Browsing by Author "Kotan, Mehmet Cetin"

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Contribution of Diffusion Weighted Mri To Diagnosis and Staging in Gastric Tumors and Comparison With Multi-Detector Computed Tomography
(Assoc Radiology & oncology, 2017) Arslan, Harun; Ozbay, Mehmet Fatih; Calli, Iskan; Dogan, Erkan; Celik, Sebahattin; Batur, Abdussamet; Kotan, Mehmet Cetin
Background. Diagnostic performance of Diffusion-Weighted magnetic resonance Imaging (DWI) and Multi-Detector Computed Tomography (MDCT) for TNM (Tumor, Lymph node, Metastasis) staging of gastric cancer was compared. Patients and methods. We used axial T2-weighted images and DWI (b-0,400 and b-800 s/mm(2)) protocol on 51 pre-operative patients who had been diagnosed with gastric cancer. We also conducted MDCT examinations on them. We looked for a signal increase in the series of DWI images. The depth of tumor invasion in the stomach wall (tumor (T) staging), the involvement of lymph nodes (nodal (N) staging), and the presence or absence of metastases (metastatic staging) in DWI and CT images according to the TNM staging system were evaluated. In each diagnosis of the tumors, sensitivity, specificity, positive and negative accuracy rates of DWI and MDCT examinations were found through a comparison with the results of the surgical pathology, which is the gold standard method. In addition to the compatibilities of each examination with surgical pathology, kappa statistics were used. Results. Sensitivity and specificity of DWI and MDCT in lymph node staging were as follows: N1: DWI: 75.0%, 84.6%; MDCT: 66.7%, 82%;N2: DWI: 79.3%, 77.3%; MDCT: 69.0%, 68.2%; N3: DWI: 60.0%, 97.6%; MDCT: 50.0%, 90.2%. The diagnostic tool DWI seemed more compatible with the gold standard method (surgical pathology), especially in the staging of lymph node, when compared to MDCT. On the other hand, in T staging, the results of DWI and MDCT were better than the gold standard when the T stage increased. However, DWI did not demonstrate superiority to MDCT. The sensitivity and specificity of both imaging techniques for detecting distant metastasis were 100%. Conclusions. The diagnostic accuracy of DWI for TNM staging in gastric cancer before surgery is at a comparable level with MDCT and adding DWI to routine protocol of evaluating lymph nodes metastasis might increase diagnostic accuracy.
The Diagnosis of Acute Appendicitis in Pregnant Versus Non-Pregnant Women: a Comparative Study
(Assoc Medica Brasileira, 2016) Aras, Abbas; Karaman, Erbil; Peksen, Caghan; Kiziltan, Remzi; Kotan, Mehmet Cetin
Objective: To investigate whether the diagnosis of acute appendicitis is affected by pregnancy or not. Method: A retrospective study with the analysis of the medical records of all women suspected of having appendicitis who underwent appendectomy at our hospital between June 2010 and March 2015 were reviewed. The patients were divided into two groups according to whether they were pregnant or not during the surgery: group I, pregnant women, and group II, non-pregnant women. Results: During the study period, 38 pregnant women and 169 non-pregnant women underwent appendectomy. The time from admission to the operation was not statistically different (2.17 +/- 1.47 days in group I vs. 1.98 +/- 1.66 day in group II; p=0.288). The pregnant group had longer hospital stay than the nonpregnant group (p=0.04). Ultrasonography (USG) was used as the first diagnostic modality in 36/38 patients in group I and 161/169 in group II. The non-visualized appendix on ultrasound was seen in 17 patients in group I and 51 patients in group II, which was not statistically different. Sensitivity and specificity of USG in diagnosis of acute appendicitis were 61.29 and 80.00% in group I, and 93.0 and 31.6% in group II, respectively. Conclusion: Although the diagnosis of appendicitis in pregnant women is not delayed, careful assessment of these patients suspected of having appendicitis should be encouraged when USG examination is normal or nondiagnostic.
Efficacy of Shear Wave Elastography in Malignity Assessment of Thyroid Nodules With Atypia of Undetermined Significance and Comparison With Ti-Rads
(Bayrakol Medical Publisher, 2022) Durmaz, Fatma; Ozgokce, Mesut; Ozkacmaz, Sercan; Dundar, Ilyas; Alay, Murat; Goya, Cemil; Kotan, Mehmet Cetin
Aim: The aim of this study is to investigate the effectiveness of shear wave elastography (SWE) in the differentiation of benign-malignant thyroid nodules diagnosed with atypia of undetermined significance (AUS) and to compare with the American College of Radiology (ACR)-thyroid imaging reporting and data system (TIRADS). Material and Methods: This monocentric study comprised 52 patients (9 males; 43 females) who were diagnosed with AUS by thyroid FNAB. All patients included in the study had gray scale ultrasound (US) and SWE images. The mean SWE value was calculated for each nodule, and TIRADS scores were determined based on the US. The obtained data were compared based on the histopathological result in patients who had undergone surgical treatment, and based on the cytology result in patients followed-up by FNAB, for the differentiation of benign and malignant nodules. Results: Nineteen patients were found to have malignant nodules and 33 had benign nodules. The mean SWE was 2.89 +/- 0.51 (2.30-3.92) and 2.91 +/- 0.48 (2.16- 3.79) in the malignant and benign cases, respectively. The results of independent T-tests between the two groups were insignificant (p=0.89). TIRADS 2-3 (total 29 patients) nodules were considered possibly benign, and TIRADS 4-5 (total 23 patients) possibly malign, the sensitivity, specificity, positive predictive and negative predictive value of TIRADS were identified 100%, 87.9%, 82.6% and 100%, respectively, when compared with the pathology results. Discussion: There was no significant difference in SWE values in the differentiation of malignant-benign thyroid nodules with AUS. However, the ACR-TIRADS criteria still maintain their importance.
Factors Affecting Morbidity, Mortality, and Recurrence in Incarcerated Femoral Hernia
(Coll Physicians & Surgeons Pakistan, 2022) Kalayci, Tolga; Iliklerden, Umit Haluk; Kotan, Mehmet Cetin
Objective: To ascertain the factors that govern morbidity, mortality, and recurrence in incarcerated femoral hernia. Study Design: Observational study. Place and Duration of Study: Department of General Surgery, Faculty of Medicine, Van Yuzuncu Yil University, Van, Turkey, between January 2010 and January 2020. Methodology: This observational study included patients operated on due to incarcerated femoral hernias under emergency conditions. The preoperative, intraoperative, and postoperative parameters of the patients were gathered. The study excluded pregnant patients and patients in the pediatric age group (0-18 years). Mann-Whitney U-test was used to compare quantitative variables. In addition, a Chi-square test and Likelihood-ratio test were used to compare the qualitative variables. A p-value <0.05 was deemed statistically significant. Results: The mean age of the 50 patients was 54.56 +/- 19.34 (19-91) years and the female/male ratio was 33:17. The morbidity, mortality, and recurrence rates of the study were 14%, 4%, and 6% respectively. Higher morbidity was observed in patients who had preoperative nausea (p = 0.003), vomiting (p <0.001), tachycardia (p <0.001), recurrent hernia (p <0.001), surgery under general anesthesia (p <0.001) or who underwent both laparotomy (p = 0.007) and visceral resection during surgery (p <0.001). Higher rates of mortality were observed in patients who had preoperative tachycardia (p = 0.054) or visceral resection during surgery (p = 0.029). However, the study identified no factors affecting recurrence. Conclusion: In cases of incarcerated femoral hernia, symptoms of intestinal obstruction or signs of strangulation are more important in the development of postoperative morbidity. In addition, the probability of mortality is higher in patients who had preoperative tachycardia and in patients who underwent visceral resection. To the extent possible, regional anesthesia should be preferred in suitable cases.
Factors Affecting Survival in Operated Esophageal Squamous Cell Carcinoma
(Springer, 2022) Akgul, Nida; Sakin, Abdullah; Sahin, Suleyman; Aldemir, Mehmet Naci; Aytekin, Aydin; Alay, Murat; Kotan, Mehmet Cetin
Purpose Esophageal squamous cell carcinoma (ESCC) is an extremely fatal and relatively rare gastrointestinal system malignancy. This study aimed to investigate the factors affecting survival in operated patients with ESCC. Materials and Methods We included 110 patients (38 [34.5%] male; 72 [65.5%] female) aged >= 18 (median age, 54 [26-77]) years who were operated without any signs of metastases and followed up at Van Yuzuncu Yil University Dursun Odabasi Medical Center between 2004 and 2019. Results Initially, 39 (35.5%) patients were clinical lymph node-positive and 71 (64.5%) patients were negative. Thirty-five (31.8%) patients underwent surgery after neoadjuvant chemoradiotherapy (nCRT), and 75 (%68.2) patients underwent direct surgery without nCRT. Five-year overall survival (OS) was 84.4% and 59.2% in patients who underwent surgery after nCRT and in those who underwent direct surgery, respectively. Median OS was significantly longer in patients who underwent surgery after nCRT (p = 0.003). There was a statistically significant difference in OS in patients who underwent surgery after nCRT depending on tumor response (p = 0.04). In multivariate analysis, advanced pathologic stage (p = 0.002) adversely affected survival, whereas nCRT administration (p = 0.031) positively affected OS. Conclusion We suggest that nCRT should be administrated before surgery, especially in locally advanced ESCCs. In addition, we believe that nCRT response can be used as a good parameter for survival. These results, however, should be supported by prospective studies.
Factors Affecting Survival in Operated Gastric Cancer
(Elsevier Sci Ltd, 2023) Sakin, Aysegul; Sahin, Suleyman; Sakin, Abdullah; Aldemir, Mehmet Naci; Sakoglu, Nevin; Bayram, Irfan; Kotan, Mehmet Cetin
In this study, our aim was to determine the possible effects of Helicobacter pylori (HP), chronic atrophic gastritis (CAG), and gastrointestinal metaplasia (GIM) on survival in operated bowel type gastric cancer patients (INTGC). Among 548 patients, 347(63.3%) were male. The median age was 57 years. Disease-free survival (DFS) and overall survival (OS) were significantly shorter in patients with GIM than those in patients without GIM (log rank, P = 0.003 and log rank P = 0.003, respectively). Multivariate analysis showed that presence of GIM (HR, 2.1) was found to be an independent factor of worse DFS. In our study, stage pIII patients with GIM had significantly shorter DFS and OS than those without GIM (log rank p = 0.008 and log rank p = 0.001, respectively). However, in subgroup analysis of patients with GIM, there was no significant DFS and OS difference between patients with stage pI and pII disease (log rank p = 0.999, log rank p = 0.184 vs. log rank p = 0.409, log rank p = 0.281, respectively).
Laminin: a New Biomarker for Gastric Cancer
(Kuwait Medical Assoc, 2024) Kalayci, Tolga; Yilmaz, Ozkan; Iliklerden, Umit Haluk; Kemik, Ozgur; Kotan, Mehmet Cetin
Objective: To evaluate the diagnostic and prognostic utility of serum laminin levels in gastric cancer Design: A prospective and observational study Setting: Department of General Surgery, Van Yuzuncu Yil University Medical Faculty, Van, Turkey Subjects: Between June 2018 and September 2018, eighty patients who were diagnosed with gastric cancer as the patient group, and forty volunteers as the control group were included in the study. Intervention: From each patient, 3 ml of peripheral blood sample was collected. Main outcome measures: Enzyme-linked immunosorbent assay kit for human laminin were used for the detection of laminin in samples of serum. Data on patient demographics (age, gender) and serum laminin levels were recorded in both control and gastric cancer groups. In gastric cancer patients, serum laminin levels were further analyzed with respect to tumor stages and tumor size. Results: Serum laminin levels were significantly higher in gastric cancer patients [median (min-max): 205 (165-483) vs. 12 (9-18) ng/mL, P <0.001]. Laminin levels were higher in patients with advanced invasion depth, distant organ metastasis and lymph node metastasis ( P <0.001). The sensitivity and specificity determined from the receiver operating characteristic curves at cut-off level of 70 were 95% and 97% for serum laminin, respectively. Conclusion: The serum concentration of laminin can be used as a biomarker at the time of diagnosis for gastric cancer with high sensitivity and specificity. In addition, laminin can be used to discriminate between earlier, advanced or metastatic stages of gastric cancer.
Morbidity, Mortality and Recurrence Factors of Incarcerated Femoral Hernia
(Oxford Univ Press, 2021) Kalayci, Tolga; Iliklerden, Umit Haluk; Kotan, Mehmet Cetin
The Prognostic Effect of Pretreatment 18f-Fdg Pet/Ct Metabolic Parameters in Locally Advanced Esophageal Squamous Cell Carcinoma Treated With Definitive Chemoradiotherapy
(Elsevier Sci Ltd, 2022) Sakin, Abdullah; Ozcelik, Mahsun; Sahin, Suleyman; Aydemir, Ozan; Aldemir, Mehmet Naci; Iliklerden, Umit Haluk; Kotan, Mehmet Cetin
Introduction: In this study, we aimed to examine the relation between pre-treatment 18F-FDG PET/CT metabolic parameters [(including the maximum standard uptake value (SUVmax), metabolic tumor volume (MTV), and tumor lesion glycolysis (TLG)] and treatment response and survival in locally-advanced Esophageal Squamous Cell Cancer (ESCC) treated with definitive chemoradiotherapy (dCRT). Methods: A total 76 patients with locally-advanced ESCC who received dCRT between June 2015 and December 2019 were included in this retrospective study. Patients were divided into two groups as complete response (CR) or non-complete response (Non-CR) according to response to treatment. AUC was obtained as 0.749 (p < 0.001) in the ROC curve drawn by MTV for the CR. The MTV value was <= 12 cm(3), with 72.1% sensitivity and 73.0% specificity. Results: Of the 76 patients, 38 (50%) were male and 38 (50%) were female. The median age was 62 (39-84) years. The treatment response in 35 (46%) patients was CR. MTV value was > 12cm3 in 41(54%) patients. Median follow-up time was 14.5 months. In patients with MTV > 12cm3, median progression-free survival(mPFS) and median overall survival(mOS) were 9 months and 11 months, respectively, whereas mPFS and OS could not be reached in those with MTV & LE;12 cm3 (p < 0.001 and p < 0.001, respectively). In patients with non-CR, mPFS and mOS were 8 months and 9 months, respectively, whereas mPFS and OS could not be reached in patients with CR (p < 0.001 and p < 0.001, respectively). In multivariate analysis, age (odds ratio [OR], 1.07), ECOG PS (OR, 11.1), and MTV (OR, 4.73) were found to be the factors affecting treatment response. Conclusion: In our study, treatment response and MTV were found to be the factors associated with survival in patients treated with dCRT, showing the pre-treatment MTV value as a predictor of treatment response.