Wos İndeksli Yayınlar Koleksiyonu

Permanent URI for this collectionhttps://hdl.handle.net/11727/4807

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    Comparison of Resection and Liver Transplant in Treatment of Hepatocellular Carcinoma
    (2020) Aksoy, Suleyman Ozkan; Unek, Tarkan; Sevinc, Ali Ibrahim; Arslan, Baha; Sirin, Haluk; Derici, Zekai Serhan; Ellidokuz, Hulya; Sagol, Ozgul; Agalar, Cihan; Astarcioglu, Ibrahim; 0000-0003-4461-4904; 29957158; AAD-6127-2021
    Objectives: Hepatic resection and liver transplant are regarded as 2 potentially curative treatments for hepatocellular carcinoma. Here, we compared both options in patients with hepatocellular carcinoma secondary to cirrhosis seen at a single center over 12 years. Materials and Methods: We evaluated early complications and survival of patients with hepatocellular carcinoma treated with liver transplant (57 patients) or hepatic resection (36 patients) at our center between 1998 and 2010. Results: The 34-month mean follow-up period was similar for both treatment groups. The liver transplant group had a longer hospital stay than the hepatic resection group (P < .001). Patients with Child-Turcotte-Pugh A stage were treated by hepatic resection more than by liver transplant (P < .001), with Child-Turcotte-Pugh B stage patients treated by liver transplant more than by hepatic resection (P = .03). All patients with Child-Turcotte-Pugh C stage had liver transplant. Both treatment groups had similar postoperative complications and early postoperative mortality rates, but liver transplant resulted in longer overall (P = .001) and higher event-free (P = .001) survival than hepatic resection. Among the liver transplant group, 57.8% of patients met the Milan criteria. Patients who met Milan criteria were treated by liver transplant statistically more than hepatic resection, and these patients had longer overall survival (P = .01) and higher event-free survival (P < .001) than patients who had hepatic resection. Hepatocellular carcinoma recurrence rates were higher after hepatic resection (P = .232). Conclusions: In patients with hepatocellular carcinoma, hospital stay was longer after liver transplant, but morbidity and mortality rates for liver transplant versus hepatic resection were similar. However, overall and event-free survival rates were better after liver transplant than after hepatic resection. These results suggest that liver transplant should be considered as the primary treatment option for patients with hepatocellular carcinoma secondary to cirrhosis.
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    Diagnostic Accuracy of Axillary Ultrasound in Early-Stage Breast Cancer
    (2019) Yilmaz, Tugba Han; Yerli, Hasan; Arslan, Baha; Erol, Varlik; Gulay, Huseyin
    Sentinel lymph node biopsy is the standard application for evaluating the axilla in patients with breast cancer. The Z0011 trial conducted by The American College of Surgeons Oncology Group (ACOSOG) revealed that axillary dissection may be redundant in selected patients with positive sentinel node. This raises questions regarding the application of this result to ultrasound-positive patients. This research therefore aimed to evaluate how accurate an ultrasound scan is for axillary node status in early-stage breast carcinoma. The study included 156 newly diagnosed clinical T1-T2, N0 breast cancer patients attending our breast clinic between January 2010 and February 2016. Sentinel lymph node biopsy and axillary lymph node clearance in the presence of sentinel lymph node metastasis was performed on all the breast cancer patients. Axillary ultrasound reports were reviewed retrospectively and the results compared with surgical pathology results. The sensitivity and specificity of axillary ultrasound for detecting axillary lymph node disease was 69.2% and 98%, respectively, with a negative predictive value of 86.4% and positive predictive value of 94.7%. Given the high sensitivity and specificity, and high positive predictive value and negative predictive value demonstrated in the present study, axillary ultrasound represents a potential alternative to sentinel lymph node biopsy for staging of the axilla in early breast cancer. Subsequent trials (SOUND) comparing axillary ultrasound alone with sentinel lymph node biopsy in early breast cancer patients will provide additional information about the subject.