Browsing by Author "Özden, E"

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    Can Aortic and Renal Arteries Calcium Scores Be New Factors to Predict Post-Operative Renal Function After Nephron Sparing Surgery?
    Akarken, I; Bilen, CY; Özden, E; Gülsen, M; Üçer, O; Sahin, H
    Several nonmodifiable factors are associated with worse postoperative renal function in patients that have undergone nephron sparing surgery. Also, a positive correlation between renal disease and the calcification of renal arteries has been shown. This study aimed to investigate whether the calcification of renal arteries and aorta may be risk factors for developing chronic kidney disease after nephron sparing surgery Introduction: This study aims to investigate whether the calcification of renal arteries and aorta may be risk factors for developing chronic kidney disease (CKD) after Nephron sparing surgery (NSS). Materials and Methods: The patients that underwent either open or laparoscopic NSS from 2000 to 2019 in 4 different centers were retrospectively assessed. Of these patients, 328 had a non-contrast-enhanced computer tomography. Calcium scores of the renal arteries and abdominal aorta were measured in the non-contrast-enhanced images with the calcium score plugin (version 2.0) of Horos (TM). Univariate and multivariate logistic regression analysis was performed to determine significant risk factors for developing CKD at the last check-up. Roc curve analysis was performed to determine the optimal cut-off values of age and abdominal aorta calcium scores. Results: A total of 302 patients, of which 52 (16,6%) with CKD and 252 (83,4%) without CKD at the last check-up, were included in the analysis. The mean warm ischemia duration was significantly higher in patients with CKD (18,79 +/- 6,72 vs 16,38 +/- 5,57 minutes, p=0,016). The mean size of the tumor diameter and the number of the patients with >= stage T1b were higher in the group with CKD (p=0,024 and 0,005, respectively). The median calcium scores of the aorta and renal arteries were higher in the group with CKD (p <0,001 and p< 0,001, respectively). In multivariate analysis, age >60 years (OR:3,65, p=0,022), calcium score of the aorta (OR:4,07, p=0,029), tumor diameter (OR:1,03, p=0,026) and pre-operative CKD stage (OR:10,13, p, 0,001) found the be significant factors for predicting last check-up CKD. Conclusion: The calcium score of the aorta may be used as an additional risk factor to predict post-operative CKD risk after NSS with sensitivity over 80%. (C) 2021 Elsevier Inc. All rights reserved.
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    Can We Predict Recurrence of pT1-2 Renal Cell Carcinoma?
    Üçer, O; Mueezzinoglu, T; Aslan, G; Sueer, E; Baltaci, S; Izol, V; Özden, E; Akdogan, B; Yazici, S; Bulut, EC; Akdogan, N; Sözen, S
    Objective: Some prognostic models have been described for localized and metastatic renal cell carcinoma (RCC). The European Association of Urology guidelines on RCC recommend using these models. However, there is no model for T1 and T2. The study evaluated the risk factors for recurrence in T1 and T2 RCC. Materials and Methods: Data of 4823 renal tumor patients from the Renal Tumor Database of the Association of Urooncology in Turkey were evaluated. Of 4823 patients, 1845 RCC patients with pathological T1 or T2 were included in this study. The patients were divided into two groups according to the recurrence status. Anatomical, histological, and clinical prognostic factors were statistically compared between the groups. Afterwards, multivariate analysis was performed for the variables that were found to be statistically significant. Results: The mean follow-up time was 30 (4-180) months. Of 1845 RCC patients, 117 (6.3%) had recurrence. Univariate analysis revealed statistically significant differences between age, preoperative hemoglobin, albumin, neutrophil, alkaline phosphates, platelet and calcium values, histological subtype, Fuhrman grade, surgical technique (radical or partial), and pathological stage in the groups. However, in multivariate analysis, only pathological stage was found to be a risk factor for recurrence (2.17 95%, 1.25-3.77). Conclusions: The results of our study show that it is difficult to design a prognostic model for the recurrence of pT1 and pT2 RCC. We suggest that patients with a higher tumor diameter should be followed up more frequently.