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Öğe Comparison of prostate cancer detection rates between the Vienna nomogram and the 10-core biopsy protocol(Sage Publications Ltd, 2020) Arda, Ersan; Demir, Zafer; Yuksel, Ilkan; Cek, MeteObjective: To compare the Vienna nomogram and the 10-core prostate biopsy protocol regarding whether there is superiority in prostate cancer detection. Methods: Between January and December 2012, a total of 215 patients applying to our outpatient clinic with lower urinary tract symptoms were evaluated, prospectively. Patients with a prostate-specific antigen level of 2.5-10 ng/mL and/or suspicious digital rectal examination were included in the study. Exclusion criteria were determined as recent pelvic radiotherapy, lower urinary tract surgery, history of acute urinary retention, or indwelling urinary catheter. Biopsies were taken systematically with at least 10 cores considering prostate volume and patient age. According to Vienna nomogram, in patients requiring 6- or 8-core biopsies, tissue sampling was completed to 10 cores (our standard protocol), whereas in patients requiring more than 10 cores additional tissue sampling was performed. Results: After the determination of inclusion/exclusion criteria, 170 patients were enrolled in our study. The median (min-max) age, prostate-specific antigen value, and prostate volume were 65 (48-86) years, 7.6 ng/dL (2.5-10), and 55 cc (17-150), respectively. Prostate cancer was detected in 49 (28.8%) patients with transrectal ultrasound-guided prostate biopsy according to the Vienna nomogram. We found that our standard 10-core biopsy protocol would have diagnosed prostate cancer in 46 (27.1%) patients in the same study group showing no statistically significant difference (p > 0.005). Conclusion: The findings of this study suggest that considering cancer detection rates no statistically significant differences were found between both methods. Further prospective research in this aspect is needed to define the ultimate prostate biopsy protocol.Öğe Prostat biyopsisinde viyana nomogramı(Trakya Üniversitesi Tıp Fakültesi, 2013) Demir, Zafer; Çek, Hakkı MeteProstat kanseri tanısı için yapılan prostat biyopsi uygulamasında kanser yakalama başarısını etkileyen en önemli faktörlerden biri alınacak biyopsi sayısıdır. Yapılan birçok çalışmada, prostat kanseri teşhisi için çeşitli sayıda biyopsiler alınmıştır. Ancak şu ana kadarki çalışmalarda prostat kanseri teşhisi için yapılacak biyopsi sayısı konusunda kesin bir sonuca varılamamıştır. Çalışmamızda standart 10-kor prostat biyopsisi ile Viyana Nomogramına göre alınan prostat biyopsi uygulamasının kanser yakalama başarısını karşılaştırmayı amaçladık. Ocak 2012 -Kasım 2012 tarihleri arasında kliniğimize başvuran 170 hastaya 10 kor prostat biyopsi alındıktan sonra prostat volümü ölçülerek Viyana Nomogramına göre kaç biyopsi alınması gerektiği hesaplanmıştır. Viyana Nomogramına göre eğer 10 kordan daha fazla biyopsi alınması gerekiyor ise bu hastalardan ek biyopsiler alınmış olup Viyana Nomogramı ile 10-kor prostat biyopsisi protokollerinin prostat kanserini saptama oranları karşılaştırılmıştır. Kanser tanısı konan 49 hastaya sadece 10-kor biyopsi yapılmış olunması halinde 46 (%27,1) hastada prostat kanserini yakalanırken, 3 (%1,8) hastada prostat kanserini atlanmış olunacaktı. 10 kor biyopsiye ek olarak Viyana Nomogramına göre biyopsiler alınarak 170 hastanın 49'unda (%28,8) kanser tanısı koyulmuştur. Çalışmamızda elde ettiğimiz sonuçlara dayanarak prostat kanseri tanısında Viyana Nomogramına göre alınan biyopsi ile 10 kor prostat biyopsisi arasında anlamlı fark bulunmamıştır.Öğe Retrospectively Analysis of Clinical/Pathological and Prognostic Features of Subtypes of Breast Cancer(Trakya Üniversitesi, 2015) Akın, Ahmet; Berlik, Hamza; Bilgili, M. Burak; Demir, Zafer; Genc, Mustafa; Gunay, Abdulsamet; Hacibey, İbrahimAims: Breast cancer is the most common type of cancer among all women across the world, with an incidence of 25.2%. Of all the cancer cases, breast cancer comes second in line after lung cancer. By 6.4% it marks fifth place as the reason for cancer-related-deaths. Therefore new studies on breast cancer are required. We aimed to retrospectively analyze clinical, pathological and prognostic features of cases that were divided into four subgroups based on their hormone receptor and HER-2 conditions. Method: Records of GATA-Oncology Clinic patients who have been diagnosed with breast cancer within years of 2008-2014, were inspected retrospectively. Cases were divided into four subgroups based on their hormone receptor and HER-2 conditions. Missing records were primarily gathered by electronic recording system, also still-missing-information about the patients were provided via phone calls. Collected data has been evaluated with SPSS 15,0. Results: While demographics such as family history and menopausal state were not different among 4 subgroups, triple negative patients tended to have a lower body-mass index and mean age (p=009, p=0.041, respectively). Only 12 patients had advanced disease at diagnosis. A total of 168 patients received chemotherapy. Progression occurred in 41 patients (21.9%) from early phase breast cancer cases that were taken to adjuvant chemotherapy program. Family history had a significant association with recurrence in breast cancer patients (p=0.026). Menopausal state, lymphovascular invasion, lymph node state and stage were not associated with progression. Independent prognostic factors were not obtained with multivariate analysis for disease-free survival. Advanced stage breast cancer patients had a higher tendency to metastasis. Triple negative patients had more drug resistance towards systemic treatment than other subgroups (p lt;0.001). It has been found that full response to anthracycline + taxane regime was less in triple negative patients. Conclusion: In conclusion, there were some differences within our subgroups. Patients of these subgroups should be followed up and treated with different strategies. All subgroups, especially triple negative group, were in need of new effective therapy strategies.
