after the diagnosis of brain metastasis may further improve survival compared to undergoing only trastuzumab-based therapy.

Renal hücreli karsinomun (RHK) cilt metastazı oldukça nadir olup %1-3.3 oranında görülmektedir. Biz burada tanıdan beş yıl sonra cilt metastazı gelişen bir RHK olgusu sunduk. Elli yedi yaşında erkek hastaya beş yıl önce RHK tanısı konularak sol nefrektomi yapılmıştı. Tanı anında metastazı olmayan hastada tanıdan bir yıl sonra metastaz gelişti. Hastaya palyatif amaçlı kemoterapi ve radyoterapi uygulandı. Hastanın takipleri esnasında yüzde, saçlı deride çok sayıda, yeni ortaya çı-kan, kırmızı morumsu tarzda nodüler cilt lezyonları saptandı. Nodüllerden yapılan biyopsi sonucu RHK cilt metastazı olarak değerlendirildi. Cilt metastazı geliştikten bir ay sonra hasta kaybedildi. Sonuç olarak, RHK'nın cilt metastazı oldukça nadirdir ve kötü prognoz göstergesidir.Anahtar sözcükler: Kutanöz metastaz; renal hücreli karsinom.Renal cell carcinoma (RCC) skin metastasis is quite rare, seen in the rate of 1-3.3%. We present here a RCC case that thrives skin metastasis after 5 years of diagnosis. A 57-year-old male patient was diagnosed as RCC 5 years ago and left nephrectomy was made. In the patient without metastasis at the diagnosis, metastasis developed 1 year after the diagnosis. The patient underwent palliative chemotherapy and radiotherapy. During follow-up of the patient, a large number of new emerging, purple red style nodular skin lesions were seen on the face and scalp. After the biopsy made from nodules, it was evaluated as skin metastasis of RCC. One month later that skin metastasis developed, the patient died. As a result, the skin metastasis of RCC is extremely rare, and indicator of poor prognosis. 163Renal cell carcinoma (RCC) constitutes approximately 3% of all malignancies in adults. [1] RCC constitutes about 90% of renal tumors and is one of the most lethal urogenital cancers. [2] In the average, 25% of RCCs are metastatic and the most common sites of metastasis are lung, lymph nodes, bone, liver, opposite kidney, adrenals and brain. [2] RCC, skin metastasis is quite rare, seen in the rate of 1-3.3%. [3] For anatomic localization and lymphohematogen spread, since it is far from kidney, RCC in the head and neck skin metastasis is quite rare. [4] We present here a RCC case that thrives skin metastasis after five years of diagnosis. CASE REPORTFive years ago, 57-year-old male patient with complaints of left flank pain and hematuria as a result of investigations was taken a diagnosis of RCC. Left nephrectomy operation was undergone. There was no metastasis at diagnosis. In the patient that was followed untreated, lung metastasis developed after 1 year and brain and bone metastasis developed after 2 years from diagnosis. Palliative

Background: The aim of this study is to determine the relationship between the survival outcomes and biological subtype in breast cancer patients with brain metastases. Methods: We retrospectively evaluated clinical data from 422 breast cancer patients with brain metastases between 2001 and 2011 from referral centers in Turkey. The study population was divided into four biological subtypes according to their hormone receptor status and HER2 expression. Results: Systemic treatment prolonged median overall survival (OS) after brain metastases in the entire group (14 vs. 3.2 months, p < 0.001). It also prolonged median OS after brain metastases in the triple negative (7.5 vs. 1.6 months, p = 0.010) and luminal A (14.3 vs. 7.1 months, p = 0.003) subgroups. The median OS for untreated patients, chemotherapy and/or hormonal therapy receiving patients, and chemotherapy and/or hormonal therapy plus targeted therapy receivers was 2, 5.8, and 17.7 months, respectively (p < 0.001), in the HER2-overexpressing subgroup. In the luminal B subgroup, it was 3.7, 5.3, and 15.4 months, respectively (p = 0.003). Conclusions: The use of systemic therapy improves OS after brain metastases in all biological subgroups. Targeted therapies also improve OS after brain metastases in HER2-positive patients. The combined use of targeted therapies and lapatinib are superior to single use and trastuzumab, respectively, in these patients.