Araştırma Çıktıları
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Item 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, LeventObjective 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.Item An Independent Validation of 2010 Tumor-Node-Metastasis Classification for Renal Cell Carcinoma: A Multi-center Study by the Urooncology Association of Turkey Renal Cancer-Study Group(GALENOS YAYINCILIK, 2017-01-01) Ozkan, Tayyar Alp; Eskicorapci, Saadettin; Yaycioglu, Ozgur; Akdogan, Bulent; Gogus, Cagatay; Dirim, Ayhan; Can, Cavit; Yildirim, Asif; Ozen, Haluk; Turkeri, Levent; Renal, Urooncology Assoc TurkeyObjective: The American Joint Committee on Cancer tumor-node-metastasis (TNM) classification has been updated by the 7th edition in 2010. The objective of the study was to evaluate cancer-specific survival (CSS) in patients with renal cell carcinoma (RCC) and assess the concordance of 2002 and novel 2010 TNM primary tumor classifications. Materials and Methods: A retrospective analysis of RCC registries from 25 institutions of the Urooncology Association of Turkey Renal CancerStudy Group was performed. Patients with RCC had a radical or partial nephrectomy. The database consisted of 1889 patients. Results: Median follow-up time was 25 months (interquartile range: 11.2-47.8). The 5-year CSS rate for pT1a, pT1b, pT2a, pT2b, pT3a and pT4 tumors were 97\% {[}95\% confidence interval (CI): 0.93-0.99], 94\% (95\% CI: 0.91-0.97), 88\% (95\% CI: 0.81-0.93), 77\% (95\% CI: 0.64-0.86) 74\% (95\% CI: 0.65-0.81) and 66\% (95\% CI: 0.51-0.77), respectively according to the 2010 TNM classification (p<0.001). CSS comparisons between pT1a-pT1b (p=0.022), pT1b-pT2a (p=0.030), pT3a-pT3b (p<0.001) and pT3b-pT4 (p=0.020) were statistically significant. Conversely, pT2a-pT2b (p=0.070) and pT2b-pT3a (p=0.314) were not statistically significant. Multivariable analyses revealed the pT stage in the 2010 TNM classification as an independent prognostic factor for CSS (p for trend=0.002). C-indexes for 2002 and 2010 TNM classifications were 0.8683 and 0.8706, respectively. Conclusion: Subdividing pT2 does not have a CSS advantage. Moving adrenal involvement to pT4 yielded a more accurate prognosis prediction. T stage and LNI are independent prognostic factors for CSS in RCC. Overall, the novel 2010 TNM classification is slightly improved over the former one. However, shown by C-index values, this improvement is not sufficient to state that 2010 TNM outperforms the 2002 TNM.Item Turkey Prostate Cancer Map 2021: Turkish Urooncology Association Prostate Cancer Database Report(GALENOS YAYINCILIK, 2022-01-01) Sahin, Bahadir; Celik, Serdar; Tinay, Ilker; Eskicorapci, Saadettin; Aslan, Guven; Sozen, Sinan; Ataus, Suleyman; Turkeri, LeventObjective: This study aimed to present the data of patients with prostate cancer (PCa) whose detailed information was stored in the Urologic Cancer Database-Prostate, Urooncology Association, Turkey with the title of ``Turkey Prostate Cancer Map 2021.{''} Materials and Methods: Patient data between 1995 and 2020 were retrospectively scanned. The age of the patients, their distribution according to age groups, symptoms during diagnosis, examination findings {[}digital rectal examination (DRE)], prostate-specific antigen (PSA) values, biopsy methods in the diagnosis, metastatic disease rates, treatment methods, and progression rates at follow-up were examined. These results were compared with the results of the previous report, namely ``Prostate Cancer Incidence (Incidence) in Turkey,{''} by the Urooncology Association in Turkey in 2009. Results: This study analyzed the data of 5040 patients from 19 different centers. The mean patient age was 63.6 (37-97) years. The age distribution examination revealed that most patients (49.8\%) were aged 60-69 years. Of the patients, 51.8\% were symptomatic at the time of diagnosis. The presence of symptoms was determined in 88.6\% in 2009 data. The ORE of patients revealed that 25\% of patients had malignancy findings. The PSA distribution examination revealed a >10 ng/mL PSA value in 37.5\% of patients. With the increasing use of magnetic imaging resonance (MRI) in PCa diagnosis over the years, increased MR-fusion biopsy rates have been observed. Considering the biopsy data, 91\% of patients were diagnosed with a classical transrectal ultrasound-guided biopsy, whereas 9\% were diagnosed with MR-Fusion biopsy. Fusion biopsies revealed that 23\% of patients with Prostate Imaging-Reporting and Data System (PI-RADS) 4 lesion and 57\% with PI-RADS 5 lesion were diagnosed with cancer. Of the patients, 8.9\% of patients had metastases during the initial diagnosis. This rate was 17\% in 2009 data. The treatment methods examination after the diagnosis revealed that 73.9\% of patients had undergone radical prostatectomy. This rate was 51.8\% in 2009. Robotic and laparoscopic approaches, which are among the surgical modalities, have increased over the years. However, the most frequently applied modality in our country was open radical prostatectomy with 62.6\%. Considering the follow-up data after treatment, 8.9\% of patients had progression, of which 62.6\% was biochemical, 30.2\% was radiological, and 6.9\% was a clinical progression. Conclusion: Technological advancements for PCa diagnosis (MRI and MR-guided biopsies) are becoming a routine part of daily practice compared to the results of the ``Prostate Cancer Incidence in Turkey{''} project in 2009. The comparative study results revealed that the rate of symptomatic and metastatic disease decreases at the time of diagnosis, and laparoscopic and robotic surgery methods are used at increasing rates for localized disease.Item 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, SumerCoronavirus 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.Item Focal Therapy for Prostate Cancer: Current Status of HIFU(GALENOS YAYINCILIK, 2015-01-01) Ozkan, Tayyar Alp; Eskicorapci, SaadettinFirst choice treatment options for Prostate Cancer (PCa) are Radical Prostatectomy (RP), brachytherapy and pelvic radiation therapy in current guidelines. The aim of this paper was to review effectiveness and oncological results of high intensity frequency ultrasound treatment (HIFU) in patients with localized PCa. HIFU technology is based on a principle of focused ultrasound (US) waves in an area-sized 3x3x11 mm with a convex ultrasound probe. HIFU ablation was first successfully used in 1995 for 29 pre-radical prostatectomy patients with unilateral tumors (T2-T2b). This treatment option mostly used in Europe in US it has not been approved yet by Food and Drug Administration (FDA) and is used only for clinical trials. HIFU is a relatively new treatment method and 10 years of mid-term results for survival were began to emerge. HIFU biopsy success rates are about 80\%. There need to be more accurate and improved results in order to define it as a new definitive treatment option for prostate cancer. Although it has low success rates, it can be used for all risk groups (low, medium, high), it can be used as a rescue treatment after unsuccessful HIFU treatment, radiotherapy and brachytherapy.