Browsing by Author "Baltaci, Sumer"

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Are the Recommended Criteria for Clinically Insignificant Prostate Cancer Applicable to 12-core Prostate Biopsy Scheme? A Multicentre Study of Urooncology Association, Turkey
(GALENOS PUBL HOUSE, 2021-01-01) Celik, Serdar; Kizilay, Fuat; Yorukoglu, Kutsal; Ozen, Haluk; Akdogan, Bulent; Izol, Volkan; Bayazit, Yildirim; Aslan, Guven; Sozen, Sinan; Baltaci, Sumer; Muezzinoglu, Talha; Narter, Fehmi; Turkeri, Levent; Assoc, Urooncology
Objective: The aim of this study is to investigate the relevance of the Epstein criteria for the 12-core transrectal prostate biopsy (TRUS-Bx) scheme with the evaluation of clinicopathologic data recorded in the Urologic Cancer Database - Prostate (UroCaD-P), Urooncology Association, Turkey (UOAT). Materials and Methods: Patients with detailed pathological 12-core TRUS-Bx data for each biopsy core and who underwent RP due to PCa were included in this study. A total of 1167 patients from seven different centres were analysed. TRUS-Bx pathological findings were separately evaluated in the areas matching the sextant biopsy (6-core paramedian-lateral) scheme and in all 12-core biopsy areas (12-core biopsy scheme). Overall detection rates of PCa and ratios of clinically significant (sPCa) and insignificant PCa (insPCa) after RP were defined and compared between the biopsy schemes. Biopsy findings, according to the Epstein criteria, were also compared between the two schemes. A model for each biopsy scheme was created, including the Epstein criteria and additional biopsy findings using logistic regression analysis to predict clinically sPCa after RP. Results: There was a high correlation for the prediction of clinically insPCa between the two biopsy schemes in the same population. However, 7.3\% of PCa could not be diagnosed in the 6-core TRUS-Bx scheme. Also, 69.4\% of these had clinically sPCa according to the Epstein criteria in 12-core TRUS-Bx scheme and 51.8\% of these were clinically sPCa after RP. The presence of perineural invasion (PNI) in 12-core biopsy was also significant regarding predicting sPCa (p<0.001). Conclusion: The Epstein criteria in 12-core prostate biopsy provide a better prediction of clinically sPCa than the 6-core biopsy scheme. Biopsy PNI findings appeared to improve the effectiveness of 12-core prostate biopsy, in addition to the Epstein criteria.
Can We Predict the Surgical Margin Positivity in Patients Treated with Radical Prostatectomy? A Multicenter Cohort of Turkish Association of Uro-Oncology
(GALENOS YAYINCILIK, 2015-01-01) Bolat, Deniz; Eskicorapci, Saadettin; Karabulut, Erdem; Baltaci, Sumer; Yildirim, Asif; Sozen, Sinan; Ates, Ferhat; Sekerci, Cagri Akin; Kurtulus, Fatih; Dirim, Ayhan; Muezzioglu, Talha; Can, Cavit; Bozlu, Murat; Gemalmaz, Hakan; Ekici, Sinan; Ozen, Haluk; Turkeri, Levent
Objective To analyze the parameters that predict the surgical margin positivity after radical prostatectomy for localized prostate cancer. Materials and Methods In this multicenter study, the data of 1607 consecutive patients undergoing radical prostatectomy for localized prostate cancer in 12 different clinics in Turkey between 1993-2011 were assessed. Patients who had neoadjuvant treatment were excluded. We assessed the relationship between potential predictive factors and surgical margin status after radical prostatectomy such as age, cancer characteristics, history of transurethral prostate resection, surgical experience and nerve-sparing technique by using univariate and multivariate Cox regression analyses and t test. Results The overall surgical margin positivity rate was 22.6\% (359 patients). In univariate analyses, preoperative prostate specific antigen level, clinical stage, biopsy Gleason score, percentage of tumor involvement per biopsy specimen, transurethral prostate resection history, surgical experience and nerve-sparing technique were significantly associated with positive surgical margin rate. In multivariate analyses, preoperative prostate specific antigen level (OR: 1.03, p=0.06), percentage of tumor involvement per biopsy specimen (OR: 7,14, p<0,001), surgical experience (OR: 2.35, p=0.011) and unilateral nerve-sparing technique (OR: 1.81, p=0.018) were independent predictive factors for surgical margin positivity. Conclusion Preoperative prostate specific antigen level, percentage of tumor involvement per biopsy specimen, surgical experience and nerve-sparing technique are the most important predictive factors of surgical margin positivity in patients undergoing radical prostatectomy for localized prostate cancer.
Management of Patients with Urological Cancers in Turkey during the COVID-19 Pandemic: Recommendations of Uro-oncology Association
(GALENOS YAYINCILIK, 2020-01-01) Celik, Serdar; Tinay, Ilker; Narter, Fehmi; Eskicorapci, Saadettin; Ataus, Suleyman; Turkeri, Levent; Baltaci, Sumer
Coronavirus disease-19 (COVID-19) has been declared as a pandemic by the World Health Organization. The number of cases has increased over time in correlation with the increasing number of testing worldwide. In order to use the available resources for COVID-19 treatment, urological practice has been limited only to emergency procedures and certain uro-oncological surgeries. In this report, we aim to share our recommendations for the daily uro-oncology practice in light of local circumstances in Turkey.
Prognostic Significance of Surgical Margin Status and Gleason Grade at the Positive Surgical Margin in Predicting Biochemical Recurrence After Radical Prostatectomy in a Turkish Patient Cohort
(GALENOS YAYINCILIK, 2021-01-01) Koparal, Murat Yavuz; Sozen, Tevfik Sinan; Aslan, Guven; Baltaci, Sumer; Suer, Evren; Muezzinoglu, Talha; Akdogan, Bulent; Turkeri, Levent
Objective: To investigate the prognostic role of positive surgical margin (PSM) features in addition to well-defined risk factors in predicting biochemical recurrence (BCR) after radical prostatectomy. Materials and Methods: This study used the prostate cancer database from the Urooncology Association in Turkey. Clinical, surgical, pathological and follow-up data were recorded from the database. PSM features, including number, location, linear length and Gleason grade (GG) were also recorded. Kaplan-Meier survival analyses were performed to assess differences in BCR-free survival (BCR-FS). In order to identify prognostic factors affecting BCR-FS, univariate and multivariate Cox regression analyses were performed. Results: The study included 984 patients who met the eligibility criteria. The median follow-up time was 29 (minimum: 6, maximum: 210) months, and BCR was detected in 178 (18.1\%) patients. BCR-FS was found to be significantly lower in patients with higher total prostate-specific antigen, higher International Society of Urological Pathology (ISUP) grade, extraprostatic extension (EPE), seminal vesicle invasion, lymphovascular invasion, lymph node involvement, PSM and GG at PSM (PSMGG) >= 4 (log-rank p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001 and p=0.005). ISUP grade, EPE and PSM were identified as independent prognostic factors in predicting BCR-FS {[}Hazard ratio (HR): 1.89, p=0.035 and HR: 4.65, p<0.001, HR: 1.82, p=0.030, HR: 1.77, p=0.042, respectively]. Unlike the univariate analysis, in multivariate analysis, PSMGG did not prove to be an independent prognostic factor in predicting BCR-FS. Conclusion: PSM GG >= 4 was found to be significantly associated with shorter BCR-FS. There is a need for large, randomised prospective studies to clarify the role of PSMGG to be used in nomograms as an independent predictor to determine patients who would benefit from adjuvant radiation therapy.