Araştırma Çıktıları

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Author: search.filters.author.Kulac, Ibrahim

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    Towards Development of a Standard Terminology of the World Health Organization Classification of Tumors of the Central Nervous System in the Turkish Language, and a Perspective on the Practical Implications of the WHO Classification for Low and Middle Income Countries
    (FEDERATION TURKISH PATHOLOGY SOC, 2022-01-01) Soylemezoglu, Figen; Oz, Buge; Egilmez, Reyhan; Pekmezci, Melike; Bozkurt, Suheyla; Danyeli, Ayca Ersen; Onguru, Onder; Kulac, Ibrahim; Tihan, Tarik
    In our manuscript, we propose a common terminology in the Turkish language for the newly adopted WHO classification of the CNS tumors, also known as the WHO CNS 5th edition. We also comment on the applicability of this new scheme in low and middle income countries, and warn about further deepening disparities between the global north and the global south. This division, augmented by the recent COVID-19 pandemic, threatens our ability to coordinate efforts worldwide and may create significant disparities in the diagnosis and treatment of cancers between the ``haves{''} and the ``have nots{''}.
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    The Past, Present, and Future Statuses of Formerly Classified ``Atypical Pituitary Adenomas'': A Clinicopathological Assessment of 101 Cases in a Cohort of More than 1,000 Pure Endoscopically Treated Patients in Single Center
    (THIEME MEDICAL PUBL INC, 2021-01-01) Bal, Ercan; Kulac, Ibrahim; Ayhan, Selim; Soylemezoglu, Figen; Berker, Mustafa
    Objective This study was aimed to assess the clinical aggressiveness of pituitary neoplasms that were previously defined as atypical adenomas. Methods A total of 1,042 pituitary adenomas were included in the study and 101 of them were diagnosed as atypical adenoma. Demographic characteristics, radiological evaluations, and clinical information were obtained from a computer-based patient database. Cases were categorized as atypical or typical using the criteria listed in 2004 Classification of Tumors of Endocrine Organs. Results The cure and reoperation rates did not show any statistically significant difference between the typical and atypical adenomas. However, a higher K (i) -67 labeling index was found to be associated with a higher rate of reoperation ( p =0.008) in atypical adenomas. Of note, cavernous sinus invasion or parasellar extension was found to be associated with lower cure rates in patients with atypical pituitary adenomas ( p <0.001 and p =0.001, respectively). Conclusion Although atypical pituitary adenomas are known to be more invasive, this study demonstrated that the reoperation and cure rates are the same for typical and atypical adenomas. Our findings advocate for omitting the use of atypical adenoma terminology based solely on pathological evaluation. As stated in the 4th edition of the World Health Organization (WHO) classification, accurate tumor subtyping, evaluation of proliferation by means of mitotic count and K (i) -67 labeling index, and radiological and intraoperative assessments of tumor invasion should be taken into consideration in the management of such neoplasms.