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    Is lesser curvature resection for GIST can be associated with delayed gastric emptying?
    (2020) Donder, Yunus; Baykan, Mehmet; Sevim, Yusuf; Ertan, Tamer; Karagoz Eren, Saliha
    Aim: Patients who performed wedge resection of the lesser curvature of the stomach due to GIST were evaluated for delayed gastric emptying. Material and Methods: Thirty patients who underwent wedge gastric resection for GIST in stomach between 2009-2019 were evaluated retrospectively. In Seven patients it is located in lesser curvature. Results: Fifty-five patients were operated between 2009 and 2019 for GIST.In 7 patients, GIST was found to be located in the lesser curvature of the stomach. Of the 7 patients, 2 (%28) were male and 5 (%72) were female. Laparoscopy was performed in 4 patients and conventional procedure was performed in 3 patients. The average age was 56±10.5 (46-67) years in the conventional procedure group, and 61.5±10.4 (50-73) in the laparoscopic group. Average hospital stay was 4.67±1.5 (3-6) days for conventional procedure and, 2.75±0.9 (2-4) days for the laparoscopic group. Age and length of hospital stay were not different between the two groups (p=0.522 and p=0.094, respectively).All patients had normal radiological findings. Stool discharge was observed on postoperative day 3 at the latest. Conclusion: In conclusion, resection of lesser curvature (with laparoscopic or conventional procedure) GISTs with a tumor free surgical margin staying near to the gastric wall to prevent vagal nerve injury is feasible without gastric emptying problems.
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    Results of concurrent HER2 (CERB-B2) staining in the primary tumor and lymph node metastasis in advanced stage gastric carcinoma
    (2020) Akay, Ebru; Tekelioglu, Fatos; Karagoz Eren, Saliha; Donder, Yunus; Karaman, Hatice
    Aim: We hypothesized that tumor cells with metastatic capacity and nodal metastasis would exhibit prominent HER2 overexpression in gastric cancer for which intratumoral heterogeneity is highly variable. This study purposed to investigate the mismatch for HER2 immunohistochemical staining between the primary tumor cells and the metastatic cells in patients with advanced-stage gastric cancer.Material and Methods: A hundred and forty-four patients with advanced staged gastric cancer, and lymph node metastasis who underwent surgical resection were enrolled in this retrospective study. Primary tumor and lymph node metastasis underwent concurrent immunohistochemical staining for addressing the HER2 positivity. The concordance of HER2 positivity between the primary tumor samples and the lymph node metastases was investigated.Results: There was a significant difference in HER2 positivity rate among the well, moderate, and poorly differentiated carcinomas, which was primarily driven by the high HER2 overexpression in well-differentiated subgroup. HER2 positivity was highly frequent in stage 3 tumors, whereas HER2 was negative in the majority of the stage 4 tumors. Tumor size was also significantly larger in subjects without HER2 overexpression compared to those with HER overexpression [6 (IQR=4.88) cm vs. 5.25 (IQR=3.5) cm, p = 0.037]. Concordance of primary tumors and the metastatic lymph nodes regarding HER2 positive IHC staining were 93.7%. Conclusion: HER2 might be positive in lymph node metastasis samples even if the primary tumor is negative for HER2. We suggest that HER2 IHC staining of the lymph node metastasis should be considered if the primary tumor is signet ring cell carcinoma, moderately or poorly differentiated, and negative for HER2 in subjects with gastric carcinoma and lymph node metastasis.