GÝRÝÞ ve AMAÇ: Meme koruyucu cerrahi uygulanmýþ meme kanseri tanýlý hastalarda adjuvan radyoterapi standart tedavidir. Radyoterapi sonrasý kozmetik sonuçlarý en çok etkileyen faktörlerden birisi de meme boyutudur. Bu çalýþmanýn amacý pandüler meme nedeni ile prone pozisyonda radyoterapi uyguladýðýmýz hastalarda kozmezis ve dozimetrik daðýlýmýnýn deðerlendirilmesidir.
YÖNTEM ve GEREÇLER: Temmuz 2015-Aðustos 2017 tarihleri arasýnda meme koruyucu cerrahi uygulanmýþ 17 hastaya prone pozisyonda radyoterapi uygulandý. Hastalara prone meme yataðý ile simülasyon yapýldý ve konvansiyonel fraksinasyonla tüm memeye 50 Gy; tümör yataðýna ortanca 14 Gy (10-16 Gy) radyoterapi uygulandý. Tedavi planlama sisteminden hedef hacim ve kritik organlarýn dozimetrik deðerlendirmeleri yapýldý. RTOG tokisisite kriterleri kullanýlarak akut ve geç yan etkiler deðerlendirildi.
BULGULAR: : Meme koruyucu cerrahi uygulanan büyük ve sarkýk (panduler) memeli 17 hasta deðerlendirildi. Ortalama yaþ 59 (38-87); ortalama tümör boyutu 2.2 cm (0,7-5.5 cm) idi. Tüm memeye 50 Gy, tümör yataðýna median 14 Gy (10-16 Gy) boost uygulandý. PTV meme minimum, maksimum, ortalama dozlarý; 3341cGy, 5544 cGy, 5161 cGy;.akciðer ortalama doz ve V5, V20, V30 ortalama yüzdeleri: 414 cGy, %10.5,% 5, %3.6;kalp ortalama doz ve V5,V10,V30 ortalama yüzdeleri; 256cGy, %7.7, %3.3, %1.2; karþý meme maksimum ve ortalama doz; 1128 cGy ve 44 cGy idi.7 hastada grade 2, 1 hastada grade 3 radyodermit geliþti. Ortalama 14.5 aylýk (1-24 ay) takipte nüks veya kötü kozmetik sonuç gözlenmedi.
TARTIÞMA ve SONUÇ: Panduler memelerin supine pozisyonda alýnmasý ile daha çok doz inhomojenitesi görülmekte ve bunun sonucu olarak kozmezis bozulmaktadýr. Ayrýca büyük alanlarýn ýþýnlanmasý ile akciðer ve kalp toksisitesi artmaktadýr. Panduler meme ýþýnlamalarýnda prone pozisyon ile iyi doz homojenitesi ve kozmezis saðlanabilmektedir.

INTRODUCTION: Adjuvant radiotherapy is the standard treatment for breast cancer patients who underwent breast conserving surgery. One of the most important factors affecting cosmetic results after radiotherapy is breast size. The aim of this study was to evaluate the cosmesis and dosimetric distribution of patients undergoing radiotherapy in the prone position due to pandular breast.
METHODS: Between July 2015 and August 2017, 17 patients who had breast conserving surgery and radiotherapy were evaluated. Patients were simulated in prone position. Fifty Gy to the breast; median 14 Gy (10-16 Gy) boost to the tumor bed were applied. Dosimetric results were evaluated from treatment planning system. Acute and late side effects were evaluated by using RTOG toxicity criteria.
RESULTS: Seventeen patients with pendulous breasts who underwent breast conserving surgery and radiotherapy were evaluated. The mean age was 59 (38-87); mean tumor size was 2.2 cm (0.7-5.5 cm). Median 50 Gy (48-50 Gy) radiotherapy was applied to the whole breast with a median 14 Gy (10-16 Gy) boost to the tumor bed. PTV minimum, maximum and mean doses were 3341 cGy, 5544 cGy, 5161 cGy; mean dose of lung and V5, V20, V30 values were 414 cGy, 10.5%, 5%, 3.6%; hear tmean dose and V5, V10, V30 values were; 256cGy, 7.7%, 3.3%, 1.2%; maximum and mean doses of the contrlateral breast were 1128 cGy and 44 cGy. In 7 patients grade 2 radiodermitis; in 1 patient grade 3 radiodermitis was observed. There was no recurrence or poor cosmetic outcome during the14.5 months follow-up (1-24 months).
DISCUSSION AND CONCLUSION: More dose inhomogenity is seen in the supine position radiotherapy of pendulous breasts and as a result bad cosmetic results may be observed. Also lung and heart toxicity increases with the irradiation of large areas. Good dose homogenities and cosmetic results may be achieved by prone position.

GÝRÝÞ ve AMAÇ: Çalýþmamýzda, mide kanserli hastalarda operasyon sonrasý hastalýksýz saðkalým ve genel saðkalýmý etkileyen prognostik faktörlerin retrospektif olarak deðerlendirilmesi amaçlandý.
YÖNTEM ve GEREÇLER: Çalýþmamýzda, Ocak 2014 - Aralýk 2018 tarihleri arasýnda merkezimizde mide kanseri tanýsýyla adjuvan tedavi alan 194 hastanýn araþtýrma kapsamýnda týbbi kayýtlarý sistem notlarýndan ve hasta dosyalarýndan retrospektif olarak incelendi. Mide kanseri nedeniyle opere olup adjuvan tedavi alan, 18 yaþ ve üzerindeki hastalar çalýþma grubuna dahil edildi. Sekonder malignite, peritoneal tutulum veya uzak metastaza sahip olan hastalar çalýþmaya dahil edilmedi. Saðkalým sürelerinin gruplar arasý karþýlaþtýrýlmasýnda Log-Rank testi, saðkalým için prognostik faktörlerinin belirlenmesinde Cox Regresyon modeli kullanýldý.
BULGULAR: Çalýþma grubunu oluþturan 194 hastanýn %66.0’sý erkek, %34.0’ü kadýn olup; medyan yaþ 60 (26-85) idi. Tek deðiþkenli analizde, ECOG performans skorunun artýþý, ileri Tümör (T), Nod (N), ileri Tümör, Nod, Metastaz (TNM) evresi, artmýþ metastatik lenf nodu oraný hastalýksýz ve genel saðkalým için kötü prognostik faktörler olarak bulundu. Lenfovasküler invazyonun olmasý ise; yalnýzca hastalýksýz saðkalým için kötü prognostik faktör olarak saptandý. Cox regresyon analizinde, genel saðkalým için ileri T evresi ve ileri TNM evresi, hastalýksýz saðkalým için ise, ileri T evresi baðýmsýz kötü prognostik faktörler olarak tespit edildi.
TARTIÞMA ve SONUÇ: Elde edilen sonuçlara göre, opere mide kanserli hastalarda, ileri T evresi ve TNM evresinin genel saðkalým açýsýndan kötü prognostik faktörler olabileceði, ayrýca ileri T evresinin hastalýksýz saðkalýmý olumsuz etkilediði gösterildi.

INTRODUCTION: The aim of the study was to retrospectively evaluate the prognostic factors affecting the disease-free survival and overall survival in gastric cancer patients after the operation.
METHODS: In the study, the medical records of 194 patients who received adjuvant therapy with the diagnosis of gastric cancer in our center between January 2014 and December 2018 were retrospectively analyzed from the system notes and patient files. Gastric cancer patients aged 18 years or older who underwent operation were included in the study group. Secondary malignancy, peritoneal involvement or distant metastasis were not included in the study group. Log-Rank test was used to compare survival times between groups, and Cox Regression analysis was used to determine prognostic factors for survival.
RESULTS: The median age of 194 patients (66.0% male, 34.0% female) was 60 (26-85). In univariate analysis; poor performance score, advanced Tumor (T) stage, advanced Node (N) stage, advanced Tumor, Node, Metastasis (TNM) stage, and increased metastatic lymph node ratio were found to be poor prognostic factors for disease-free survival and overall survival. Lymphovascular invasion was found only as a poor prognostic factor for disease-free survival. In Cox regression analysis, advanced T stage and advanced TNM stage for overall survival and advanced T stage for disease-free survival were determined as independent poor prognostic factors.
DISCUSSION AND CONCLUSION: According to the results obtained, it was shown that advanced T stage and TNM stage may be poor prognostic factors in terms of overall survival in patients with operated gastric cancer and also advanced T stage negatively affected disease-free survival.

GÝRÝÞ ve AMAÇ: RENAL nefrometri skoru 7 ve üzerinde olan renal kitlelerde robot yardýmlý parsiyel nefrektominin perioperatif, onkolojik ve fonksiyonel sonuçlarýnýn deðerlendirilmesi.
YÖNTEM ve GEREÇLER: Nisan 2015- Mart 2019 tarihleri arasýnda robotic parsiyel nefrektomi uygulanan ve nefrometri skoru 7 ve üzeri olan vakalarýn demografik, perioperatif ve postoperatif verileri retrospektif olarak deðerlendirildi. Soliter böbrekli, sýcak iskemi uygulanmayan, multiple renal kitlesi olan ve retroperitoneal teknikle parsiyel nefrektomi uygulanan hastalar çalýþma dýþý býrakýldý.
BULGULAR: Hastalarýn ortalama yaþý 58.08 ± 12.71 yýl idi. Ortalama tümör çapý, RENAL skor, preoperative eGFR deðerleri sýrasýyla 4.19 ± 1.56 cm, 7.88 ± 1.12 ve 78.73 ± 18.10 ml/min/1.73m² idi. Ortalama operasyon süresi, kanama miktarý, hastanede kalýþ süresi sýrasýyla 156.15 ± 45.70 dk, 139.06 ± 72.96 mL ve 3.58 ± 1.03 gün þeklindeydi. Açýða ve radikal nefrektomiye dönüþ izlenmedi. Cerrahi sýnýr pozitifliði 2 (4.2%) hastada izlendi. Postoperatif 12. Ay eGFR deðiþimi -7.19± 8.83 ml/min/1.73m² (9.13%) idi. Yeni baþlangýçlý Evre 3-4 kronik böbrek yetmezliði (eGFR< 60 ml/min/1.73m²) oraný 6.3% olarak saptandý. Hastalarýn ortalama takip süresi 35.08 ± 11.09 ay idi. Takip boyunca kansere baðlý ölüm izlenmezken, genel saðkalým 95.8% olarak saptandý.
TARTIÞMA ve SONUÇ: Robot yardýmlý parsiyel nefrektomi RENAL skoru orta-yüksek risk grubu renal kitlelerde güvenilir onkolojik ve fonksiyonel sonuçlarla baþarýyla uygulanabilir cerrahi bir yöntemdir.

INTRODUCTION: To evaluate the perioperative, oncological and functional outcomes of robot-assisted partial nephrectomy in renal masses with a RENAL nephrometry score ≥7.
METHODS: Demographics, perioperative and postoperative outcomes of robot-assisted partial nephrectomy with a RENAL nephrometry score ≥7 who operated between April 2015 and March 2019 were retrospectively evaluated. Patients with solitary kidney, zero ischemic, multiple renal mass and partial nephrectomy with retroperitoneal technique were excluded from the study.
RESULTS: The mean age of the patients was 58.08 ± 12.71 years. Mean tumor diameter, RENAL score, preoperative eGFR values were 4.19 ± 1.56 cm, 7.88 ± 1.12 and 78.73 ± 18.10 ml / min / 1.73m², respectively. The mean operation time, estimated blood loss, and length of hospital stay were 156.15 ± 45.70 min, 139.06 ± 72.96 mL and 3.58 ± 1.03 days, respectively. No conversion to open or radical nephrectomy was observed. Positive surgical margin was observed in 2 (4.2%) patients. The 12th month postoperative eGFR change was -7.19 ± 8.83 ml / min / 1.73m² (9.13%). The rate of new-onset Stage 3-4 chronic kidney disease (eGFR <60 ml / min / 1.73m²) was 6.3%. The mean follow-up period was 35.08 ± 11.09 months. Overall survival was 95.8%, while cancer-related death was not observed during follow-up.
DISCUSSION AND CONCLUSION: Robot-assisted partial nephrectomy with intermediate and high risk RENAL nephrometry scores is a safe surgical method that can be applied successfully with comparable oncological and functional results.

GÝRÝÞ ve AMAÇ: Adneksiyal kitlelerin teþhisi için intraoperatif frozen section (IFS) ile final histopatolojik sonuçlar arasýndaki uyumu deðerlendirmek.
YÖNTEM ve GEREÇLER: Adneksiyal kitle nedeniyle IFS incelemesi yapýlan 274 hastanýn verileri retrospektif olarak toplandý. Adneksiyal kitlelerin teþhisinde IFS ve final histopatolojik sonuçlarýnýn uyumu, rastgele uyum oranýný düzelterek hesaplayan kappa testi kullanýlarak deðerlendirildi.
BULGULAR: IFS ve final patoloji sonuçlarý arasýndaki genel uyum oraný (%94,0), Cohen’s kappa tablosu ile deðerlendirildiðinde güçlü bir uyumu göstermiþtir (K = 0,847; p <0,001). IFS sensitivite deðerleri benign, borderline ve malign vakalarda sýrasýyla %99,0; %68,4 ve %84,0 idi. Spesifite oranlarý benign, borderline ve malign vakalarda sýrasýyla %84,1; %99,2 ve %98,7 idi. Benign, borderline ve malign vakalarda prevalans oranlarý sýrasýyla %74,8; %6,9 ve %18,3 idi.
TARTIÞMA ve SONUÇ: Adneksiyal kitlelerin teþhisi için IFS ile final patoloji sonuçlarý arasýndaki güçlü uyum, IFS'nin en düþük prevalansa sahip olan borderline vakalar için bile güvenilir olduðunu göstermiþtir.

INTRODUCTION: To evaluate the concordance between the intraoperative frozen section (IFS) and final histopathological results for diagnosing adnexal masses.
METHODS: The data of 274 patients who underwent IFS examination of an adnexal mass were collected retrospectively. The concordance of IFS and final histopathological results for diagnosing adnexal masses was evaluated using the Kappa test, which was calculated by correcting the random fit rate.
RESULTS: The overall agreement rate (94.0%) between the IFS and final pathology results showed strong agreement when evaluated with Cohen’s kappa table (K = 0.847; p < 0.001). The IFS sensitivity values were 99.0%, 68.4%, and 84.0% for benign, borderline, and malignant cases, respectively. Specificity ratios were 84.1%, 99.2%, and 98.7% for benign, borderline, and malignant cases, respectively. Prevalence rates were 74.8%, 6.9%, and 18.3% for benign, borderline, and malignant cases, respectively.
DISCUSSION AND CONCLUSION: Strong concordance between IFS and final pathology results for diagnosing adnexal masses showed that IFS is reliable even for borderline cases, which have the lowest prevalence.

GÝRÝÞ ve AMAÇ: Prostat Kanseri (PK) erkeklerde en sýk görülen kanser türüdür ve özellikle ileri yaþlarda görülmektedir. Çalýþmamýzda 55 yaþ altýnda PK tespit ettiðimiz ve Radikal retropubik prostatektomi (RRP) uyguladýðýmýz hastalarýn uzun dönem onkolojik sonuçlarý sunuldu.
YÖNTEM ve GEREÇLER: Kliniðimizde Ocak 2000 ile Haziran 2017 tarihleri arasýnda PK tanýsý almýþ ve RRP uygulanmýþ 346 hasta çalýþmaya dahil edildi ve datalarý retrospektif olarak incelendi. Hastalar 55 yaþ altý (n: 64 (%18.5)) ve 55 yaþ üstü (n: 282 (%81.5)) olmak üzere iki gruba ayrýldý. RRP yapýlan hastalarýn gleason skor (GS), pozitif cerrahi sýnýr (PCS), seminal vezikül invazyonu (SVÝ), lenf nodu invazyonu (LNÝ), ekstrakapsüler yayýlým (EKY) sonuçlarý deðerlendirildi.
BULGULAR: Çalýþmamýzda ortalama takip süresi 80.1±36.1 ay idi ve takip esnasýnda hastalarýn % 22.3’ünde (n: 77) BCR tespit edildi. Çok deðiþkenli lojistik regresyon analizinde de BCR ile iliþkili faktörler; serum PSA düzeyinin >20 ng/ml, EKY, SVÝ, PCS ve RRP spesmeninde GS olarak tespit edildi (p<0.05). Yaþ gruplarý arasýnda (55 yaþ altý ve üstü) BCR’siz saðkalým oranlarý bakýmýndan istatistiksel olarak anlamlý fark yoktu (p: 0.9).
TARTIÞMA ve SONUÇ: Çalýþmamýzda literatüre paralel olarak yüksek PSA düzeyi, EKY, SVÝ, PCS varlýðý ve GS yüksekliði ile BCR arasýnda istatiksel olarak anlamlý iliþki bulunmuþtur; ancak yaþ gruplarý ile BCR arasýnda istatiksel olarak anlamlý iliþki bulunmamýþtýr.

INTRODUCTION: Prostate cancer (PK) is the most common type of cancer in men and is seen especially in older ages. In this study we presented the long-term oncological results of patients who are under 55-year-old underwent radical retropubic prostatectomy (RRP).
METHODS: In this study we diagnosed with PK in 346 patients between January 2000 and June 2017 and underwent RRP in our clinic and their datas were analyzed retrospectively. Patients were divided into two groups (under (n: 64 (%18.5)) and over (n: 282 (%81.5)) 55-year-old). The results of gleason score (GS), positive surgical margin (PSM), seminal vesicle invasion (SVI), lymph node invasion (LNI, extracapsular invasion (ECI) were evaluated.
RESULTS: In our study, the mean follow-up was 80.1 ±36.1months and BCR was detected in %22.3 (n: 77) of patients during follow-up. In multivariate logistic regression analysis, BCR-related factors were; serum PSA level was>20 ng/ml, ECI, SVI, PSM and GS in RRP spesimens (p<0.05). There was no statistically significnt difference in BCR-free survival rates between age groups (under 55-year-old and older) (p: 0.9).
DISCUSSION AND CONCLUSION: In our studyi statistically significant relationship was found between BCR and presence of high PSA level, ECI, SVI, PSM and GS in parallel with the litarature; however there was no statistically significant between agre groups and BCR.

GÝRÝÞ ve AMAÇ: Proksimal radius tümörlerinin rezeksiyonu sonrasýnda, birçok rekonstrüksiyon tekniði tanýmlanmýþ olmasýna raðmen, hangi tekniðin en uygun olduðu konusu hala tartýþmalýdýr. Bu çalýþmanýn amacý geniþ yumuþak doku ve kas tutulumu olan olgularda single bone forearm tekniðinin sonuçlarýnýn araþtýrýlmasýdýr.
YÖNTEM ve GEREÇLER: 2008-2014 yýllarý arasýnda 9 hastaya en bloc proksimal radius rezeksiyonu ve sonrasýnda single bone forearm procedürü uygulandý. Ortalama takip süresi 49.1 ay(46-52)dý. Hastalarda VAS(Visual Analog Scale), Quality of Life (SF-30) skoru, modified musculoskeletal tumor society (MSTS) skoru ve diðer üst ekstremitesiyle kýyaslanmak üzere eklem hareket açýklýðý(ROM) ve kavrama güçleri karþýlaþtýrýldý. Ayrýca kaynama zamaný, ek cerrahi operasyonlara ihityaç ve nüks açýsýndan da deðerlendirildi.
BULGULAR: 6.aydaki ortalama eklem hareketleri açýsýndan, 70°(60°-75°) el bileði ekstansiyonu, 90° (70°-95°) el bileði fleksiyonu, 25° (15°-35°) radial deviasyonu, 25º (15°-29°) ulnar deviasyonu ve 0º supinasyon ve pronasyon olarak ölçüldü. VAS ve SF-30 skorlarýnda iyileþme saðlanmýþ olup, ortalama modifiye MSTS skoru %72,77(63-82) olarak ölçüldü. Akciðer metastazýndan ötürü bir hasta öldü. Rekürrens gözlenmedi. Neoadjuvan radyoterapi almýþ 3 hasta pseudoartroz sebebiyle yeniden opere edildi.
TARTIÞMA ve SONUÇ: Single bone forearm tekniði, geniþ yumuþak doku tutulumu olan proksimal radius tümörlerinin rezeksiyonu sonrasýnda rekonstrüksiyon tekniði olarak alternatif ve akýlda tutulmasý gereken bir tekniktir.

INTRODUCTION: Despite several surgical techniques introduced for the treatment of malignant tumors of proximal radius, the most appropriate treatment remains to be undiscovered. The aim of the study is to analyze the results of patients who underwent proximal radius resection and reconstruction with the single bone forearm procedure in malignant tumors involving the proximal radius with large muscle and soft tissue.
METHODS: Between 2008 and 2014, 9 patients with malignant tumors involving the proximal radius were treated by en bloc resection and reconstruction with the single bone forearm procedure. Patients were followed for 49.1(46-52) months. VAS (Visual Analog Scale), Quality of Life (SF-30), modified musculoskeletal tumor society (MSTS) scoring system, range of motion (ROM) and grip strength compared to contralateral side were measured. Also, time of union, need for further operations and recurrence of the tumor were evaluated.
RESULTS: The mean ranges of the ROM of extremity at the follow up of sixth month was 70°(60°-75°), wrist extension, 90° (70°-95°) palmar flexion, 25° (15°-35°) radial deviation, 25º (15°-29°) ulnar deviation, 0º supination, and 0º pronation. VAS and SF-30 were improved dramatically. The mean modified MSTS score was 72.77(63-82)%. Death from lung metastasis occurred in one patient. Recurrence did not occur. Three patients who had been given neoadjuvant radiotherapy underwent pseudoarthrosis surgery.
DISCUSSION AND CONCLUSION: Single bone forearm technique after proximal radius resection is a good alternative procedure in proximal radius malignant tumors with advanced soft tissue involvement.

GÝRÝÞ ve AMAÇ: Robot yardýmlý laparoskopik radikal prostatektomi (RYLRP) ve geniþletilmiþ pelvik lenf nodu diseksiyonu yapýlan hasta serimizde patoloji spesmeninde pT0 hastalarýn oraný ile bu hastalarýn patolojik ve klinik özelliklerini belirlemek.
YÖNTEM ve GEREÇLER: 2009-2019 tarihleri arasýnda tek merkezde RYLRP ve bilateral geniþletilmiþ pelvik lenf nodu dsieksiyonu yapýlan toplam 1950 hastanýn verileri retrospektif olarak incelendi.. RYLRP sonrasý spesmenler patolojik olarak incelendi ve pT0 olanlar kaydedildi. pT0 olan hastalarýn yaþý, preoperatif serum PSA düzeyi, klinik evresi, prostat biyopsi sonuçlarý (Gleason derecesi, biyopsi sayýsý, toplam kor ve pozitif kor sayýsý, tümör uzunluðu ve kordaki yüzdesi), patolojik spesmendeki prostat aðýrlýðý ve diðer patoloji verileri kaydedildi. Postoperatif takiplerde PSA düzeyinin iki kez0.2 ng/ ml üzerine ölçülmesi biyokimyasal rekürrens olarak kabul edildi.
BULGULAR: RYLRP yapýlan 1950 hastanýn 16’ sý pT0 olarak raporlandý. Ortalama PSA deðeri 9.3±1.06 ng/ml (0.25-34.6) idi. RYLRP sonrasý pT0 patolojiye sahip 10 hastanýn neoadjuvan hormon tedavisi (NHT) ve 1 hastanýnda TUR-P öyküsü vardý. 5 hastada NHT veya TUR-P öyküsü yoktu ve biyopside düþük riskli prostat kanseri nedeniyle yapýlan RYLRP’ de pT0 olarak raporlandý. Ortalama prostat aðýrlýðý 60.3 ± 30.8 gr (26-154) idi. Ortalama takip süresi 18.64 ± 4.66 (12-80) ay idi. 1 hastada PSA rekürrrensi gözlendi ve radyoterapi aldý.
TARTIÞMA ve SONUÇ: Hem açýk hem de robotik radikal prostatektomi sonrasý pT0 nadir görülmektedir. Cerrahi öncesi tedavi alan küçük bir hasta grubunda takipler rekürrens ve sistemik progresyon açýsýndan dikkatli bir þekilde yapýlmalýdýr.

INTRODUCTION: To determine the pathological and clinical characteristics of these patients with pT0 ratio in the pathology specimen of patients undergoing robot-assisted laparoscopic radical prostatectomy and extended pelvic lymph node dissection.
METHODS: The data of 1950 patients who underwent robot-assisted laparoscopic radical prostatectomy and bilateral dilated pelvic lymph node dissection in a single center between 2009-2019 were analyzed retrospectively. Patients' age, preoperative serum PSA, clinical stage, prostate biopsy results (Gleason grade, biopsy number, total core and positive core number, tumor length and percentage in core), weight of pathological specimen and other pathology data were recorded. Increasing PSA level above 0.2 ng / ml in postoperative follow-up was accepted as biochemical recurrence.
RESULTS: 16 of the 1950 patients who underwent robot-assisted laparoscopic radical prostatectomy were reported as pT0. The mean PSA value was 9.3 ± 1.06 ng / ml (0.25-34.6). Ten patients with pT0 pathology after RYLRP had neoadjuvant hormone therapy (NHT) and 1 patient had a history of TUR-P. Five patients had no history of NHT or TUR-P and were reported as pT0 in RYLRP due to low-risk prostate cancer in biopsy. The average prostate weight was 60.3 ± 30.8 g (26-154). The mean follow-up was 18.64 ± 4.66 (12-80 months). Recurrence of PSA was observed in 1 patient and received radiotherapy.
DISCUSSION AND CONCLUSION: Both open and robotic radical prostatectomy pT0 is rare. In a small group of patients receiving preoperative treatment, follow-up should be done carefully in terms of recurrence and systemic progression.

GÝRÝÞ ve AMAÇ: Çalýþmamýzda radikal prostatektomi (RP) yapýlmýþ, metastatik olmayan prostat kanseri hastalarýnda ileri yaþýn onkolojik sonuçlara etkisini araþtýrmak amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Toplamda 593 hastanýn verileri geriye dönük incelendi. Hastalar 70 yaþ altý (n=454) ile 70 yaþ ve üzeri (n=139) olarak iki gruba ayrýldý. Demografik, patolojik ve cerrahi sonrasý onkolojik sonuçlar iki grup arasýnda karþýlaþtýrýldý. Birincil hedef nokta olarak ileri yaþýn biyokimyasal nüks olmaksýzýn sað kalým (BNOS) ve genel sað kalým (GS) üzerine etkisi deðerlendirildi. BNOS ve GS üzerine etki eden faktörlerin deðerlendirilmesi için lojistik regresyon analizi yapýldý. 10 yýllýk takiplerde BNOS ve GS oranlarýný gösteren Kaplan-Meier eðrileri oluþturuldu.
BULGULAR: GS oranlarý sýrasýyla 5 ve 10 yýllýk takiplerde daha genç yaþtaki hasta grubu ile ileri yaþtaki hasta grubu karþýlaþtýrýldýðýnda %85.2’ye karþý %64 ve %67.2’ye karþý %23.7 olarak bulundu (her iki karþýlaþtýrma için de p < 0.001). BNOS oranlarý sýrasýyla 5 ve 10 yýllýk takiplerde daha genç yaþtaki hasta grubu ile ileri yaþtaki hasta grubu karþýlaþtýrýldýðýnda %83.9’a karþý 80.9% ve %85.2’ye karþý %39.4 olarak bulundu (sýrasýyla p = 0.29, and p < 0.001). RP sonucundaki Gleason skorunun 7 ve üzerinde olmasý, seminal vezikül invazyonu ve ileri evre hastalýk BNOS üzerine etkin faktörler olarak bulundu. Çok deðiþkenli analizde ise ileri patolojik evre (pT3) ve yüksek Gleason skoru (8 ve üzeri) BNOS üzerine etkili faktörler olarak bulundu. Genel sað kalým ileri yaþtaki hastalarý içeren grupta daha düþük bulundu ve yaþ GS üzerine etkin birincil faktör olarak saptandý.
TARTIÞMA ve SONUÇ: Metastaz yapmamýþ prostat kanseri hastalarýnda radikal prostatektomi sonrasý onkolojik sonuçlar üzerine ileri yaþýn bir etkisi görülmemiþtir.

INTRODUCTION: We evaluated the effect of advanced age on oncological outcomes after radical prostatectomy (RP) in non-metastatic prostate cancer (PCa) patients.
METHODS: Totally 593 patients’ data was retrospectively evaluated. All patients were divided into two groups: <70 (n=454) and ≥70 (n=139) years of age. Demographic, pathological and post-operative oncological outcomes were compared between these two groups. The primary endpoint was to evaluate the effect of advance age on biochemical recurrence free survival (BRFS) and overall survival (OS). Logistic regression analysis was performed to predict BRFS and OS. Kaplan-Meier pilots are provided for BRFS and OS up to ten years.
RESULTS: The OS rates were 85.2% vs. 64%, and 67.2% vs. 23.7% in comparing the younger group to the older group at the 5th, and 10th year of follow-ups, respectively (p < 0.001 for the both comparisons). The BRFS rates were 83.9% vs. 80.9%, and 85.2% vs. 39.4% when comparing the younger group to the older group at the 5th, and 10th year of follow-ups, respectively (p = 0.29, and p < 0.001, respectively). Factors of a Gleason score higher than 7 on radical prostatectomy, seminal vesicle invasion, and advanced stage were found to be significant factors affecting BRFS, in univariate analysis. In the multivariate analysis, it denoted advanced pathological stage (T3) and high Gleason score (≥8) as prognostic factors affecting BRFS. OS was found to be worse in the older patients’ group and age was found as a primary factor in prediction of OS.
DISCUSSION AND CONCLUSION: There is no relationship between advanced age and oncological outcomes after RP in non-metastatic PCa patients.

GÝRÝÞ ve AMAÇ: Günümüzde birçok kronik miyelod lösemi (KML) hastasý için primer tedavi imatinib mesilattýr. Ýkinci kuþak tirozin kinaz inihibitörü (TKÝ) olan dasatinib ve nilotinib 1. basamakta da etkin olmakla birlikte sýklýkla dirençli ya da intoleran hastalarda kullanýlýr. Tedavi oral olarak kullanýlan bu ilaçlara sýký uyum ve düzenli kan kontrolleri yapýlmasýný gerektirir. Ömür boyu tedavi yanýsýra düzenli kontroller hastanýn yaþam kalitesini etkilemektedir. Yeni kuþak tirozin kinaz inhibitörleriyle yaþam kalitesine ait veriler daha azdýr. Ayrýca ülkemizdeki KML hastalarýnýn hemen tümü fiyat farký nedeniyle artýk orijinal olmayan imatinib kullanmaktadýr. Çalýþmamýzda KML tanýsýyla takip ve tedavisi yapýlan ve halen TKÝ (imatinib, dasatinib, nilotinib) kullanmakta olan hastalarýn yaþam kalitelerinin deðerlendirilmesi amaçlanmýþtýr
YÖNTEM ve GEREÇLER: Bu çalýþmada KML tanýsýyla takip edilen toplam 120 hastanýn yaþam kalitesi deðerlendirildi.Yaþam kalitesini deðerlendirmek amacýyla EORTC QLQ-CML24 ve EORTC QLQ-C30 (versiyon 3.0) ölçekleri kullanýldý.
BULGULAR: Nilotinib için hesaplanan uykusuzluk ölçeði imatinib ölçeðinden anlamlý oranda düþük bulundu (p=0.027). Ýmatinib kullanan hastalar için hesaplanan günlük hayata etki ölçeði dasatinib kullanan hastalar ile kýyaslandýðýnda daha düþüktü (p=0.007). Diðer parametreler için gruplar arasýnda fark saptanmadý.
TARTIÞMA ve SONUÇ: Çalýþmamýzda jenerik imatinib, dasatinib ve nilotinib alan kronik miyeloid lösemi hastalarý arasýnda yapýlan karþýlaþtýrma sonuçlarýnýn büyük oranda benzer bulunmasý daha potent olan 2.kuþak TKÝ’lerin imatinib kadar iyi tolere edildiðini ve yaþam kalitesine benzer etki yaptýðýný düþündürmüþtür.

INTRODUCTION: The first line treatment for chronic myeloid leukaemia (CML) is still imatinib mesylate in many countries. Dasatinib and nilotinib are also effective in first line treatment but often used in resistant or intolerant patients. The treatment requires strict drug compliance and regular blood tests. Lifelong treatment as well as regular controls may negatively affect the quality of life. The aim of this study was to evaluate the quality of life of CML patients taking tyrosine kinase inhibitors (TKI).
METHODS: A total of 120 patients were included in the study and divided into 3 groups according to the TKI they take generic imatinib (n=72), dasatinib (n=23) or nilotinib (n=25). EORTC QLQ-CML24 and EORTC QLQ-C30 (version 3.0) scales were used to evaluate the quality of life.
RESULTS: Insomnia in nilotinib group was lower than the dasatinib group (16.00 ± 23.80 vs 28.70± 35.25, p= 0.027). The satisfaction with care information of imatinib group was lower than dasatinib group (75.46± 17.00 vs 84.78± 20.66, p = 0.007). No difference was found between the 3 groups for other parameters.
DISCUSSION AND CONCLUSION: The comparison of chronic myeloid leukemia patients under generic imatinib, dasatinib and nilotinib suggested that the second generation TKIs are generally well tolerated and have nearly similar effects with imatinib on quality of life.

GÝRÝÞ ve AMAÇ: Son dönemde immünoterapilerin saðkalýma küçük bir katkýsý olsa da küçük hücreli akciðer kanserinde halen yeni tedavilere ihtiyaç vardýr. Bu çalýþmada, küçük hücreli akciðer kanserinde (KHAK) bilinen prognostik faktörlere ek olarak bir sistemik inflamatuar indeks olan nötrofil-lenfosit oranýnýn (NLO) prognostik öne¬mini göstermeyi amaçladýk.
YÖNTEM ve GEREÇLER: Toplam 203 KHAK’li hasta retrospektif olarak deðerlendirildi. Hastalarýn demografik bilgileri, tedavi rejimleri, hastalýk progresyon ve eksitus tarihleri hastane otomasyon sisteminden veya hasta dosyalarýndan elde edildi. Genel saðkalýmý (OS) etkileyen faktörler tek deðiþkenli analizle saptandýktan sonra baðýmsýz prognostik faktörlerin tespiti için çok deðiþkenli Cox regresyon analizi yapýldý.
BULGULAR: Ortalama yaþ 58±9,3 idi. Hastalarýn %91,6’sý erkek idi. Hastalarýn %64,5’i yaygýn hastalýk evresindeydi. En sýk uygulanan kemoterapi rejimi cisplatin + etoposid, ortanca kür sayýsý 6 idi. Objektif yanýt oraný (ORR) %65,7 idi. Çok deðiþkenli Cox regresyon analizi sonucunda yaygýn hastalýk evresi, ileri yaþ (≥65), yüksek NLO (≥5) ve yüksek LDH düzeyi (≥550) OS için baðýmsýz kötü prognostik faktörler olarak tespit edildi.
TARTIÞMA ve SONUÇ: NLO’nun genel sað kalýmý (OS) etkileyen baðýmsýz prognostik faktörlerden biri olabileceði gösterildi.

INTRODUCTION: Although immunotherapies have made a small contribution to survival in recent years, there is a need for new treatments for small cell lung cancer (SCLC). We aimed to show the prognostic importance of the neutrophil-lymphocyte ratio (NLR), which is a systemic inflammatory index, in addition to the known prognostic factors in SCLC in this study.
METHODS: We retrospectively evaluated a total of 203 SCLC patients. Demographic data, treatment regimes, disease progression and date of exitus were retrieved from patient files and the hospital automated records system. After the determination of factors affecting overall survival (OS) with univariate analysis, Cox regression model was performed to demonstrate the prognostic factors affecting OS.
RESULTS: The patients comprised 91.6% males and 8.4% of females with a mean age of 58±9.3 years. One-hundred-thirty-one (64.5%) patients had extensive-stage disease. The most frequently applied chemotherapy regime was cisplatin+etoposide, with a median of 6 cycles. The objective response rate (ORR) was 65.7%. As a result of Cox regression analysis, the extensive-stage disease, advanced age (≥65 years), high NLR (≥5), and high LDH level (≥550) were determined to be independent poor prognostic factors for OS.
DISCUSSION AND CONCLUSION: The results of the study showed that high NLR has negative impact on OS in patients with SCLC.

GÝRÝÞ ve AMAÇ: Bu çalýþmada ürotelyal mesane kanseri nedeniyle radikal sistoprostatektomi yapýlan hastalarda eþlik eden prostat patolojilerini deðerlendirmeyi amaçladýk.
YÖNTEM ve GEREÇLER: Retrospektif çalýþmada, 2001 - 2019 tarihleri arasýnda mesane tümörü nedeniyle radikal sistektomi yapýlan 197 hasta deðerlendirildi. Non-ürotelyal mesane kanseri nedeniyle opere edilenler, kadýnlar, prostat korunarak sistektomi yapýlanlar ve operasyon öncesinde prostat kanseri tanýsý olan hastalar çalýþma dýþý býrakýldý. Ürotelyal mesane tümörü nedeniyle radikal sistoprostatektomi yapýlan toplam 169 erkek hasta çalýþmaya dahil edildi.
BULGULAR: Hastalarýn yaþ ortalamasý 64.9 ± 8.2 (38 – 86) yýldý. Eþlik eden prostat patolojilerinin daðýlýmý 80 (%47.3) hastada benign prostat patolojileri, 38 (%22.5) hastada yüksek dereceli prostatik intraepitelyal neoplazi ve 51 (%30.2) hastada prostat kanseri þeklindeydi. 47 (%27.81) hastada mesane kanserinin prostata invazyonu mevcuttu. Prostat kanseri saptanan hastalarýn prostat spesifik antijen deðerleri (3.5 ± 3.0) prostat kanseri olmayanlara göre (2.6 ± 4.0) anlamlý olarak yüksekti (p= 0.014).
TARTIÞMA ve SONUÇ: Mesane kanseri nedeniyle opere edilecek erkek hastalarýn yönetiminde prostat kanserinin, prostat kanseri prekürsörü lezyonlarýn ve prostata mesane kanseri invazyonun eþlik edeceði göz önünde bulundurulmalýdýr. Prostat koruyucu sistektomi planlanan hastalarda operasyon öncesi prostatýn ayrýntýlý olarak deðerlendirilmelidir. Mesane kanserine eþlik eden prostat kanserinin klinik önemi tartýþmalý olsa da, Gleason skoru yüksek ileri yaþlý hastalarýn prostat kanseri açýsýndan takibi göz ardý edilmemelidir.

INTRODUCTION: In this study, we aimed to evaluate the accompanying prostate pathologies in patients undergoing radical cystoprostatectomy for urothelial bladder cancer.
METHODS: In the retrospective study, 197 patients who underwent radical cystectomy due to bladder tumor between 2001 and 2019 were evaluated. Those who were operated for non-urothelial bladder cancer, women, those who underwent prostate-sparing cystectomy, and those diagnosed with prostate cancer before the operation were excluded. A total of 169 male patients who underwent radical cystoprostatectomy due to urothelial bladder tumor were included in the study.
RESULTS: The mean age of the patients was 64.9 ± 8.2 (38 – 86) years. Distribution of concomitant prostate pathologies was benign prostate pathologies in 80 (47.3%), high grade prostatic intraepithelial neoplasia in 38 (22.5%) and prostate cancer in 51 (30.2%) patients. Prostate specific antigen values (3.5 ± 3.0) of patients with prostate cancer were significantly higher than those without prostate cancer (2.6 ± 4.0) (p = 0.014).
DISCUSSION AND CONCLUSION: In the management of male patients who will be operated for bladder cancer, it should be considered that prostate cancer, prostate cancer precursor lesions and prostate invasion might accompany bladder cancer. Prostate should be evaluated in detail before the operation in patients who are planned to undergo prostate-sparing cystectomy. Although the clinical importance of prostate cancer accompanying bladder cancer is controversial, the follow-up of patients with advanced Gleason score in terms of prostate cancer should not be ignored.

GÝRÝÞ ve AMAÇ: Bevasizumab, kanser tedavisinde kullanýlan ve anjiogenezi inhibe eden bir vasküler endotelyal büyüme faktörü reseptörüdür. Bu etkisinden dolayý bazý deneysel çalýþmalarda tiroid ve pankreas boyutlarýnda azalmaya neden olduðu gösterilmiþtir. Bu doðrultuda çalýþmada bevasizumab kullanan hastalarda tedavinin tiroid ve pankreas boyutlarýnýn ve fonksiyonlarý üzerine etkileri araþtýrýlmýþtýr.
YÖNTEM ve GEREÇLER: Malignite tanýsýyla baþvuran 50 hastanýn evreleme ve takip amacý ile çekilmiþ toraks ve abdomen tomografileri retrospektif deðerlendirilmiþ ve tedavi öncesi ve tedavinin 6. ayýndaki tiroid sað ve sol lob antero-posterior (AP) çaplarý ve pankreas baþ, gövde ve kuyruk AP çaplarý ölçülmüþtür. Ayrýca hastalarýn hastane kayýtlarýndaki tetkiklerinden kan amilaz, lipaz deðerleri ve tiroid fonksiyon testleri ayný zaman dilimlerinde deðerlendirilerek karþýlaþtýrýlmýþtýr.
BULGULAR: Yapýlan tüm ölçüm deðerlerinde bevasizumab tedavisi ile ortalama deðerlerde bir miktar azalma gözlenmekle birlikte istatistiksel anlamlý fark saptanmamýþtýr. Yine yapýlan tetkik incelemelerinde sadece 1 hastada tedavinin 6. ayýnda kan lipaz deðerinde yükselme, 3 hastada da tiroid fonksiyon testlerinde bozulma izlenmiþ ve anlamlý fark saptanmamýþtýr.
TARTIÞMA ve SONUÇ: Bevasizumab kullanýmý, tiroid ve pankreas boyut ve fonksiyonlarýnda anlamlý deðiþiklik yapmamýþtýr. Fakat anlamlý fark olmasa da yaptýðýmýz ölçümlerde tiroid bezi ve pankreas boyutlarýnda azalma saptadýk. Bu nedenle daha geniþ populasyon ve daha fazla hasta sayýlarý ile yapýlacak ayrýntýlý prospektif çalýþmalara ihtiyaç olduðunu düþünmekteyiz.

INTRODUCTION: Bevacizumab is a vascular endothelial growth factor receptor used in cancer treatment that inhibits angiogenesis. Due to this effect, it has been shown in some experimental studies that the thyroid and pancreas sizes are reduced. Accordingly, the effects of Bevacizumab treatment on thyroid and pancreatic dimensions and functions were investigated in this study.
METHODS: Thorax and abdominal tomography taken from 50 patients with malignancy for staging and follow-up were evaluated retrospectively and thyroid right and left lobe AP diameters and pancreatic head, trunk and tail AP diameters were measured before treatment and at the 6th month of treatment. In addition, blood amylase, lipase values and thyroid function tests were evaluated from patients' tests on the system and compared in the same time frames.
RESULTS: Although a slight decrease in average values was observed with Bevacizumab treatment in all measurement values, there was no statistically significant difference. Again, in the examination studies, only 1 patient showed an increase in blood lipase value and 3 patients have a deterioration in thyroid function tests in the 6th month of treatment and there was no significant difference.
DISCUSSION AND CONCLUSION: It has been observed that bevacizumab use does not significantly change thyroid and pancreatic size and functions. However, even though there is no significant difference, it is thought that detailed prospective studies with more patient groups may be required due to the decrease in the measurements.

GÝRÝÞ ve AMAÇ: Over kanseri kadýnlarda görülen beþinci en sýk kanser olmakla birlikte jinekolojik kanserlere baðlý ölüm nedenleri arasýnda ilk sýrada yer almaktadýr. Çalýþmamýzda merkezimizde over kanseri nedeniyle tedavi verilen hastalarýn nüks durumunun, saðkalým sonuçlarýnýn ve tedaviye baðlý gözlenen yan etkilerin retrospektif olarak deðerlendirilmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Çalýþmamýzda Ocak 2010 –Ocak 2020 yýllarý arasýnda Dr. Abdurrahman Yurtaslan Ankara Onkoloji Eðitim ve Araþtýrma Hastanesi Medikal Onkoloji Kliniðinde taný ve tedavi amacýyla takibi yapýlmýþ over kanserli 160 olgunun týbbi kayýtlarý sistem notlarý ve dosyalarýndan retrospektif olarak incelenmiþtir. Çalýþmamýza over kanseri tanýsý almýþ 18 yaþ ve üzeri hastalar dahil edildi. Olgular yaþ ortalamasýna, over kanseri histopatolojik tiplerine, taný anýndaki evreye, aldýklarý kemoterapiye baðlý görülen yan etkilerine, progresyonsuz saðkalým (PFS) ve genel saðkalým (GS) sürelerine göre ayrýntýlý olarak incelenmiþtir. Saðkalým sürelerinin hesaplanmasýnda Kaplan–Meier analizi kullanýldý.
BULGULAR: Çalýþmaya alýnan 160 hastanýn ortanca yaþý 61 ± 11 idi. Histopatolojik alt gruplara göre en sýk (%80,6) seröz epitelyal over kanseri saptandý. Taný esnasýndaki evre daðýlýmý incelendiðinde olgularýn en çok Evre III’de taný aldýðý görüldü. Kemoterapiye baðlý en sýk görülen yan etki alopesi (%100) olurken; alopesi dýþýnda yan etki görülme insidansý %51,2 olarak bulundu. Olgularýn %48,8’inde nüks saptanýrken; medyan progresyonsuz saðkalým 19,1 ay; tüm grupta ise genel saðkalým 89,9 ay olarak hesaplandý. Doz azaltýmý yapýlan olgularda ise genel saðkalým anlamlý olarak düþük bulundu (p<0,05).
TARTIÞMA ve SONUÇ: Çalýþmamýz olgularýn yaþ ortalamasý, hastalýðýn tanýdaki evresi, kemoterapi yan etkileri, saðkalým oranlarý açýsýndan diðer çalýþmalarla benzerlik göstermektedir. Doz azaltýmýnýn genel saðkalým üzerine olan negatif etkisi ise çoðu çalýþma ile benzerlik göstermekle birlikte bu konuda yapýlacak yeni araþtýrmalarýn gerekliliði göze çarpmaktadýr.

INTRODUCTION: Ovarian cancer is the fifth most common cancer in women and ranks first among the causes of death due to gynecological cancers. In our study, we aimed to evaluate the recurrence status, survival outcomes and treatment-related side effects of patients treated for ovarian cancer retrospectively.
METHODS: The study is performed at Dr.Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital. In this study, 160 patients with ovarian cancer who were followed up for diagnosis and treatment between January 2010 and January 2020 were analyzed retrospectively. The cases were analyzed according to the average age, histopathological types of the ovarian cancer, the stage at the time of diagnosis, the side effects associated with the chemotherapy, the progression-free survival (PFS) and overall survival (OS) rates.Log-Rank test was used to determine survival times.
RESULTS: The median age of patients included in the study is 61 ± 11 (50-72). Serous epithelial ovarian cancer was the most common (80.6%) according to histopathological subgroups. When the stage distribution at the time of diagnosis was examined, it was seen that the cases were mostly diagnosed in Stage III. While the most common side effect associated with chemotherapy was alopecia (100%), the incidence of side effects other than alopecia was 51.2%. Recurrence was detected in 48.8% of the cases, and median progression-free survival was 19.1 months, and overall survival was 89.9 months in the whole group.. Overall survival was significantly low in cases with dose reduction (p <0.05).
DISCUSSION AND CONCLUSION: The present study shows similarity with other studies in terms of mean age, stage of diagnosis, chemotherapy side effects, survival rates. The negative effect of dose reduction on overall survival is similar to most studies, but the necessity of new research on this subject is noticeable.

GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý malign yumuþak doku sarkomlarý ile AB0 gruplarý arasýndaki iliþkiyi deðerlendirmektir.
YÖNTEM ve GEREÇLER: 2010-2018 yýllarý arasýnda malign yumuþak doku sarkomu nedeniyle cerrahi tedavi uygulanan 206 hastanýn (vaka grubu) kan gruplarý, tümör tipleri, yaþ ve cinsiyet bilgileri retrospektif olarak deðerlendirildi. Hastanemiz kan merkezine baþvuran, vaka grubu ile yaþ ve cinsiyet açýsýndan benzer olan 249 (%54,7) saðlýklý gönüllü kiþinin kan gruplarý kontrol grubunu oluþturmuþtur.
BULGULAR: Vaka grubunun yaþ ortalamasý 49,5 ± 17,3; kontrol grubunun ise 49,5±19,9 yýldýr. Vaka grubunda AB0 kan grubu özellikleri daðýlýmý incelendiðinde %42,7 A kan grubu, %30,1 0 kan grubu, %19,9 B kan grubu ve %7,3 AB kan grubuna sahip hasta gözlenmiþtir. Kontrol grubunda da AB0 kan grubu daðýlýmýnýn benzer bir daðýlým gösterdiði saptanmýþtýr. Buna göre A kan grubu %44,2, 0 kan grubu %28,5, B kan grubu %19,3 ve AB kan grubu %8 olarak gözlenmiþtir. Vaka ve kontrol grubunun AB0 kan grubu daðýlýmlarýnýn istatistiksel olarak benzer olduðu tespit edilmiþtir. Vaka grubunda %89,8 hastanýn Rh (+), kontrol grubunda ise %86,7 hastanýn Rh(+) olduðu gözlenmiþtir ve istatistiksel olarak gruplar arasýnda anlamlý farklýlýk gözlenmemiþtir.
TARTIÞMA ve SONUÇ: Sonuç olarak bu çalýþmada malign yumuþak doku sarkomlarý ile AB0 ve Rh grubu arasýnda anlamlý bir iliþki saptanmamýþtýr. AB0 kan gruplarýnýn, malign yumuþak doku sarkomlarýnýn ayýrýcý tanýsýnda yol gösterici olup olmadýðýný anlayabilmek için özellikle tümör alt gruplarýndaki hasta sayýlarý da göz önünde bulundurularak daha büyük örneklemli çalýþmalara ihtiyaç vardýr.

INTRODUCTION: The aim of this study is to evaluate the relationship between malignant soft-tissue sarcomas and AB0 blood groups.
METHODS: The blood groups, tumor types, age and gender information of 206 patients (case group) operated for malignant soft-tissue sarcoma between 2010-2018 were evaluated retrospectively. The control group consisted of 249 (54.7%) healthy volunteers who were similar in age and gender to the case group that applied to blood center of our hospital.
RESULTS: The average age of the case group was 49.5 ± 17.3; the control group is 49.5 ± 19.9 years. When the distribution of AB0 blood group characteristics in the case group was analyzed, patients with 42.7% A blood group, 30.1% 0 blood group, 19.9% B blood group and 7.3% AB blood group were observed. It was found that the distribution of AB0 blood group showed a similar distribution in the control group as well. Accordingly, A blood group 44.2%, 0 blood group 28.5%, B blood group 19.3% and AB blood group 8%. The AB0 blood group distributions of the case and control groups were found to be statistically similar. In the case group, 89.8% of the patients were Rh (+) and in the control group, 86.7% of the patients were Rh (+), and there was no statistically significant difference between the groups.
DISCUSSION AND CONCLUSION: In conclusion, in this study, no significant relationship was found between malignant soft tissue sarcomas and AB0 and Rh groups. In order to understand whether AB0 blood groups guide the differential diagnosis of malignant soft tissue sarcomas, larger sample studies are needed, especially considering the number of patients in tumor subgroups.

GÝRÝÞ ve AMAÇ: Bu araþtýrmanýn amacý, acil servise intihar ve intihar giriþimi nedeniyle baþvuran olgularý incelemek ve riskleri belirlemekti.
YÖNTEM ve GEREÇLER: Çalýþmamýzda; acil servise Ocak 2018 - Aralýk 2018 tarihleri arasýnda intihar giriþimi nedeni ile baþvuran olgularýn verileri retrospektif olarak deðerlendirildi. Bu olgularýn verileri; medeni durum, eðitim durumu, yaþ, cinsiyet, ekonomik nedenler, sosyal özellikler, aile geçimsizliði, psikiyatrik hastalýk tanýsý varlýðý veya yokluðu, tedavi süreçleri açýsýndan incelendi. Ayrýca olgular intihar giriþim yöntemleri ve nedenleri açýsýndan araþtýrýldý.
BULGULAR: Bu çalýþmada ki toplam 246 olgunun %69,5’ i kadýn %30.5’ i erkekti. Hastalarýn %93.9’u ilaç veya toksik madde alarak intihar giriþiminde bulunduðu tespit edildi. Olgulardan %19,5’inin daha önce de intihar giriþiminde bulunduðu, %80,5’nin önceden intihar giriþiminde bulunmadýðý belirlendi. Ýntihar giriþiminde bulunana vakalarýn %93.9’ine psikiyatri konsültasyonu istendiði, %6.1’ine psikiyatri konsültasyonu istenmediði belirlendi. Psikiyatrik tedavi gören ve daha önceden intihar giriþiminde bulunan olgular arasýnda iliþkinin istatistiksel olarak anlamlý olduðu tespit(edildi (p<0.001). Önceden intihar giriþimi olan hastalarýn %54,2’sinin psikiyatrik tedavi aldýðý, %45,8’sinin ise psikiyatrik tedavi almadýðý belirlendi. Ýntihar giriþimlerinin aylara göre daðýlýmý deðerlendirildiðinde %11,0 intihar giriþimi ile en sýk haziran ayýnda, mevsimsel olarak da %25,6 intihar giriþimi ile en sýk sonbahar mevsiminde gerçekleþmiþtir. Ýntihar giriþimlerinin %45,9’unun gündüz saatlerinde olduðu belirlendi.
TARTIÞMA ve SONUÇ: Ýntihar giriþimi yöntemi açýsýndan en sýk kullanýlan yöntemin ilaç ve toksik madde belirlenmiþ olmasý nedeniyle bu tür maddelerin evlerde daha güvenlikli ortamlarda saklanmasý intihar eðilimi olan kiþilerin bu maddelere ulaþmasýný zorlaþtýracaktýr. Ýntihar giriþimi kadýnlarda erkeklerden, gençlerde yaþlýlardan daha fazla görülmesi nedeniyle intihar eðilimi olan kiþilere yönelik önlemlerin arttýrýlmasý intihar giriþimini azaltacaðý kanaatindeyiz.

INTRODUCTION: The aim of this study was to evaluate cases with suicide attempts in the emergency department and to determine risk factors for suicides in these patients.
METHODS: The study was performed retrospectively with the data of suicide patients who applied to the emergency department between January-December 2018. These cases’ data were evaluated in terms of marital status, education, age, gender, economic reasons, social characteristics, family incompatibility, psychiatric diagnosis and treatment processes. Moreover, suicide methods and etiology were recorded.
RESULTS: In our study, of the 246 cases, 69.5% were female and 30.5% were male. 93.9% of patients attempted suicide by taking a drug or toxic substance. In 19.5% of these patients, there was a suicide attempt previously. 93.9% of the suicide cases were consulted by a psychiatrist. There was a significant relationship between psychiatric treatment and suicide attempts (p<0.001). 54.2% of the patients with a suicide attempt previously had received psychiatric treatment. According to the frequency distribution of suicide event, June was the most attempted month (11% of patients) and autumn was the most attempted season (%25 of patients). It was observed that 45.9% of the suicide attempts were in the daytime hours.
DISCUSSION AND CONCLUSION: The most commonly used method in suicide attempts is drug and toxic substances. Storing such substances in a safer environment will make it difficult for people with suicidal tendencies to access these substances. Suicide attempts are seen more in women than in men and in the young than in the elderly. So, we believe that increased measures for these people with suicidal tendencies will reduce suicide events.

GÝRÝÞ ve AMAÇ: Bu çalýþma, primer fibromiyalji sendromlu (FMS) hastalarýn klinik semptomlarýnýn tedavisinde ve yaþam kalitesinin düzeltilmesinde düþük yoðunluklu lazer (DYL) tedavisinin etkinliðini araþtýrmak amacýyla planlandý.
YÖNTEM ve GEREÇLER: Primer FMS’lu 60 hasta, aktif gallium- arsenide (GaAs) lazer (30 hasta) ve plasebo lazer (30 hasta) olmak üzere rastgele iki gruba ayrýldý. Tüm hastalar, hassas nokta sayýsý, aðrý, sabah sertliði, uyku bozukluðu, yorgunluk, kas spazmý, subjektif þiþlik hissi ve parestezilerdeki iyileþme oraný açýsýndan deðerlendirildi. Yaþam kalitesinin deðerlendirilmesi ise fibromiyalji etki sorgulamasýna (FIQ) göre yapýldý. Aktif lazer grubunda hastalara, her noktaya 2 dakika, 4,4 J/cm2 Ga-As lazer tedavisi 10 gün boyunca uygulandý. Plasebo tedavi için ise lazer ýþýný yayýlmadan yine ayný cihaz kullanýldý.
BULGULAR: Tedavi sonrasýnda tüm parametrelerde her iki grupta da istatiksel olarak anlamlý düzeyde iyileþme saptandý.
TARTIÞMA ve SONUÇ: Elde ettiðimiz sonuçlar, FMS nin tedavisinde DYL uygulanmasýnýn etkili olduðunu ve etyopatogenezinde emosyonel faktörlerin önemli rol oynadýðýný düþündürmektedir.

INTRODUCTION: This study investigates the efficiency of low level laser therapy (LLLT) in the treatment of clinical symptoms and improvement of the quality of life in patients diagnosed with primary fibromyalgia syndrome (FMS).
METHODS: Sixty primary FMS patients were randomly divided into two groups: active gallium-arsenide (GaAs) laser (30 patients) and placebo laser (30 patients). All the patients were assessed in terms of recovery rates in tender point quantity, pain, morning stiffness, sleep disorder, fatigue, muscle spasm, subjective swelling and paresthesia. Assessment of the quality of life was performed according to the fibromyalgia impact questionnaire (FIQ). Two minutes of 4,4 J/cm2 Ga-As laser therapy to every point was applied to the patients in the active laser group for 10 days. For placebo therapy, the application was applied for the same period of time without radiating any laser beams.
RESULTS: After the treatment, statistically significant recovery was observed in both groups in terms of all parameters.
DISCUSSION AND CONCLUSION: Our results suggest that application of LLLT is effective in the treatment of FMS and emotional factors may play an important role in its etiopathogenesis.

GÝRÝÞ ve AMAÇ: Bu çalýþmada dahil edilme kriterlerine uygun 182 özefageal kanserli hastanýn tek merkez gözlemsel verisinin deðerlendirilmesi, klinik ve demografik özelliklerinin incelenmesi ve multimodal tedavi dahil diðer prognostik faktörlerin analizi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Araþtýrma kapsamýnda, Ocak 2010-Aaralýk 2019 tarihleri arasýnda özefagus kanseri tanýsý alan 182 hasta çalýþmaya dahil edilmiþtir. Hastalarýn demografik, klinik, patolojik özellikleri ile tedavi ve yan etki bilgilerine dosya kayýtlarýndan ulaþýlmýþtýr. Saðkalým analizleri Kaplan- Meier testi ile, tek deðiþkenli analizler Log-Rank testi ile ve çok deðiþkenli analizler Cox-Regresyon testi ile deðerlendirilmiþtir
BULGULAR: Hastalarýn en sýk görülen histopatolojik tipi skuamoz hücreli kanser (n: 153, % 84.1) ve en sýk tümör lokalizasyonu alt uçta bulunmaktadýr. Uygulanan sistemik tedaviler adjuvan kemo(radyoterapi) %6, neoadjuvan kemoterapi %2.7, neoadjuvan kemoradyoterapi % 30.8 ve definitif kemoradyoterapi %37.9 olarak saptanmýþtýr. Uzak metastatik hastalar da çalýþma grubuna dahil edilmiþtir. Tek deðiþkenli analizlerde diferansiyasyon derecesi, multimodal tedavi varlýðý, rezeksiyon tipi, neoadjuvan tedavi yanýtý, tanýda metastaz varlýðý açýlarýndan genel saðkalým (GS) ve progresyonsuz saðkalým (PS) farký saptanmýþtýr (p<0.05). Çok deðiþkenli analizlerde cerrahi sýnýr negatifliðinin progresyon riskini 3.4 kat azalttýðý (p<0.001), lenfovasküler invazyon (LVÝ) varlýðýnýn da progresyon riskini 1.9 kat arttýrdýðý (p=0.004) gözlenmiþtir. Genel saðkalým açýsýndan ise tek prognostik faktörün cerrahi sýnýr negatifliði olduðu gözlenmiþ ve ölüm riskini 2.4 kat azalttýðý (p<0.001) saptanmýþtýr.
TARTIÞMA ve SONUÇ: Sonuç olarak tek merkeze ait gözlemsel veriler sunulmuþ ve oluþturulan alt gruplarda tedavi yanýtý, rezeksiyon tipi, histolojik alt tip ve tümör lokalizasyonu ile ilgili literatür ile uyumlu bulgular elde edilmiþtir. Prognostik faktörler açýsýndan LVÝ ve cerrahi sýnýr negatifliðinin kuvvetli prognostik faktörler olduðu gösterilmiþtir

INTRODUCTION: In this study, it was aimed to evaluate the single-center observational data of 182 patients with esophageal cancers, to examine their clinical and demographic features and to analyze other prognostic factors including multimodal treatment
METHODS: Within the scope of the study, medical records of 182 patients diagnosed with esophageal cancer between January 2010 and December 2019 were included. The demographic, clinical, pathological features, treatment and side effects of the patients were obtained from the file records. Survival analyzes were evaluated by the Kaplan-Meier test, univariate analyzes by the Log-Rank test, and multivariate analyzes by the Cox-Regression test
RESULTS: The most common histopathological type is squamous cell cancer (n: 153, 84.1%) and the most common tumor localization in the patients is located at the lower part. Systemic treatments applied were adjuvant chemo (radiotherapy) 6%, neoadjuvant chemotherapy 2.7%, neoadjuvant chemoradiotherapy 30.8% and definitive chemoradiotherapy 37.9%. Distant metastatic patients were also included in the study group. In univariate analysis, the difference in overall survival (OS) and progression-free survival (PFS) was determined in terms of differentiation, presence of multimodal therapy, resection type, neoadjuvant treatment response, and presence of metastases (p <0.05). In multivariate analysis, it was observed that surgical margin negativity decreased the progression risk by 3.4 times (p <0.001), and the presence of lymphovascular invasion (LVI) increased the risk of progression by 1.9 times (p = 0.004). In terms of overall survival, it was observed that the only prognostic factor was surgical margin negativity and decreased the risk of death by 2.4 times (p <0.001).
DISCUSSION AND CONCLUSION: As a result, observational data belonging to a single center were presented and findings compatible with the literature regarding the treatment response, resection type, histological subtype and tumor localization were obtained. In terms of prognostic factors, LVI and surgical margin negativity have been shown to be strong prognostic factors.

GÝRÝÞ ve AMAÇ: Bu çalýþmanýn primer amacý, küratif cerrahi ve adjuvan kemoradyoterapi (KRT) uygulanan mide adenokarsinomlu hastalarýn lokal yineleme bölgelerini radyoterapi planlarý ile birleþtirilerek tanýmlamaktýr. Ýkincil amaç ise saðkalým sonuçlarýný sunmaktýr.
YÖNTEM ve GEREÇLER: Ýki merkezde küratif rezeksiyon yapýlan ve adjuvan KRT alan 62 eriþkin mide adenokarsinomlu hastalar retrospektif olarak incelendi. Radyoterapi 25-28 fraksiyonlarda 4500-5040 cGy olarak uygulandý. Takipte, nüksün tariflendiði bilgisayarlý tomografi RT planlama sistemine aktarýldý ve RT izodoz eðrilerine göre nüks bölgesi tanýmladý.
BULGULAR: Ortanca takip süresi 18 aydý, 22 hastanýn (% 35) hastalýðý tekrarladý. Beþ hastada izole lokal-bölgesel baþarýsýzlýk (3 nodal, 2 lokal nüks) görüldü. Bu nükslerin üçü RT alanýnda, biri marjinal nüks, kalan biri de RT alaný dýþýnda idi. Ýki nodal nüks, % 95 ve % 100 izodoz eðrisi içinde kalýrken, diðer nodal nüks ise recete edilen dozun % 20’sini oluþturduðu izodoz hattýnda idi. Bir lokal nüks, % 90 izodoz eðrisi içinde, anastomoz bölgesinde, diðeri ise % 50 izodoz eðrisi içinde, peritoneal yüzeydeydi. Üç ve beþ yýllýk genel saðkalým (GS) sýrasýyla % 71 ve % 55 olarak bulundu. D2 lenf nodu diseksiyonu yapýlan hastalarda genel sað kalým daha yüksek olup farklýlýk istatistiksel olarak anlamlý düzeyde bulunmadý.
TARTIÞMA ve SONUÇ: Lokal nüks bölgesinin tanýmlanmasý RT hedef hacmin belirlenmesinde yol gösterici olabilir. Bunun için daha fazla hasta ile yapýlan kontrollü çalýþmalara ihtiyaç bulunmaktadýr.

INTRODUCTION: The primary aim of this study is to evaluate and define locoregional recurrence regions individually matching with radiotherapy (RT) plans in gastric adenocarcinoma patients treated with curative surgery and adjuvant chemoradiotherapy (CRT). The secondary aim is to present the survival results.
METHODS: 62 adult gastric adenocarcinoma patients who underwent curative resection and received adjuvant CRT at two radiation oncology centers were analyzed. The 4500-5040 cGy was delivered in 25-28 fractions. At follow-up, computed tomography, which described recurrence, was transferred to the RT planning system and defined the site of relapse according to RT isodose curves.
RESULTS: The median follow up time was 18 months, 22 patients (35%) have been relapsed. Five patients had isolated loco-regional failure. Three of these relapses were in the RT field, one was marginal recurrence and the remaining one was outside the RT field. Two nodal recurrence regions were covered by 95% and 100% isodose lines and the other nodal recurrence region was covered by 20% isodose line with respect to their initial radiotherapy volumes. One local recurrence was in the anastomosis site covered by 90% isodose line and the other was on the peritoneal surface covered by 50% isodose line. The 3 and 5-year overall survival (OS) were 71% and 55% respectively, and were better with D2 lymph node dissection without statistical significance.
DISCUSSION AND CONCLUSION: Identification of the local recurrence site may be helpful in determining the RT target volume. For this, controlled studies with more patients are needed.

GÝRÝÞ ve AMAÇ: Baðýþýklýk sistemi melanom hastalarýnýn saðkalýmýnda etkin bir rol oynamaktadýr. Nötrofil lenfosit oraný (NLR) tümöre karþý etkin baðýþýklýk sisteminin indirek bir göstergesidir. Biz de çalýþmamýzda malign melanom hastalarýnda bazal NLR’nin prognostik önemini araþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: Sekiz yýllýk dönemde taný konmuþ olan 134 malign melanom hastasý retrospektif olarak deðerlendirilmiþ ve 94 hasta çalýþmaya dahil edilmiþtir. Taný anýndaki NLR deðerleri incelenmiþtir. ROC analizine göre eþik deðer 2,1 olarak saptanmýþtýr ve bu deðere göre hastalar yüksek veya düþük olarak sýnýflandýrýlmýþtýr. NLR’nin prognostik açýdan hasta ve tümör karakteristikleri ile iliþkisi de araþtýrýlmýþtýr.
BULGULAR: 94 hastanýn 37’si metastatiktir ve 57 hasta adjuvan tedavi almýþtýr. Hastalardan NLR’si düþük olanlarýn medyan saðkalýmý 83,8 ay iken NLR’si yüksek olanlarýn 23,8 aydýr. (p<0,001). Metastatik olmayan hastalardan NLR düþük grupta medyan saðkalýma ulaþýlamazken NLR yüksek grupta medyan saðkalým 40,2 aydýr (p=0.031), medyan hastalýksýz saðkalým ise NLR düþük ve yüksek grupta sýrasýyla 60,8 ay ve 14,4 aydýr (p=0,038). Hasta yaþý > 60 olanlarda NLR yüksekliði ile iliþki dýþýnda (p=0,027) NLR ile hasta ve tümör karakteristikleri arasýnda iliþki bulunamamýþtýr.
TARTIÞMA ve SONUÇ: Melanom hastalarýnda NLR yüksekliði kötü prognozla belirgin olarak iliþkili bulunmuþtur ve prognoz için bir belirteç olarak kullanýlabileceði görülmüþtür.

INTRODUCTION: Immune system could play an effective role on clinical outcome of the melanoma patients. Neutrophil-to-lymphocyte ratio (NLR) is an indirect indicator for the immune response against to the tumor. So, we aimed to evaluate the prognostic importance of basal NLR in patients with malignant melanoma.
METHODS: We retrospectively reviewed 134 patients with malignant melanoma diagnosed in about an eight year period and 94 patients were included in the study. The values of NLR were assessed at the time of diagnosis. NLR cut-off value was determined as 2.1 by ROC curve. All patients were classified as high and low according to this cut-off value. The prognostic significance of NLR on clinical outcome of the patients was evaluated according to tumor or patient characteristics.
RESULTS: Among 94 patients, 37 were metastatic and 57 had received adjuvant therapy. For all cases, median overall survival (OS) was 83.8 months in NLR low group and 23.8 months in NLR high group (p<0.001). For non-metastatic subgroup, median OS could not be reached in low NLR group and 40.2 months in high NLR group (p=0.031), median disease free survival were 60.8 months and 14.4 months (p=0.038) in NLR low and high group, respectively. There were no correlation between NLR and tumor or patient characteristics except of a higher NLR ratio was found in patients age > 60 (p=0.027).
DISCUSSION AND CONCLUSION: High NLR value showed a strong association with poor prognosis in melanoma patients and it can be used as a marker for prognosis.

GÝRÝÞ ve AMAÇ: Türkiye, COVID-19'dan en fazla etkilenen iki kýta olan Avrupa ve Asya arasýndaki köprüdür. Bu çalýþma nefroloji bölümüne danýþýlan COVID-19 hastalarýnýn prognozunu ve sonuçlarýný paylaþmaktadýr.
YÖNTEM ve GEREÇLER: 11 Mart 2020 ve 22 Nisan 2020 tarihleri arasýnda COVID-19 tanýsý ile yatýrýlan hastalarýn kayýtlarý retrospektif olarak deðerlendirildi ve bunlardan hemodiyaliz (HD) alan ve akut böbrek hasarý (ABH) tanýsý alan hastalar bu çalýþmaya dahil edildi.
BULGULAR: COVID-19 ile tedavi edilen 352 hasta çalýþmaya dahil edildi. Bunlardan nefroloji bölümüne baþvuran 16 hastanýn 8'ine daha önce HD tedavisi uygulanýrken COVID-19 teþhisi konuldu. Diðer 8 hasta COVID-19 ile takip edilirken ABH tanýsý aldý. Bunlardan 5 ABH hastasý yoðun bakým ünitesine alýndý ve hepsi takip döneminde entübe edildi. Ancak ABH tanýsý alan beþ hasta öldü. Yoðun bakýma ihtiyaç duymayan üç ABH tanýlý hasta taburcu edildi.
TARTIÞMA ve SONUÇ: Bu çalýþma, ABH geliþen hastalarda COVID-19'un daha önce HD alan hastalara göre daha ölümlü olduðunu göstermektedir. Bunun COVID-19 ile iliþkili akut böbrek tutulumuna baðlý olabileceðini düþünüyoruz.

INTRODUCTION: Turkey is the bridge between Europe and Asia, which are the two continents that are affected by COVID-19 the most. This study shares the prognosis and results of COVID-19 patients, who have been consulted to the department of nephrology.
METHODS: The records of patients who were hospitalized with the diagnosis of COVID-19 between 11 March 2020 and 22 April 2020 were evaluated retrospectively and of these, the patients with receiving hemodialysis (HD) and diagnosed with acute kidney injury (AKI) were involved in this study.
RESULTS: 352 patients who were treated with COVID-19 were included in this study. Of these, 8 of the 16 patients consulted to the nephrology department were diagnosed with COVID-19 while receiving HD treatment previously. The remaining 8 patients who were diagnosed with AKI while being followed-up for COVID-19. Of these, 5 patients with AKI were taken to intensive care unit and all of them were intubated in the follow-up period. But five patients diagnosed with AKI were died. Three patients with AKI who did not need intensive care were discharged.
DISCUSSION AND CONCLUSION: This study shows that COVID-19 was more mortal in patients who developed AKI compared to patients who previously received HD. We think that this may be due to acute renal involvement related to COVID-19.

GÝRÝÞ ve AMAÇ: Tümörlerin neden olduðu kemik defektleri bazen kemiðin kendi dokusu ile iyileþmeyebilir. Bu gibi durumlarda, iyileþmeyi kolaylaþtýrmak veya baþlatmak için kemik defektlerininn kemik grefti materyalleriyle doldurulmasý gerekebilir. Bu çalýþmadaki amacýmýz iyi huylu kemik kistlerinde kullanan cam greft (CG)(GlassBone NORAKER) ve trikalsiyum fosfat greft (TKF) sonuçlarýný klinik ve radyolojik olarak karþýlaþtýrmaktýr.
YÖNTEM ve GEREÇLER: 2013 -2015 yýllarý arasýnda iyi huylu kemik tümörleri (çoðu basit kemik kisti (BKK) ve anevrizmal kemik kisti (AKK)) nedeniyle küretaj, koterizasyon ve grefonaj yapýlan 41 hastaya greft olarak CG ve TKF greft kullanýldý. Hastalar CG ve TKF greft ile tedavi edilenler olarak 2 gruba ayrýldý. Greft konsoludasyonu aylýk çekilen röntgenlerle radyolojik olarak deðerlendirildi. Hastalarýn klinik sonuçlarý retrospektif olarak deðerlendirildi.
BULGULAR: Ortalama yaþ 22,0 (14-32 yaþ arasý) olan 20 erkek ve 21 kadýn (%51,2) mevcuttu. CG kullanýlan hastalarda TKF kullanýlan hastalara göre, 14.-16. Aylar arasýnda radyolojik olarak konsolidasyonun daha hýzlý olduðunu gözlendi(p= 0.0001).
TARTIÞMA ve SONUÇ: Ýyi huylu kemik tümörlerinin tedavisinde, cam greftlerin trikalsiyum fosfat greftlerine alternatif olarak kullanýlabileceði sonucuna vardýk. Ayrýca cam greftlerle tedavi edilen hastalarýn radyolojik olarak daha hýzlý füzyon gösterdiðini fark ettik.

INTRODUCTION: Bone defects caused tumors sometimes may not heal with bone tissue. In such cases, bone defects may need to be filled with bone graft materials to facilitate or start healing. The purpose of our study is to compare results of glass graft(GG) (GlassBone NORAKER) and tricalcium phosphate (TCP) grafts that we use in benign bone cysts clinically and radiologically.
METHODS: 41 patients with benign bone tumors (mostly simple bone cysts (SBC) and aneurysmal bone cysts (ABC) ) had been treated between either glass graft or tricalcium phosphate graft between 2013-2015. Patients were divided into two groups as those treated with GG and TCP grafts. Graft consolidation evaluated radiologically with x-rays monthly.
RESULTS: There were 20 men and 21 women (51.2%) with a mean age of 22.0 years (range 14-32 years). In patients using GG, compared to patients using TCP, radiological consolidation was observed faster between 14.-16. months (p = 0.0001).
DISCUSSION AND CONCLUSION: We conclude that in the treatment of benign bone tumors glassbone can be used as an alternative to tricalcium phosphate grafts. We also noticed that patients treated with glassbone showed a faster rate of fusion radiologically.

GÝRÝÞ ve AMAÇ: Bu çalýþmada orta-ciddi derecede halluks valgus deformitesinde Mau Osteotomisinin erken dönem fonksiyonel ve radyolojik sonuçlarýnýn deðerlendirilmesi amaçlandý.
YÖNTEM ve GEREÇLER: Temmuz 2016 – Ocak 2019 tarihleri arasýnda halluks valgus deformitesi tanýsý ile Mau Osteotomisi uygulanan 16 hasta geriye dönük olarak gözden geçirildi. Hastalarýmýzýn ameliyat öncesi ve son takiplerinde klinik bulgularý; AOFAS (Amerikan Ortopedi Derneði Ayak-Ayak Bileði Skoru) ve VAS (Visual Analog Skala) ile deðerlendirildi. Radyolojik bulgular için her 2 ayak basarak ön-arka ve yan grafiler ile HVA (Halluks valgus açýsý), ÝMA (Ýntermetatarsal açý) ölçüldü.
BULGULAR: Hastalarýn 9’u kadýn (%56) 7’si erkek (%44) olup, ortalama yaþ 43,7 idi. Hastalarýn takip süresi ortalama 18 ay (daðýlým: 6-27 ay) idi. Ameliyat sonrasý klinik olarak AOFAS ve VAS skorlarý ameliyat öncesine göre anlamlý olarak düzelmiþti (p<0.05). Ameliyat öncesi radyolojik olarak, HVA 43.75 ± 7.58, ÝMA 16.00 ± 2.82 iken; son takipte HVA 22.13 ± 6.63, ÝMA 7.44 ± 3,38 olarak düzelmiþti (p<0.05). Hastalarýn %81’inde mükemmel ve iyi sonuç tespit edildi.
TARTIÞMA ve SONUÇ: Sonuç olarak hastalarýmýzýn %81’inde mükemmel ve iyi sonuç alýndý. Halluks valgus deformitesinde Mau Osteotomisi erken dönemde klinik ve radyolojik sonuçlarýmýza dayanarak etkin ve güvenilir bir yöntem olabilir.

INTRODUCTION: The aim of the present study was to evaluate the early functional and radiological results of Mau osteotomy in the treatment of moderate -severe hallux valgus deformity.
METHODS: A retrospective evaluation was made of 16 patients undergoing Mau osteotomy for treatment of hallux valgus deformity between July 2016 and January 2019. Clinical findings of patients were evaluated in preoperative and the last follow-up visits using the American Orthopaedic Association Foot and Ankle Score (AOFAS) and Visual Analog Scale (VAS). Radiological findings were measured with hallux valgus angle (HVA) and the intermetatarsal angle (IMA) on anteroposterior and lateral standing radiographs of both feet.
RESULTS: 9 (56%) patients were female and 7 (44%) male with a mean age of 43.7 years. The mean follow-up period was 18 months (range, 6-27 months). A statistically significant improvement was determined in AOFAS and VAS postoperatively compared to the preoperative values (p<0.05). Radiologically, the HVA improved from 43.75 ± 7.58 preoperatively to 22.13 ± 6.63 at the final follow-up examination, and the IMA from 16.00 ± 2.82 to 7.44 ± 3.38 (p<0.05). Excellent and good results were obtained in 81% of the patients.
DISCUSSION AND CONCLUSION: In conclusion, Mau osteotomy can be considered an effective and reliable method in the treatment of hallux valgus deformity, based on the excellent and good clinical and radiological results obtained in 81% of the current study patients.

GÝRÝÞ ve AMAÇ: EDTA'ya baðlý yalancý trombositopeni (EDTA-PTCP), otomatik kan sayýmý analizörleri ile yapay düþük trombosit sayýmlarýna yol açan, in vitro bir trombosit kümelenmesi olgusudur. PTCP bilgisi, klinik deðerlendirmenin doðruluðu ve gereksiz tedaviyi önlemek için önemlidir. Bu çalýþmanýn amacý, trombositopeni durumunda PTCP þüphesi için kullanýlabilecek öngörücü belirleyicileri tespit etmektir.
YÖNTEM ve GEREÇLER: Ocak 2016-Ocak 2019 tarihleri arasýnda 3 yýllýk süre boyunca hematoloji bölümümüze baþvuran hastalarýn retrospektif bir deðerlendirmesi yapýldý. PTCP ayýrýcý tanýsý için ayýrt edici bir parametre belirlemek amacý ile PTCP hastalarý ile immün trombositopeni (ITP) hastalarý ve saðlýklý bireyler arasýnda karþýlaþtýrmalar yapýldý. Demografik özellikler, hemogram ve biyokimyasal parametreler, altta yatan ve eþlik eden hastalýklar ve trombosit indeksler araþtýrýldý.
BULGULAR: EDTA-PTCP'li 164 hasta, ITP'li 43 hasta ve 45 saðlýklý kontrol hastasýnýn deðerlendirmesi yapýldý. PTCP hastalarýnda komorbidite sayýsý, trombosit sayýsý, ortalama trombosit hacmi, trombosit ve trombosit daðýlým geniþliði hem ITP hem de kontrol grubundan anlamlý olarak farklýydý (p<0.05). Lojistik regresyon analizi, PTCP'yi ITP'den veya kontrol grubundan ayýrt etmek için kullanýlabilecek anlamlý bir parametre olmadýðýný gösterdi (p>0.05).
TARTIÞMA ve SONUÇ: PTCP'yi trombositopenik ve saðlýklý durumlardan ayýrmak için hematolojik parametrelerin kullanýmý düþünülebilir. Ancak, mikroskobik periferik kan yayma analizi hala en güvenilir ve ayýrt edici yöntemdir.

INTRODUCTION: EDTA-dependent pseudothrombocytopenia (EDTA-PTCP) is an in-vitro phenomenon of platelet clumping that leads to artificial low platelet counts by automatic hematology analyzers. Knowledge of PTCP is important for the accuracy of a clinical assessment and to avoid unnecessary treatment. The aim of this study was to determine easily available predictive markers which can be used for suspicion of PTCP in case of thrombocytopenia.
METHODS: A retrospective evaluation was made of patients admitted or referred to our hematology department during the 3-year period from January 2016 to January 2019. Comparisons were made of the PTCP patients with immune thrombocytopenia (ITP) and healthy subjects to determine a distinctive parameter for the differentiation of PTCP. Differences were investigated in demographic characteristics, hemogram and biochemical parameters, underlying and comorbid diseases and platelet indices.
RESULTS: Evaluation was made of 164 patients with EDTA-PTCP, 43 patients with ITP and 45 healthy control subjects. In PTCP patients, the number of comorbidities, platelet count, mean platelet volume, plateletcrit and platelet distribution width were significantly different from both the ITP and control groups (p<0.05). Logistic regression analysis revealed no significant parameter that could be used to differentiate PTCP either from ITP or the control group (p>0.05).
DISCUSSION AND CONCLUSION: Hematological parameters may be considered for the use to differentiate PTCP from thrombocytopenic and healthy conditions. However, microscopic peripheral blood smear analysis is still the most reliable and distinctive method.

GÝRÝÞ ve AMAÇ: Serebrovasküler hastalýk (SVH) tanýsý ve prognozunun tayininde görüntüleme yöntemlerinin yaný sýra, her geçen gün yenisi eklenen biyokimyasal belirteçlerin de klinik önemi artmaktadýr.
Çalýþmamýzda iskemik ve hemorajik SVH’larda soluble-CD40 ligand (sCD40L), ortalama trombosit (MPV) ve ortalama eritrosit hacmi (MCV) düzeylerinin erken prognoz ve mortalite ile iliþkisinin tespit edilmesi amaçlanmýþtýr

YÖNTEM ve GEREÇLER: Çalýþmaya 100 iskemik ve 80 hemorajik inme olan hastalar ve 50 saðlýklý gönüllü kontrol grubundan oluþan 230 birey dahil edildi. Her hastanýn demografik verileri ve Glasgow Koma skalalarý, intraserebral kanamalý hastalarda ÝSK skoru ve iskemik inmeli hastalarda NIHSS puanlarý, kan MPV, MCV, sCD40L düzeyleri kaydedildi.

BULGULAR: sCD40L ve MCV düzeyleri açýsýndan hasta gruplarý ile kontrol grubu arasýnda anlamlý bir farka rastlanmadý. MPV düzeyinin iskemik ve hemorajik inme geçiren hastalarda kontrol grubuna göre anlamlý oranda yüksek olduðu gözlendi. Ýnme geçiren hastalarýn % 22,2’si, ilk hafta içerisinde yaþamýný yitirdi. Ölen hastalarda sCD40L deðerlerinin, yaþayan hastalarýn sCD40L deðerine göre anlamlý oranda düþük olduðu gözlendi. MCV ve MPV düzeyleri açýsýndan yaþayan ve ölen hastalar arasýnda anlamlý bir fark tespit edilmedi.

TARTIÞMA ve SONUÇ: MPV düzeyleri akut inme ile baþvuran hastalarda anlamlý oranda yükselmektedir. Ýlk taný anýndaki düþük serum sCD40L düzeyleri akut inme geçiren hastalarda erken prognozun daha kötü olacaðýna iþaret edebilir.

INTRODUCTION: The clinical importance of biochemical indicators as well as imaging methods in diagnosis and prognosis of cerebrovascular disorder increase continuously. The aim of the present study is to determine the relationship among soluble-CD40 ligand, mean platelet volume (MPV), mean red blood cell volume (MCV) levels and early prognosis in ischemic and hemorrhagic stroke.
METHODS: 100 ischemic and 80 hemorrhagic stroke patients and 50 healthy volunteers were included in the study. Demographic data, Glasgow Coma Scale, intraserebral hemorrhage scale and NIH Stroke Scale/Score results for stroke, hemoglobin, MPV, MCV and sCD40L measurement results were enrolled.
RESULTS: MPV levels for patients with ischemic and hemorrhagic stroke were significantly higher than the control group. There was no a significant correlation between blood MCV/serum sCD40L levels and strokes. sCD40L levels for exitus patients was statistically significantly lower when compared to sCD40L levels in living patients.
DISCUSSION AND CONCLUSION: MPV levels in patients with stroke increase considerably. The low level of sCD40L may be a parameter associated with early unfavorable prognosis and mortality.

GÝRÝÞ ve AMAÇ: Akut lenfoblastik lösemi (ALL), hematopoietik lenfoid öncüllerinden kaynaklanan blastlarýn anormal çoðalmasýndan kaynaklanýr. ALL, pediatrik lösemi vakalarýnýn % 75'ini oluþturur ve yetiþkinlerde 1.28/100.000 insidansý vardýr. ALL etiyolojisi hala tartýþma konusudur. Bazý çalýþmalarda, ABO kan gruplarýnýn kardiyovasküler, onkolojik ve diðer hastalýklarýn geliþiminde rol oynadýðý gösterilmiþtir. Bu çalýþmada ALL ile ABO ve Rh kan gruplarý arasýndaki iliþkileri araþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: Merkezimizde Þubat 2014 ile Nisan 2020 arasýnda tedavi edilen 124 ALL hastasý retrospektif olarak incelendi. Saðlýklý trombosit donörlerinin yaþ, cinsiyet ve kan grubu verileri kontrol grubu olarak kullanýldý.
BULGULAR: Hem erkek hem de kadýnlarda en yaygýn kan grubu A Rh + olmasýna raðmen, kontrol grubu ve ALL hastalarý arasýnda ABO kan grubu daðýlýmý ve Rh pozitifliði açýsýndan istatistiksel olarak anlamlý bir fark bulamadýk. Her iki grup da cinsiyete göre alt gruplandýrýldýðýnda, gruplar arasýnda ABO ve Rh daðýlýmý açýsýndan farklýlýk izlenmemiþtir.
TARTIÞMA ve SONUÇ: ALL ve kan gruplarý arasýndaki iliþkiye dair çok az çalýþma vardýr. Çalýþmamýz ALL kan grubu ile saðlýklý insanlar arasýnda kan gruplarý sýklýðýnýn benzer olduðunu desteklemektedir. Daha büyük hasta popülasyonlarý ile ileri çalýþmalara ihtiyaç vardýr.

INTRODUCTION: Acute lymphoblastic leukemia (ALL) is caused by abnormal proliferation of blasts originated from hematopoietic lymphoid precursors. ALL constitutes 75% of pediatric leukemia cases and has an incidence of 1.28/100.000 in adults. The etiology of ALL is a still matter of debate. In some studies, ABO blood groups were shown playing a role in development of cardiovascular, oncologic, and other diseases. In this study, we aimed to investigate relationship with ALL and ABO and Rh blood groups.
METHODS: 124 ALL patients treated at our center between February 2014 and April 2020 were retrospectively studied. The data of age, gender and blood group of healthy thrombocyte donors were used as the control group.
RESULTS: Although the most common blood group was A Rh+ among both males and females, we did not find a statistically significant difference between control group and ALL patients regarding ABO blood group distribution and Rh positivity. When both groups were sub-grouped according to gender, they did not differ between ABO and Rh distribution.
DISCUSSION AND CONCLUSION: There are few studies about the relationship between ALL and blood group types. Our study suggests blood group frequency might be similar among ALL patients with healthy individuals. Further studies with larger patient populations are needed.

GÝRÝÞ ve AMAÇ: Literatürde hemipelvektomi anestezi yönetimi hakkýnda karþýlaþýlan çok fazla bilgi bulunmamaktadýr. Bu çalýþma ile nadiren yapýlan hemipelvektomi sonrasý allogreftle rekonstrüksiyon anestezi yönetimine dikkat çekmek istiyoruz.
YÖNTEM ve GEREÇLER: Aralýk 2010- Þubat 2014 tarihleri arasýnda internal hemipelvektomi ve allogreftle rekonstrüksiyon cerrahisi yapýlan hastalarda dosya incelemesi retrospektif olarak yapýldý. Yaþ, cinsiyet, ASA, ek hastalýk, uygulanan anestezi yöntemi, preoperatif ve postoperatif hemoglobin deðeri, intraoperatif kanama miktarý, intraoperatif verilen mayi ve kan transfüzyon miktarý, operasyon süresi, yoðun bakým ve hastanede kalýþ süreleri, mortalite-morbidite oranlarý deðerlendirildi.
BULGULAR: Bu çalýþmada 12 hasta dosyasý deðerlendirildi. Hastalar ortalama yaþlarý 37,5 ± 14,6 (10 – 57 arasýnda) idi. 10 hastaya genel anestezi, 2’sine kombine spino-epidural (KSE) anestezi uygulandýðý görüldü. Ortalama intraoperatif kanama miktarý 2346 ± 1504 ml idi. Sývý yönetimi ile ilgili olarak ortalama 3916 ± 1673 ml kristalloid, 812 ± 441 ml kolloid, 1479 ± 856 ml eritrosit süspansiyonu ve 350 ± 302 ml TDP intraoperatif kullanýldý. Ortalama cerrahi süre 273,8 ± 69 dk, postoperatif yoðun bakýmda kalýþ süresi 38,0 ± 34,6 saat, hastanede kalýþ süresi 25,4 ± 21,4 gün idi. 12 hastanýn 5’i anestezi dýþý sebeplere baðlý olarak operasyondan birkaç ay sonra kaybedildi.
TARTIÞMA ve SONUÇ: Hemipelvektomi sonrasý allogreftle rekonstrüksiyon cerrahisi yapýlan hastalarýn, tam bir anestezi öncesi viziti ve bütün perioperatif dönemi kapsayan yakýn takibi öneriyoruz.

INTRODUCTION: There are not many reports encountered regarding anesthesia management of hemipelvectomy in the literature. We would like to call attention to anesthetic management of allograft reconstruction following hemipelvectomy with this study, which is rarely performed.
METHODS: The records of patients who underwent internal hemipelvectomy between December 2010 and February 2014 were retrospectively evaluated. The age, gender, ASA, comorbidity, anesthesia method applied, hemoglobin values, intraoperative amount of bleeding, amount of intraoperatively administered fluid and blood transfusion, duration of operation, intensive care stay and hospitalization, mortality and morbidity rates were analyzed.
RESULTS: 12 patients were evaluated in this study. The mean age of all patients was 37,5 ± 14,6 (range between 10 and 57). The anesthetic management was provided by general anesthesia for ten patients and combined spinal-epidural (CSE) anesthesia for two patients. The mean intraoperative amount of bleeding was 2346 ± 1504 ml. With regards to fluid management, 3916 ± 1673 ml crystalloids, 812 ± 441 ml colloids, 1479 ± 856 ml erythrocyte suspension, and 350 ± 302 ml fresh frozen plasma were infused during intraoperative period. The mean duration of surgery, intensive care stay and hospitalization were 273.8 ± 69 minutes, 38.0 ± 34.6 hours and 25.4 ± 21.4 days, respectively. Five patients out of 12 were died a few months after the surgery, but the anesthetic management was not found to related with the mortality.
DISCUSSION AND CONCLUSION: We recommend a perfect pre-anesthetic visit and close follow up including whole perioperative period for the patients undergoing allograft reconstruction surgery following hemipelvectomy.

Perivasküler epiteloid hücre tümörleri (PEComa) belirsiz malignite potansiyeli olan, çok nadir bir mezenkimal kanserdir. Mesane lokalizasyonunda primer PEComa nadir olarak görülür. PEComa’larda malignite kriterleri tümör boyutunun 5 cm’den büyük olmasý, yüksek mitotik aktivite, nekroz, infiltrasyon ve vasküler invazyon varlýðýdýr. Bu kriterlerden en az 2'sinin bulunduðu PEComa’lar malign olarak kabul edilir. Görüntüleme yöntemleri ile ayrýcý tanýya yardýmcý spesifik makroskopik özellikler göstermemesi nedeni ile tanýsý sadece histopatolojik inceleme ile konulabilmektedir. Mesanede tümörün büyüklüðü ve yerine göre transüretral rezeksiyon, parsiyel sistektomi veya radikal sistektomi ile cerrahi tedavi önerilir. Bu olgu sunumunda mesane lokalizasyonunda primer PEComa’lý bir vakanýn taný ve tedavisi deðerlendirildi.

Perivascular epithelioid cell tumors (PEComa) are a very rare mesenchymal cancer with unclear malignancy potential. Primary PEComa is rare in bladder localization. We have presented a case with a primary PEComa of the bladder. The criteria for malignancy in PEComas include greater than 5 cm tumor size, high mitotic activity, necrosis, infiltration and vascular invasion. PEComas with at least 2 of these criteria are considered malignant. The diagnosis can be made only by histopathological examination because it does not show specific macroscopic features to assist in differential diagnosis with imaging methods. Surgical treatment is recommended with transurethral resection, partial cystectomy or radical cystectomy according to the size and location of the tumor in the bladder. In this case report, the diagnosis and treatment of a case with primary PEComa in bladder localization were evaluated.