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Öğe Does tumor volume affect survival in patients with operated early-stage non-small-cell lung cancer?(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2017) Kaya, Seyda Ors; Akcam, Tevfik Ilker; Akcay, Onur; Samancilar, Ozgur; 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) cm(3), 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 cm(3)) 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 The Efficacy of VATS and Intrapleural Fibrinolytic Therapy in Parapneumonic Empyema Treatment(Medical Tribune Inc, 2018) Samancilar, Ozgur; Akcam, Tevfik Ilker; Kaya, Seyda Ors; Ozturk, Ozgur; Akcay, Onur; Ceylan, Kenan CanBackground: Development of multiloculation-septation is a challenging entity in empyema patients. In this study, it is aimed to investigate the success rates of videothoracoscopic deloculation (VATS-D) and intrapleural fibrinolytic (IPFib) application after tube thoracostomy. Methods: The study retrospectively examined the patients diagnosed with empyema with multiloculation and septation between January 2005 and December 2014. Among these patients, the study included those who received VATS-D or IPFib therapy. Results: VATS-D (Group 1) was applied to 54 patients and IPFib (Group 2) was applied to 24 patients. The success of both procedures was evaluated considering the need of decortication in the following periods. In the VATS-D group, 4 (7.4%) patients required decortication via thoracotomy where it was 1 (4.1%) patient (p = 0.577) in the IPFib group. The length of hospital stay was 6.81 +/- 2.55 (4-15) days in Group 1 compared to 14.25 +/- 6.44 (7-27) days in Group 2 (p < 0.001). Conclusions: It was demonstrated that both of the methods applied in the study have high efficacy and are preferable methods based on the general conditions of patients. Additionally, the shorter length of hospital stays in patients received VATS-D was established as a significant parameter.Öğe Prediction of postoperative pulmonary complications in lung cancer surgery: Is proportion of emphysema important?(Turkish Respiratory Soc, 2018) Akcam, Tevfik Ilker; Kaya, Seyda Ors; Akcay, Onur; Samancilar, Ozgur; Sevinc, 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?(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2017) Akcay, Onur; Akcam, Tevfik Ilker; Kaya, Seyda Ors; Samancilar, Ozgur; Ceylan, Kenan Can; Sevinc, Serpil; Unsal, SabanBackground: 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 VATS and Intrapleural Fibrinolytic Therapy for Parapneumonic Empyema Reply(Medical Tribune Inc, 2018) Samancilar, Ozgur; Akcam, Tevfik Ilker; Kaya, Seyda Ors; Ozturk, Ozgur; Akcay, Onur; Ceylan, Kenan Can
