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    Our surgical experience in cholangiocellular carcinoma
    (2020) Saritas, Ahmet Gokhan; Ulku, Abdullah; Topal, Ugur; Dalci, Kubilay; Aydin, Erdi; Akcam, Tolga
    Aim: Cholangiocellular carcinomas are rare bile duct tumors. They are categorized as intrahepatic(iCCA), perihilar(pCCA) or distal(dCCA) cholangiocarcinomas according to their anatomical location. In this study, we aimed to present our clinical experience in patients with cholangiocellular carcinoma. Material and Methods: Patients who underwent curative surgery with the diagnosis of cholangiocellular carcinoma between 2010 and 2019 were retrospectively reviewed. Demographic and clinical characteristics, surgical procedures, tumor characteristics, short- and long-term results and survival of the patients were analyzed.Results: Twentynine patients were included in the study. The mean age of the patients was 63.3(±10.8) years, and 52% of the patients were older than 65 years. Male sex was 79.3%. Percutaneous biliary drainage was performed in 52% of the patients before the operation. Tumor localizations were distal (dCCA) in 12 (41.4%) patients, perihilar (pCCA) in 11 (38%) patients, and intrahepatic (iCCA) in 6 (20.6%) patients. Only biliary resection was performed in 69%, hepatic + biliary resection in 27.6%, and only hepatic resection in 3.4% of the patients. The mean tumor size was 3.08 cm (±1.91), tumor stage was commonly stage II (58.6%) and postoperative complication was seen in 13.8% of the patients. Ninety-day unplanned readmission was observed in 31.3%, postoperative mortality in 6.9%, and recurrence during postoperative follow-up in 24.2% of the patients. The mean survival time was 22.82(±13.72) months. Conclusion: The type of surgical approach to be performed in cholangiocellular carcinoma is related to the localization of the tumor. With the right patient selection, curative surgical treatment can be performed at low morbidity and mortality rates.
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    Prognostic value of neutrophil-to-lymphocyte ratio in patients undergoing curative surgical resection for hepatocellular carcinoma
    (2020) Saritas, Ahmet Gokhan; Ulku, Abdullah; Topal, Ugur; Dalci, Kubilay; Eray, Ismail Cem; Akcam, Tolga
    Aim: the purpose of this study is to determine the prognostic value of the preoperative Neutrophil-to-Lymphocyte ratio (NLR) in patients who underwent curative surgical treatment for hepatocellular carcinoma (HCC). Materials and Methods: Patients who underwent curative resection for HCC between 2004 and 2015 were included in the study. Patients were divided into two groups based on the cut-off value: Group 1 (NLR low) and Group 2 (NLR elevated). Demographics and clinical characteristics, tumor characteristics, and mean survival of patients were compared between the groups.Results: 41 patients were included in our study and Group 1 (NLR low) consisted of (n:11) patients; Group 2 (NLR elevated) consisted of (n:30) patients based on a cut-off value of 2.43. The number of males was higher in both groups (90.9% vs 90%, p:0.712). The Child-Plug class A was the most common one in both groups (81.8%vs76.7%, p:0.680). HBV infection was the most common etiological cause (81.8% vs 53.3%, p:0.344). Lesions were predominantly located in the right lobe (63.6% vs 66.7%, p:0.568). The total tumor diameter was similar (6.56 cm vs 8.69 cm, p:0.258). In the multivariate analysis for survival, tumor diameter greater than 5 cm (HR 1.412 95% - Cl0.345-5.780, p:0.018) and NLR higher than 2.43 (HR 0.100 95% -Cl 0.011-0.882, p:0.038) were independent risk factors. Overall survival time was found to be lower in Group 2 compared to Group 1 (171 vs 106 months p:0.033). Disease-free survival rates were similar in the groups (37 vs 43 months, p:0.485).Conclusion: Although the elevated NLR level was found to be a risk factor for decreased overall survival in our study, this was not related to clinicopathological variables.