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Öğe Does tumor volume affect survival in patients with operated early-stage non-small-cell lung cancer?(2017) Kaya, Şeyda Örs; Akçam, Tevfik İlker; Akçay, Onur; Samancılar, Özgür; Ceylan, Kenan Can; Usluer, OzanBackground: This study aims to investigate whether tumor volume affects survival in patients with operated early-stage non-small-cell lung cancer. Methods: A retrospective analysis of 156 patients (146 males, 10 females; mean age 62.3±8.0 years; range 38 to 79 years) with non -small-cell lung cancer who underwent anatomical resection and mediastinal lymph node dissection between September 2009 and June 2013 was performed. the tumor volumes were calculated using histopathological data. the effect of tumor volume on prognosis and survival was investigated. Results: of the patients, 116 had Stage I disease and 40 patients had Stage II disease. the mean tumor volume was 38.2±54.6 (range, 356.15 to 0.01) cm3, and the mean largest diameter was 4.2±2.0 (range, 10 to 0.3) cm. in the Cox regression analysis, the tumor volume below the cut- off value (29.69 cm3) increased survival with an odds ratio (OR) of 2, and this value was statistically significant (p=0.022). the cut- off value per T factor was 4.5 cm and the OR was 1.7; however, no significant correlation with the survival was observed (p=0.058). Conclusion: the present study found a closer correlation between the tumor volume and survival in contrast to the known correlation between the tumor’s largest diameter and survival. Based on our study results, it is recommended to calculate and consider the tumor volume along with the tumor diameter in the staging of lung cancer.Öğe Prediction of postoperative pulmonary complications in lung cancer surgery: Is proportion of emphysema important?(2018) Akçam, Tevfik İlker; Kaya, Şeyda Örs; Akçay, Onur; Samancılar, Özgür; Sevinç, Serpil; Susam, Seher; Ceylan, Kenan CanOBJECTIVE: Preoperative evaluation in thoracic surgery is highly important to determine surgical suitability, estimate postoperative pulmonary complications, and for patient follow?up. However, there is neither a definite explanation about the possible complications nor a gold standard method. MATERIALS AND METHODS: In this study, 297 patients undergoing anatomic lung resection for primary lung carcinoma were retrospectively evaluated. To form a homogeneous group, all factors that increase the rate of pulmonary complication were excluded except emphysema. Patients who did not meet these criteria were removed from the study. The study continued with 104 other patients. This patient subgroup was divided into groups according to Goddard Classification– Score (GdCS). The correlation between GdCS and other variables was statistically investigated. RESULTS: According to the GdCS of 104 patients, the patient distribution was as follows: 10 patients (9.6%) were G0, 28 patients (26.9%) were G1, 42 patients (40.4%) were G2, 22 patients (21.2%) were G3, and 2 patients (1.9%) were G4. Thirty?five (33.6%) of 104 patients had a pulmonary complication during the postoperative follow?up. The average drainage time was longer for higher GdCS scores, and the rate of exposition to a pulmonary complication was higher in the patients with increased GdCS. CONCLUSION: In view of these findings, Goddard’s scoring for chronic obstructive pulmonary disease?emphysema patients was considered likely to be an indicative parameter in the preoperative evaluation and postoperative follow?up of thoracic surgery patients.Öğe Prediction of postoperative pulmonary complications in lung cancer surgery: Is proportion of emphysema important?(2018) Akçam, Tevfik İlker; Kaya, Şeyda Örs; Akçay, Onur; Samancılar, Özgür; Sevinç, Serpil; Susam, Seher; Ceylan, Kenan CanOBJECTIVE: Preoperative evaluation in thoracic surgery is highly important to determine surgical suitability, estimate postoperative pulmonary complications, and for patient follow?up. However, there is neither a definite explanation about the possible complications nor a gold standard method. MATERIALS AND METHODS: in this study, 297 patients undergoing anatomic lung resection for primary lung carcinoma were retrospectively evaluated. To form a homogeneous group, all factors that increase the rate of pulmonary complication were excluded except emphysema. Patients who did not meet these criteria were removed from the study. the study continued with 104 other patients. This patient subgroup was divided into groups according to Goddard Classification– Score (GdCS). the correlation between GdCS and other variables was statistically investigated. RESULTS: According to the GdCS of 104 patients, the patient distribution was as follows: 10 patients (9.6%) were G0, 28 patients (26.9%) were G1, 42 patients (40.4%) were G2, 22 patients (21.2%) were G3, and 2 patients (1.9%) were G4. Thirty?five (33.6%) of 104 patients had a pulmonary complication during the postoperative follow?up. the average drainage time was longer for higher GdCS scores, and the rate of exposition to a pulmonary complication was higher in the patients with increased GdCS. CONCLUSION: in view of these findings, Goddard’s scoring for chronic obstructive pulmonary disease?emphysema patients was considered likely to be an indicative parameter in the preoperative evaluation and postoperative follow?up of thoracic surgery patients.Öğe Skip metastasis in non-small cell lung cancer: does it affect the prognosis?(2017) Akçay, Onur; Akçam, Tevfik İlker; Kaya, Şeyda Örs; Samancılar, Özgür; Ceylan, Kenan Can; Sevinç, Serpil; Ünsal, ŞabanBackground: This study aims to examine skip metastases in patients who had resection due to non-small cell lung cancer. Methods: A total of 111 patients (94 males, 17 females; mean age: 58.9±10.2 years; range 35 to 82 years) who were diagnosed with non-small cell lung cancer and in whom an ipsilateral mediastinal lymph node metastasis was detected based on the pathological examination of the R0 pulmonary resection samples between January 2005 and December 2011 in our clinic were retrospectively analyzed. the patients were divided into two groups: the skip metastasis group (sN2) (group 1, n=55) [N1(-), N2(+)] and non-skip ipsilateral mediastinal lymph node metastasis group (nsN2) (group 2, n=56) [N1(+), N2(+)]. Results: the median survival was 25 months and five-year overall survival rate was 13% for both study groups. Five -year overall survival rate was higher in group 1, compared to group 2 (20% vs. 7.4%, respectively), although the difference was not statistically significant (p=0.084). Conclusion: Our study results show that five-year overall survival rates of operable patients with skip metastases are higher than those without skip metastases, although the difference is not statistically significant.Öğe We need a common definition and treatment algorithm for displaced rib fracture(2022) Kahraman, Drseda; Akçam, Tevfik İlker; Yoldaş, Banu; Zorlu, Ekin; Akın Türker, Asuman; Akçay, Onur; Kavurmacı, ÖnderBackground: Displaced rib fracture (DRF) definition is frequently used to draw attention to severity and importance of fracture in daily practice. DRF is associated with increased morbidity and mortality in addition patients with DRF should be followed more carefully. Despite these characteristics, we do not have a clear definition for DRF concept and big differences of opinion among physicians could be monitored. In this study, we tried to reveal these perceptual differences and emphasized the importance of creating a common language for DRF. Materials and Methods: We used a special and inventive survey form which contains visual section, true-false section and case reports. In the visual section, real tomography images and schematic drawings were presented to participants and asked which were compatible with DRF. In the true-false section, propositions about the definition of DRF were presented. Finally, imaginary trauma cases were presented and the minimum follow-up period was questioned. Results: 156 physicians from 23 different center were included in the study. Of the participants, 56 (35.9%) were emergency physicians, 54 (34.6%) were thoracic surgeons and 46 (29.5%) were radiologists. The answers were statistically different for 3 tomography image (p = 0.056, p < 0.001, p = 0.001) and for 1 schematic drawings (p = 0.001). Again in 4 of the 7 true-false questions, there were significant differences between answers (p = 0.001, p = 0.001, p = 0.005, p < 0.001). The minimum follow-up period for a patient with DRF was also different between physicians, and have been recommended as 15.9 ± 2.2 (2-72 hours) by emergency physicians, 27.3 ± 5.5 (2-120) by radiologist and 31.5 ± 3.1 (2-120) by thoracic surgeons. Conclusions: Our study clearly demonstrates a big conflict about DRF defination and treatment among physicians. There is also no consensus on the minimum follow-up time. We believe that our study will be a guide for multidisciplinary clinical studies on this subject.
