Bahri Gök

Low ERCC1 expression is associated with prolonged survival in patients with bladder cancer receiving platinum-based neoadjuvant chemotherapy

PURPOSE Excision repair cross-complementation group 1 enzyme (ERCC1) plays a key role in the removal of platinum induced DNA adducts and cisplatin resistance. Prognostic role of ERCC1 expression in the neoadjuvant setting in bladder cancer has not been reported before. We evaluated the prognostic role of ERCC1 expression in bladder cancer receiving platinum-based neoadjuvant chemotherapy. MATERIALS AND METHODS Thirty-eight patients with muscle invasive bladder cancer who received neoadjuvant platinum-based chemotherapy were included. Clinical and histopathologic parameters along with immunohistochemical ERCC1 staining were examined and correlated with response rates and survival. RESULTS Pathologic complete response rates were similar between patients with low and high ERCC1 expression. Median disease-free survival (DFS) was 9.3 vs. 20.5 months (P = 0.186) and median overall survival (OS) was 9.3 vs. 26.7 months (P = 0.058) in patients with high ERCC1 expression compared with those with low expression, respectively. In multivariate Cox regression analysis: pathological complete response (pCR) after chemotherapy (hazard ratio (HR) 0.1, 95% CI 0.012-0.842, P = 0.034) and high ERCC1 expression (HR 3.7, 95% CI 1.2-11.2, P = 0.019) were significantly associated with DFS. Patient age (>60 vs. ≤ 60 years) (HR 3.4, 95% CI 1.2-9.4, P = 0.018), the presence of pCR (HR 0.11, 95% CI 0.014-0.981, P = 0.048) and high ERCC expression (HR 6.1, 95 CI 1.9-19.9, P = 0.002) were significantly associated with OS. CONCLUSIONS Our results showed that high ERCC1 expression was independently associated with shorter disease-free and overall survival in patients with bladder cancer who received neoadjuvant platinum-based chemotherapy. ERCC1 may represent a potential predictive marker for platinum-based treatment in bladder cancer.

Outcomes of robot-assisted laparoscopic radical prostatectomy in high-risk prostate cancer patients: experience in 34 patients with oncologic and functional outcomes

© 2015 Canda et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php

Factors Influencing the Duration of Fluoroscopy in Percutaneous Nephrolithotomy

DOI: 10.4328/JCAM.1318 Received: 05.10.2012 Accepted: 26.11.2012 Printed: 01.07.2014 J Clin Anal Med 2014;5(4): 300-3 Corresponding Author: Alper Gök, Türkiye Yüksek İhtisas Hastanesi, Üroloji Kliniği, Sıhhıye 06100 Ankara, Türkiye. GSM: +905326031181 E-Mail: alper_gok@hotmail.com Özet Amaç: Perkütan nefrolitotomi (PCNL) ameliyatı üroloji pratiğinde sıklıkla floroskopik görüntüleme eşliğinde yapılmaktadır. Bu çalışmanın amacı perkütan nefrolitotomide floroskopi süresini etkileyen faktörleri araştırmaktır. Gereç ve Yöntem: Ocak 2008 ile Mayıs 2011 tarihleri arasında Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi Üroloji Kliniği’nde 199 perkütan nefrolitotomi vakası floroskopi sürelerini etkileyen faktörler açısından değerlendirildi. Tüm hastalara İntravenöz Pyelografi(İVP) ve Kontrastsız Bilgisayarlı Tomografi(BT) çekilerek taşların boyutu ve Hounsfield Ünitesi(HU) yani sertlik derecesi değerlendirildi. Taş yükü, cetvel yardımıyla taşın en büyük eksen çapının ve bunu dik kesen çapın çarpımıyla elde edilen değer olarak kaydedildi. Çalışmamızda cerrahi deneyim, böbreğe giriş sayısı, olgunun daha önceden aynı böbrekten ameliyat geçirip geçirmediği, taşın Bilgisayarlı Tomografide hesaplanan Hounsfield Ünitesi ve preoperatif dönemde hesaplanan taş yükünün floroskopi sürelerine etkileri incelendi. Bulgular: Deneyimin artmasının floroskopi sürelerini istatistiksel olarak etkilediği gözlendi (p=0,006). Ameliyat öncesi hesaplanan taş yükü kategorileri ile floroskopi süreleri arasında istatistiksel anlamlı bir ilişki gözlenmiştir (p<0,001). Geçirilmiş bir böbrek cerrahisinin floroskopi süreleri üzerine etkisi incelendiğinde istatistiksel olarak anlamlı bir ilişki yoktu (p=0,393). Ameliyat öncesi hesaplanan Hounsfield Ünitesi değerleri ile floroskopi süreleri arasında istatistiksel anlamlı bir ilişki vardı (p<0,001). Tek giriş ve multiple girişin floroskopi süreleri ile ilişkisi değerlendirildiğinde aralarında yine istatistiksel olarak anlamlı bir ilişki vardı (p<0,001). Tartışma: Çalışmamızda taş boyutu, Hounsfield Ünitesi, deneyim ve giriş sayısının floroskopi süreleri ile ilişkili olduğu ancak hastanın daha önceden aynı böbrekten cerrahi işlem geçirmesinin floroskopi süreleri ile ilişkili olmadığı gözlendi. Floroskopi sürelerinin uzun olacağı tahmin edilen vakalarda cerrahi ekip radyasyondan korunma önlemlerini daha dikkatli bir şekilde almalıdır.

Outcomes of Testis Sparing Surgery

DOI: 10.4328/JCAM.1094 Received: 11.05.2012 Accepted: 31.05.2012 Printed: 01.09.2013 J Clin Anal Med 2013;4(5): 360-2 Corresponding Author: Muhammet Fuat Ozcan, Iscibloklari Mah. 1489. Cad. 6/43 06530 Cankaya, Ankara, Turkiye. GSM: +905056407025 T.: +90 3122912740 E-Mail: mfuatozcan@hotmail.com Ozet Amac: Parsiyel orsiektomi endikasyonlari ve sonuclarinin gozden gecirilmesi amaclanmistir. Gerec ve Yontem: Şubat 2005 –Aralik 2011 tarihleri arasinda parsiyel orsiektomi yapilan hastalarin demografik ve patolojik ozellikleri retrospektif olarak incelendi. Bulgular: Yaslari 2 ile 30 arasinda degisen 7 hastaya parsiyel orsiektomi yapildi. Parsiyel orsiektomi endikasyonlari: 3 hastada soliter testiste kitle, 2 hastada bilateral testikuler kitle, 1 hastada ise travma idi. Travma nedeniyle parsiyel orsiektomi yapilan hastada insidental olarak miks germ hucreli tumor saptandi. Tartisma: Fertilitenin korunmasi, uzun donemde hormon replasman tedavisi gereksinimini ortadan kaldirabilmesi ile testis koruyucu cerrahi secilmis vakalarda tercih edilebilecek tedavi secenegidir.

Does Presence of a Median Lobe Affect Perioperative Complications, Oncological Outcomes and Urinary Continence Following Robotic-assisted Radical Prostatectomy?

PURPOSE To evaluate of the presence of a median lobe(ML) affect perioperative complications, positive surgical margins(PSM), biochemical recurrence(BCR) and urinary continence(UC) following robotic-assisted radical prostatectomy(RARP). MATERIALS AND METHODS Data of 924 consecutive patients who underwent RARP for prostate cancer (PCa) and who have at least 1-year follow-up were evaluated retrospectively. All patients were divided into two groups: Group 1(n=252) included patients with ML and Group 2 (n=672) included patients without ML. The primary endpoint of this study was to compare complication rates between two groups. The secondary endpoints were to compare PSM, BCR and UC rates. RESULTS Both groups were statistically similar in terms of demographics and variables about PCa. Mean prostate volume was higher in Group 1 vs. Group 2 (69± 31 vs. 56±23 mL, p<.001). Total operative time was longer in Group 1 vs. Group 2 (144±38 vs. 136±44 min, p=.01). Biochemical recurrence, PSM, perioperative and postoperative complication rates of our population were 13.6%, 14.9%, 1.7% and 8.7%, respectively. There were no statistical differences in terms of perioperative complication, PSM and BCR rates between the groups(p>0.05). At the first month after RARP, total continence rate was statistically significant lower in Group 1 vs. Group 2 (49.2% and 56.5%, p=.03), respectively. However, there were no significant differences in terms of continence rates at 3rd month, 6th month and 1st-year follow-up. CONCLUSIONS Due to our experience, the presence of ML does not seem to affect perioperative complication, intraoperative blood loss, PSM and BCR following RARP. However, the presence of ML seems to be a disadvantage in gaining early UC following RARP.

Is there a difference in the number of interstitial cells, neurons, presence of fibrosis and inflammation in ureteropelvic junction tissues of patients with ureteropelvic junction obstruction with and without crossing vessels?

OBJECTIVE We compared the number of interstitial cells (ICs), nerves, presence of fibrosis and inflammation at the level of full-thickness human ureteropelvic junction (UPJ) tissues obtained from normal subjects, and patients with UPJ obstruction with and without crossing vessels. MATERIAL AND METHODS Normal UPJ tissues (n=12) histopathologically confirmed to be without tumor involvement were obtained from subjects who underwent radical nephrectomy for kidney mass. Additional UPJ tissues were obtained from patients who underwent pyeloplasty due to UPJ obstruction. Crossing vessel was identified in 17 patients. In 57 patients, no crossing-vessel was noted. ICs were stained immunohistochemically with anti-human CD117 (c-kit) antibody. Neural tissue was stained with S-100. The numbers of ICs and neurons were compared between the groups: controls with normal UPJ (Group I), Ureteropelvic junction obtruction (UPJO) with crossing vessel (Group II) and UPJ obstruction without crossing vessel (Group III). Groups were also compared in terms of the presence of fibrosis and inflammation. RESULTS The mean age of total population included in the study was 30.5±18.5 years. No significant differences were detected between the three groups regarding mean and median numbers of ICs at the level of UPJ (lamina propria and muscle layer) and mean and median numbers of neurons at the level of lamina propria (p>0.05). Likewise, no significant differences were detected between the three groups regarding the presence of fibrosis and inflammation (p>0.05). CONCLUSION Number of ICs, neurons, presence of fibrosis and inflammation seem to be similar in the intact UPJ and UPJ with obstruction with and without crossing vessel. Cellular function rather than the number ICs might play a role that warrants further research.

Can Hounsfield Unit Value Predict Type of Urinary Stones

1 Alper Gök1, Ali Çift1, Bahri Gök2, Kemal Ener3, Mehmet Özgür Yücel1, Hacı Polat1, Can Benlioğlu1, Bedreddin Kalyenci1, Zeki Ender Güneş4 1Adıyaman Üniversitesi Tıp Fakültesi, Üroloji, Adıyaman, 225 Aralık Devlet Hastanesi, Üroloji, Gaziantep, 3Ankara Atatürk Eğitim ve Araştırma Hastanesi, Üroloji, Ankara, 4Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Üroloji, Ankara, Türkiye Böbrek Taş Cinsleri / Type of Urinary Stones Can Hounsfield Unit Value Predict Type of Urinary Stones?

Semptomatik Periüretral Kistte Tanı ve Tedavi

Ozet Periuretral kist nadir bir antitedir. Periuretral kitlelerin cogunun benzer semptomlara sahip olmasindan dolayi periuretral kistlerin degerlendirilmesi ve tedavisi zordur. Periuretral kistlerin cogu fizik muayene ile teshis edilebilir.Cerrahi eksizyon etkili bir tedavi yontemidir ve takiplerde minimal rekurrens riski vardir. Biz calismamizda perineal agri sikayeti olan 54 yasinda kadin hastada periuretralkist vakasini sunduk.