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Publication Metadata only Standards and Definitions in Neck Dissections of Differentiated Thyroid Cancer(YERKURE TANITIM YAYINCILIK HIZMETLERI AS, 2018) Uludag, Mehmet; Tanal, Mert; Isgor, Adnan; Istanbul Sisli Hamidiye Etfal Training & Research Hospital; Bahcesehir University; Memorial Healthcare GroupPublication Metadata only Hormone receptor status and survival of medullary breast cancer patients(SAUDI MED J, 2017) Aksoy, Asude; Odabas, Hatice; Kaya, Serap; Bozkurt, Oktay; Degirmenci, Mustafa; Topcu, Turkan O.; Aytekin, Aydin; Arpaci, Erkan; Avci, Nilufer; Pilanci, Kezban N.; Cinkir, Havva Y.; Bozkaya, Yakup; Cirak, Yalcin; Gumus, Mahmut; Firat University; Istanbul Kartal Dr Lutfi Kirdar Training & Research Hospital; Marmara University; Bahcesehir University; Bezmialem Vakif University; Istanbul Haseki Training & Research Hospital; Ankara Numune Training & Research Hospital; Erciyes University; Karadeniz Technical University; Gazi University; Dr. Abdurrahman Yurtaslan Oncology Hospital; Zonguldak Bulent Ecevit University; Ali Osman Sonmez Oncology HospitalObjectives: To analyze the relationship between clinical features, hormonal receptor status, and survival in patients who were diagnosed with medullary breast cancer (MBC). Methods: Demographic characteristics, histopathological features, and survival statuses of 201 patients diagnosed with MBC between 1995 and 2015 were retrospectively recorded. Survival analyses were conducted with uniand multivariate cox regression analysis. Results: Median follow-up time was 54 (4-272) months. Median patient age at the time of diagnosis was 47 years old (26-90). Of the patients, 91.5% were triple negative. Five-year recurrence free survival time (RFS) rate was 87.4% and overalll survival (OS) rate 95.7%. For RFS, progesterone receptor (PR) negativity, atypical histopathological evaluation, absence of lymphovascular invasion, smaller tumor, lower nodal involvement were found to be favourable prognostic factors by univariate analysis (p<0.05). The PR negativity and smaller tumor were found to be favourable factors by univariate analysis (p<0.05). However, none of these factors were determined as significant independent prognostic factors for OS (p>0.05). Conclusion: Turkish MBC patients exhibited good prognosis, which was comparable with survival outcomes achieved in the literature. The PR negativity was related to a better RFS and OS rates.Publication Metadata only Postchemoradiotherapy Neutrophil-to-Lymphocyte Ratio Predicts Distant Metastasis and Survival Results in Locally Advanced Pancreatic Cancers(WILEY, 2022) Topkan, Erkan; Selek, Ugur; Haksoyler, Veysel; Kucuk, Ahmet; Durankus, Nulifer Kilic; Sezen, Duygu; Bolukbasi, Yasemin; Pehlivan, Berrin; Baskent University; Koc University; University of Texas System; UTMD Anderson Cancer Center; Medline Health Group; Bahcesehir UniversityBackground and Objectives. In the absence of similar research, we endeavored to investigate the prognostic usefulness of posttreatment neutrophil-to-lymphocyte ratio (NLR) in patients treated with definitive concurrent chemoradiotherapy (CCRT) for locally advanced pancreatic adenocarcinoma (LAPAC). Materials and Methods. Our retrospective research included a sum of 126 LAPAC patients who received CCRT. The NLR was calculated for each patient based on the complete blood count test results obtained on the last day of the CCRT. The availability of optimal cutoff(s) that might dichotomize the whole cohort into two groups with significantly different clinical outcomes was searched using receiver operating characteristic (ROC) curve analysis. Primary and secondary endpoints were the potential association between the post-CCRT NLR measures and distant metastasis-free survival (DMFS) and overall survival (OS) outcomes. Results. The median follow-up duration was 14.7 months (range: 2.4-94.5). The median and 3-year OS and DMFS rates for the whole group were 15.3 months (95% confidence interval: 12.4-18.2) and 14.5%, and 8.7 months (95% CI: 6.7-10.7) and 6.3% separately. The ROC curve analysis findings separated the patients into two groups on a rounded NLR cutoff of 3.1 (area under the curve (AUC): 75.4%, sensitivity: 74.2%, specificity: 73.9%) for OS and DMFS: NLR < 3.1 (N = 62) and NLR >= 3.1 (N = 64), respectively. Comparisons between the NLR groups displayed that the median OS (11.4 vs. 21.4 months, P < 0.001) and DMFS (6.0 vs. 16.0 months, P < 0.001) lengths were significantly shorter in the NLR >= 3.1 group than its NLR < 3.1 counterparts, as well as the 3-year actuarial DM rate (79.7% vs. 50.0%, P=0.003). The N1-2 nodal stage, CA 19-9 > 90 U/mL, and NLR > 3.1 were found to be independent predictors of poor prognosis in the multivariate analysis. Conclusion. The present study found that the posttreatment NLR >= 3.1 was independently linked with a higher risk of DM and subsequent degraded survival outcomes in unresectable LAPAC patients managed with exclusive CCRT.Publication Metadata only Effects of Central Neck Dissection on Complications in Differentiated Thyroid Cancer(KARE PUBL, 2021) Unlu, Mehmet Taner; Aygun, Nurcihan; Demircioglu, Zeynep Gul; Isgor, Adnan; Uludag, Mehmet; University of Health Sciences Turkey; Istanbul Sisli Hamidiye Etfal Training & Research Hospital; Kars State Hospital; Bahcesehir UniversityObjective: It is still controversial whether performing central neck dissection (CND) in addition to total thyroidectomy ( TT) increases the risk of complications. In the present study, we aimed to evaluate the effect of CND on the development of complications in differentiated thyroid cancer (DTC) compared to TT. Material and Methods: The data of 186 patients (136 females and 50 males) with a mean age of 48.73 +/- 14.78 (range, 17-82) whom were operated for DTC were evaluated retrospectively. The patients were divided into two groups, TT (Group 1) and CND +/- TT/ Completion thyroidectomy +/- lateral neck dissection (Group 2). Results: There were 117 (91 F, 26 M) patients in Group 1 and 69 (45 F, 24 M) patients in Group 2. Parathyroid auto transplantation (PA) was significantly higher in Group 2 compared to Group 1 (42% vs. 6%) (p=0.000). Total (58% vs. 21.4%, respectively, p=0.000) and transient hypoparathyroidism (52.2% vs. 20.5%, respectively, p=0.000) were significantly higher in Group 2 than in Group 1, but permanent hypoparathyroidism rates were statistically not significant (5.8% vs. 0.9%, respectively, p=0.064). In the multinomial logistic regression analysis, CND alone was determined as an independent risk factor for increased both total and transient hypoparathyroidism. The relative risk (RR) of CND for total hypoparathyroidism was 5.2 times increased (odds ratio [OR]: 0.192) (p=0.007), while the RR for transient hypoparathyroidism was 3.5 times increased (OR: 0.285) (p=0.036). According to the number of nerves at risk, CND was performed in 119 neck side and only thyroidectomy was performed in 253 neck side. Total vocal cord paralysis (VCP) rate (9 [7.6%] vs. 6 [2.4%], respectively) (p=0.017) and transient VCP rate (7 [6%] vs. 4 [1.6%], respectively) (p=0.021) in patients who underwent CND were significantly higher compared to those who underwent only thyroidectomy. In multinomial logistic regression analysis performing only CND was an independent risk factor for total VCP, and increased the total VCP RR approximately 5.34 times (OR:0.184, p=0.007). Conclusion: Although CND can be applied without increasing the rates of permanent hypoparathyroidism and VCP compared to TT, it increases the risk of total and transient hypoparathyroidism, total, and transient VCP. Patients undergoing CND should be followed carefully in terms of transient hypoparathyroidism.Publication Metadata only Predictive factors of lymph node metastasis in patients with 2014 figo stage Ib1-IIa2 cervical squamous cell cancer: A multicentric study(BAYRAKOL MEDICAL PUBLISHER, 2024) Aytekin, Okan; Yalcin, Necim; Yildirim, Hande Esra Koca; Unsal, Mehmet; Oktar, Okan; Celik, Fatih; Tokalioglu, Abdurrahman Alp; Gokkaya, Mustafa; Yuksel, Dilek; Cakir, Caner; Kilic, Cigdem; Selcuk, Ilker; Comert, Gunsu Kimyon; Toptas, Tayfun; Korkmaz, Vakkas; Ureyen, Isin; Karalok, Alper; Basaran, Derman; Koc, Sevgi; Tasci, Tolga; Turan, Taner; University of Health Sciences Turkey; Antalya Training & Research Hospital; University of Health Sciences Turkey; University of Health Sciences Turkey; Hacettepe University; Bahcesehir UniversityAim: The objective of this study is to identify the risk variables associated with lymph node metastasis (LNM) in individuals diagnosed with cervical squamous cell carcinoma (SCC). Material and Methods: Cervical cancer patients who underwent type II/III radical hysterectomy and pelvic lymphadenectomy +/- para-aortic lymphadenectomy were analyzed. Results: In total, 422 SCC patients were included in the cohort. Three hundred-twenty-three (76.5%) patients were stage IB1, 59 (14%) were stage IB2, 33 (7.8%) were stage IIA1, and 7 (1.7%) were stage IIA2. Eighty-seven (20.6%) patients had LNM only in the pelvic region, 2 (0.5%) patients in the paraaortic region, and 8 (1.9%) patients in both regions. In the multivariate logistic analysis, parametrial invasion (hazard ratio [HR]: 2.182, 95% confidence interval [CI]: 1.090-4.366, p=0.027), lymphovascular space invasion (LVSI) (HR: 6.300, 95% CI: 2.968-13.370, p<0.001) and deep stromal invasion (HR: 2.122, 95% CI: 1.088-4.139, p=0.027) were identified as significant risk factors for LNM. Discussion: In summary, age, FIGO stage, tumor size, vaginal invasion, surgical border involvement, and uterine involvement were not identified as independent risk factors for LNM. However, parametrial invasion, LVSI, and deep stromal invasion are independent risk factors for LNM in stage IB1-IIA2 cervical SCC patients.Publication Metadata only Can Active Surveillance be an Alternative to Surgery in Papillary Thyroid Microcarcinoma?: The Current Situation Worldwide(KARE PUBL, 2018) Aygun, Nurcihan; Isgor, Adnan; Uludag, Mehmet; University of Health Sciences Turkey; Istanbul Sisli Hamidiye Etfal Training & Research Hospital; Bahcesehir University; Memorial Healthcare GroupPapillary thyroid carcinoma is the most common endocrine malignancy. Papillary thyroid microcarcinomas (PTMCs) are tumors with a size of <= 1 cm. The biological behavior of these tumors differs due to the presence of their aggressive features. The prognosis of PTMCs with high-risk features, such as clinical node metastasis, distant metastasis, and significant extrathyroidal extension to the tracheal or recurrent laryngeal nerve invasion, is poor, even if a sufficient immediate surgery is performed at diagnosis. However, PTMCs without these aggressive features are low-risk tumors because of their indolent and slow growth behaviors. The increase in thyroid cancer incidence is mostly a result of overdiagnosis of small low-risk PTMCs with indolent clinical course. Despite the sudden increase in thyroid cancer incidence worldwide, cancer mortality did not increase. Although the traditional treatment strategy for PTMC is immediate surgery at diagnosis, because of the rather low disease-specific mortality rate, low recurrence rate, and potential risk for postoperative complications, active surveillance has been proposed recently as an alternative option for PTMCs without invasion, metastasis, or cytological or molecular characteristics. The recent data support that active surveillance of low-risk PTMC should be the initial treatment modality, because only a small percentage of low-risk PTMCs show signs of progression, and delayed surgery has not caused significant recurrence. However, recent management guidelines are shifting toward more conservative treatments, such as active surveillance. Although there is an increase in the number of studies related to active surveillance, prospective studies have been mostly from academic referral centers in Japan. The world still needs class 1 evidence extended prospective studies originating from different geographic regions. Active surveillance may be a good alternative to immediate surgery for appropriately selected patients with PTMC.Publication Metadata only Prognostic Value of Tissue-Resident Memory T Cells and Tumor Microenvironmental Features in Resected Pancreatic Adenocarcinoma(GALENOS PUBL HOUSE, 2022) Basoglu, Tugba; Akar, Kadriye Ebru; Bagci, Pelin; Babacan, Nalan Akgul; Ozturk, Mehmet Akif; Ozturk, Fatih Emin; Demircan, Nazim Can; Arikan, Rukiye; Telli, Tugba Akin; Ercelepl, Ozlem; Dane, Faysal; Yumuk, Perran Fulden; Marmara University; Marmara University; Bahcesehir University; Marmara UniversityBackground: Pancreatic ductal adenocarcinoma differs from other solid tumors with its unique immunosuppressive microenvironment and non-immunogenic feature. There are not many studies in the literature investigating the effect of these features on prognosis. Aims: To investigate the prognostic value of tissue-resident memory T cells, tumor microenvironment features, and tumor-associated immune cells in resected pancreatic ductal adenocarcinomas. Study Design: Retrospective cross-sectional study. Methods: Of 138 patients diagnosed with pancreatic ductal adenocarcinoma between 2011 and 2018, 81 were included in the study. Specimens from operated patients were reassessed separately as peritumoral and intratumoral areas for tissue resident memory cells and tumor microenvironmental elements (tumor infiltrating lymphocytes, tumor stroma, CD204+ macrophages, PDL1+ immune cells). Disease-free survival and overall survival were defined from the date of operation to the date of recurrence and the date of first diagnosis to the date of death, respectively. If the patient was alive, the last visit date was taken into account. Results: The median age at diagnosis was 63 (range: 40-78). The median follow-up period was 18.9 months (range: 1.4-80.4 months). Median overall survival was 23.7 months (1.4-80.4 months) and median disease-free survival was 10.8 months (1.4-74.4 months). Patients with higher intra-tumoral tissue-resident memory cell counts had a longer survival trend than those having lower values (25.6 months vs. 18 months, respectively, P = .84). According to microenvironmental evaluations, lower stromal score (defined as stroma having less desmoplasia and rich in cells) and presence of peritumoral Crohn's-like inflammatory response were associated with higher survival (29.2 months vs. 19.7 months for low vs. high stromal scores, respectively, P = .16 and 30.2 months vs. 18.1 months for the presence of Crohn's-like inflammatory response P = .13). Decreased survival was observed in tumors with increased CD204+ tumor-associated macrophages which were immunosuppressive elements of the microenvironment (12 months vs. 26.3 months for intra-tumoral assessment, P = .29). Conclusion: Tissue-resident memory T cells and other microenvironmental features may be prognostic in resectable pancreatic ductal adenocarcinomas. Further studies with larger cohorts are needed for validation.