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Öğe Impact of adjuvant treatment modalities on survival outcomes in curatively resected pancreatic and periampullary adenocarcinoma(Chinese Journal Cancer Research Co, 2015) Turan, Nedim; Benekli, Mustafa; Unal, Olcun Umit; Unek, Ilkay Tugba; Tastekin, Didem; Dane, Faysal; Algin, EfnanBackground: We examined the impact of adjuvant modalities on resected pancreatic and periampullary adenocarcinoma (PAC). Methods: A total of 563 patients who were curatively resected for PAC were retrospectively analyzed between 2003 and 2013. Results: Of 563 patients, 472 received adjuvant chemotherapy (CT) alone, chemoradiotherapy (CRT) alone, and chemoradiotherapy plus chemotherapy (CRT-CT) were analyzed. Of the 472 patients, 231 were given CRT-CT, 26 were given CRT, and 215 were given CT. The median recurrence-free survival (RFS) and overall survival (OS) were 12 and 19 months, respectively. When CT and CRT-CT groups were compared, there was no significant difference with respect to both RFS and OS, and also there was no difference in RFS and OS among CRT-CT, CT and CRT groups. To further investigate the impact of radiation on subgroups, patients were stratified according to lymph node status and resection margins. In node-positive patients, both RFS and OS were significantly longer in CRT-CT than CT. In contrast, there was no significant difference between groups when patients with node-negative disease or patients with or without positive surgical margins were considered. Conclusions: Addition of radiation to CT has a survival benefit in patients with node-positive disease following pancreatic resection.Öğe The prognostic value of lymph node ratio in patients with curatively resected pancreatic adenocarcinoma.(Amer Soc Clinical Oncology, 2015) Turan, Nedim; Araz, Murat; Algin, Efnan; Unal, Olcun Umit; Benekli, Mustafa; Tastekin, Didem; Dane, Faysal[Abstract Not Available]Öğe Retrospective evaluation of patients diagnosed solid pseudopapillary neoplasms of the pancreas(Mosby-Elsevier, 2019) Ercelep, Ozlem; Ozdemir, Nuriye; Turan, Nedim; Topcu, Turkan Ozturk; Uysal, Mukremin; Tanriverdi, Ozgur; Demirci, UmutPurpose: Solid pseudopapillary neoplasm (SPN) is a rare, low-grade neoplasm with excellent prognosis. In this study, we evaluated clinicopathological characteristics of patients diagnosed with SPN retrospectively. Methods: This is a retrospective study intended to characterize patients with the diagnosis of SPN between 2005 and 2015. Clinicopathological features, recurrence rate, and overall survival of 28 patients were recorded. Malignant SPN criteria were defined as the presence of distant metastasis (developed at diagnosis or during follow up) or lymph node involvement. Results: The mean age at diagnosis was 42 (range: 17-41). Among patients, 82% (n = 23) were female and 17.9% (n = 5) were male. The mean size of tumor was 5.81 cm (range: 2-15). The mean follow up period was 55.6 months, 1-year survival was 96.5% and 5-year survival rate was 88%. A total of 25 patients were alive at the end of follow-up period and 3 of the patients became exitus due to disease. Two patients had a metastatic presentation in livers at the diagnosis and metastasis developed in 3 patients during follow-up (liver of 1 patient, peritoneum in 1 patient and liver and peritoneum in 1 patient). The reason of admission was headache in 68% patients. The type of operation was frequently subtotal pancreatectomy (n = 11, 39.3%) and distal pancreatectomy (n = 10, 35.7%). Tumors were located frequently in body and tail regions (n = 18, 64.3%) and the number of patients with malignant criteria was 6 (21.4%). Although the mean age of malignant patients was significantly higher than benign patients (P = 0.046), there was no significant difference between 2 groups in terms of gender, tumor size, capsule invasion, perineural invasion, vascular invasion, and margin status. Conclusion: SPN is a rarely seen tumor with low malignity potential. Surgical resection provides long-term survival rate even in local invasion or metastasis conditions. (C) 2018 Elsevier Inc. All rights reserved.Öğe Subklinik hipotiroidili hastalardaki kalp hızı değişkenliğinin değerlendirilmesi(İnönü Üniversitesi, 2004) Turan, NedimSemptomu olsun veya olmasın yüksek TSH düzeyine normal sınırlardaki tiroid hormonlarının eşlik ettiği tabloya subklinik hipotiroidizm denilir ve yaygın olarak görülür. Her ne kadar son çalışmalar SH’yi tedavi etmenin kardiyovasküler riskleri azaltacağı, lipit profilini düzelteceği ve nöropsişik yakınmaları azaltacağı iddia edilse de subklinik hipotiroidiyi tedavi edip etmeme konusu hala tartışılmaya devam edilmektedir. Ancak günümüzde, subklinik hipotiroidiyi tedavi etmek veya basitçe hastalardaki klinik ve biyokimyasal bozuklukları takip etme kararının, hastaya tedavi verildiğindeki olası riskleri veya tedavisiz bırakıldığındaki olası riskleri dikkate alarak verilmesi önerilmektedir. Kardiyovasküler sistemdeki sempatovagal dengeyi noninvazif olarak tespit etmede ve tedavilere klinik cevabı değerlendirmede kalp hızı değişkenliği (HRV) kullanılabilir. Aşikar hipotiroidizme vagal aktivite artışı başta olmak üzere otonomik bozukluklar eşlik etmektedir ve bu bozukluklar tiroksin tedavisi ile kısmen de olsa geri dönmektedir. Kardiyovasküler sistem tiroid hormonları için ana hedef konumunda olduğundan subklinik hipotiroidinin kardiyovasküler sistemde bozukluklara neden olup olmadığını öğrenmek istedik. Bu güne kadar subklinik hipotiroidinin kardiyovasküler sistemin otonomik dengesine olası etkilerini inceleyen bir çalışmaya rastlama olmadığı için subklinik hipotiroidizmin HRV üzerindeki olası etkileri hakkında herhangi bir bilgi sahibi değiliz. Buradan yola çıkarak HRV analizi aracılığıyla subklinik hipotiroidik hastalardaki sempatovagal aktiviteyi test etmek ve eğer sempatovagal aktivite ile subklinik hipotiroidizm arasıda bir ilişki varsa tiroksin tedavisi ile düzelip düzelmediğini anlamaya çalıştık.
