Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Importance of SUVmax Threshold in Positron Emission Tomography-Computed Tomography Assessment of Mediastinal and Hilar Lymph Nodes in Non-Small Cell Lung Cancer(2016) Yildiz, Oya; Cangir, Ayten Kayi; Kilic, Dalokay; Yuksel, Cabir; Enon, Serkan; Kutlay, Hakan; Akal, Murat; Ozdemir, Nezih; Kavukcu, Sevket; Okten, Ilker; H-7700-2019Background: This study aims to determine a new cut-off value for standardized uptake value in positron emission tomography-computed tomography evaluation of mediastinal lymph nodes in non-small cell lung cancer in Turkey. Methods: A total of 207 patients with non-small cell lung cancer who were performed positron emission tomography-computed tomography between November 2006 and February 2010 were prospectively analyzed. Of these patients, 143 patients (125 males, 18 females; mean age 62.1 years; range 39 to 85 years) whose invasive staging was performed after positron emission tomography were included in the study. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rates of positron emission tomography were calculated and compared using a maximum standardized uptake value cut-off value of >= 2.5 and the newly determined maximum standardized uptake value cut-off value. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rates were 45.3%, 78.9%, 55.8%, 71%, and 66.4%, respectively, when the maximum standardized uptake value cut-off value was considered 2.5 in mediastinal lymph nodes. The new maximum standardized uptake value cut-off value was determined to be 4.8 in metastatic lymph nodes. These values were 39.6%, 91.1%, 72.4%, 71.9% and 72%, respectively, according to the new maximum standardized uptake value cut-off value of 4.8. There was a significant difference only between specificity rates when the two different maximum standardized uptake value cut-off values were used (p=0.022). Conclusion: In this study, the sensitivity of positron emission tomography in the evaluation of mediastinal lymph nodes was lower than those reported in the literature. This situation may be associated with the frequently observed granulomatous infections such as tuberculosis in our country. Results of positron emission tomography should be evaluated according to countries and a new maximum standardized uptake value cut-off value should be calculated particularly for mediastinal lymph node metastasis in multicenter studies in our country.Item Seroma Cytology in Breast Cancer: An Underappreciated Issue(2016) Aytac, Huseyin Ozgur; Nursal, Tarik Zafer; Colakoglu, Tamer; Bolat, Filiz Aka; Moray, Gokhan; 0000-0002-3583-9282; 0000-0003-2031-7374; 0000-0003-2498-7287; 27387392; AAJ-7913-2021; IQV-1169-2023; HJZ-1654-2023; AAE-1041-2021The presence of cancer cells in postoperative drain fluid has been ignored when achieving local disease control in breast cancer. We designed a prospective study to examine the drain cytology and demonstrated malignant cells in the drainage fluid from 4 of 68 cases, mostly independent of the axillary status. These findings highlight the danger regarding the overall objective of "disease-free local control" in breast cancer surgery. Background: The presence of malignant cells in postoperative seroma has been ignored in current breast cancer treatment. We aimed to assess the presence of malignant seroma cytology and to evaluate its relationship with the known prognostic factors for breast cancer. Patients and Methods: The solution from irrigation of the operation field and postoperative drainage fluid from 68 patients were prospectively collected and examined for malignant cytology. The results were evaluated according to the tumor characteristics and patient demographics. Results: Malignant cytology was found in none of the intraoperative samples but was found in the postoperative samples from 4 patients. Of these 4 patients, 3 were free of axillary metastasis. None of the common risk factors for breast cancer was associated with the finding of malignant cytology. Conclusion: Malignant cells can be seen in the drainage fluids from breast cancer patients independent of any contamination occurring during surgery, even in those without axillary metastasis.Item Risk Factors for Lymph Node Metastasis among Lymphovascular Space Invasion-Positive Women with Endometrioid Endometrial Cancer Clinically Confined to the Uterus(2018) Sari, Mustafa Erkan; Meydanli, Mehmet Mutlu; Yalcin, Ibrahim; Sahin, Hanifi; Coban, Gonca; Celik, Husnu; Kuscu, Esra; Gungor, Tayfun; Ayhan, Ali; 0000-0002-3285-5519; 0000-0002-0992-6980; 30419557; AAD-8494-2019; AAI-9974-2021; AAL-1923-2021; AAI-8792-2021; AAJ-5802-2021Introduction: We aimed to assess risk factors for lymph node (LN) metastasis among lymphovascular space invasion(LVSI)-positive women with pure endometrioid endometrial cancer (EC) clinically confined to the uterus. Methods: Medical records of women who underwent primary surgery for EC between 2007 and 2016 at either of 2 gynecological oncology centers were retrospectively reviewed. Patient data were analyzed with respect to LN involvement, and predictive factors for LN metastasis were investigated. Results: 280 patients with surgically staged endometrioid-type EC with LVSI were identified. LN involvement was detected in 88 patients (31.4%) with a systematic LN dissection. In multivariate analysis, elevated baseline serum CA 125 levels, deep myometrial invasion (MMI), adnexal involvement and positive peritoneal cytology were found to be independent risk factors for LN metastasis. In women without deep MMI and elevated baseline serum CA 125 levels, the rate of LN metastasis was 19%. The presence of solely deep MMI increased this probability up to 29.1%. The rate of LN metastasis was found to be 46.8% for women with both deep MMI and elevated baseline serum CA 125 levels. Conclusion: These findings may be useful in the decision- making process for LVSI-positive women who are unstaged. (c) 2018 S. Karger GmbH, FreiburgItem Does lymph node ratio have any prognostic significance in maximally cytoreduced node-positive low-grade serous ovarian carcinoma?(2020) Aslan, Koray; Meydanli, Mehmet Mutlu; Akilli, Huseyin; Durmus, Yasin; Gokcu, Mehmet; Kayikcioglu, Fulya; Demirkiran, Fuat; Ayhan, Ali; 0000-0002-5404-0118; 32409929; AAP-6729-2021; AAJ-5802-2021Purpose To determine the prognostic impact of the lymph node ratio (LNR) in node-positive low-grade serous ovarian cancer (LGSOC). Methods We retrospectively reviewed women with LGSOC who had undergone maximal cytoreduction followed by standard chemotherapy in 11 centers from Turkey during a study period of 20 years. Sixty two women with node-positive LGSOC were identified. LNR was defined as the number of metastatic lymph nodes (LNs) divided by the number of total LNs removed. We grouped patients pursuant to the LNR as LNR <= 0.09 and LNR > 0.09. The prognostic value of LNR was investigated by employing the univariate log-rank test and multivariate Cox-regression model. Results With a median follow-up of 45 months, the 5-year progression-free survival (PFS) rates were 61.7% for women with LNR <= 0.09 and 32.0% for those with LNR > 0.09 (p = 0.046) whereas, the 5-year overall survival (OS) rates were 72.8% for LNR <= 0.09 and 54.7% for LNR > 0.09 (p = 0.043). On multivariate analyses, lymphovascular space invasion (LVSI) (Hazard Ratio [HR] 4.18, 95% confidence interval [CI] 1.88-9.27; p < 0.001), omental involvement (HR 3.48, 95% CI 1.36-8.84; p = 0.009) and LNR > 0.09 (HR 3.51, 95% CI 1.54-8.03; p = 0.003) were adverse prognostic factors for PFS. Additionally, LVSI (HR 6.56, 95% CI 2.33-18.41; p < 0.001), omental involvement (HR 6.34, 95% CI 1.86-21.57; p = 0.003) and LNR > 0.09 (HR 7.20, 95% CI 2.33-22.26; p = 0.001) were independent prognostic factors for decreased OS. Conclusion LNR > 0.09 seems to be an independent prognosticator for decreased survival outcomes in LGSOC patients who received maximal cytoreduction followed by standard adjuvant chemotherapy.