Browsing by Author "Baltaci S."

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    A survey of patient preparation and technique of ultrasound-guided prostate biopsy: A multicenter study og urooncological association; [Ultrasonografi kιlavuzluǧunda yapιlan prostat biyopsisinde hasta hazιrlιǧι ve teknik anketi: Üroonkoloji derneǧi çcok merkezli çalιşmasι]
    (Turk Uroloji Dernegi, 2007) Bozlu M.; Akduman B.; Mungan U.; Özen H.; Baltaci S.; Türkeri L.; Kirkali Z.; Akdaş A.; Adsan Ö.; Akdoǧan B.; Altinel M.; Ataus S.; Ayan S.; Bilen C.Y.; Çal Ç.; Çek M.; Dündar M.; Işeri C.; Koşan M.; Lekili M.; Müezzinoǧlu T.; Özer G.; Özgök Y.; Perk H.; Soyupak B.; Soyupek S.; Soylu A.; Sözen S.; Şengör F.; Tansuǧ Z.; Tekin A.; Yildirim A.
    Introduction: Ultrasound-guided prostate biopsy is the standard method for the diagnosis of prostate cancer. The aim of the present survey is to assess the variability in patient preparation and technique of ultrasound-guided prostate biopsy among Turkish Urologists. Materials and Methods: In July 2004, a questionnaire was sent out to e-mail addresses of the members of Urooncological Association, asking about the details of prostate biopsy protocol of the members. The survey consisted of multiple choice questions about the patient preparation and prostate biopsy technique. Responses were acquired via e-mail and analyzed in detail. Results: Thirty two urologists from 24 centers responded. The biopsy procedure was performed by the urologist only in 54.16% of the centers, both urologist and radiologist in 37.5%, and radiologist only in 8.33%. Transrectal route was the most common method for ultrasound-guided prostate biopsy. A half of the responders performed biopsy when PSA was greater than 4 ng/ml. All of the centers administered antibiotic and a half of them used enema before the procedure. Approximately 37% of responders did not administer any type of analgesia, but 29.1% of all responders administered a periprostatic nerve block for reducing pain during the procedure. Most urologists obtained 10 or 12 biopsy cores and only 20.8% of them obtained routine transitional zone biopsy during the initial biopsy session. Conclusion: This survey demonstrated that patient preparation and technique of ultrasound-guided prostate biopsy is not standardized among Turkish Urologists, and a guideline on prostate biopsy is needed.
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    Predicting factors of acute kidney injury after partial nephrectomy and its impact on long-term renal function: A multicentre study of the Turkish Urooncology Association
    (John Wiley and Sons Inc, 2021) Suer E.; Akpinar C.; Izol V.; Bayazit Y.; Sozen S.; Cetin S.; Ozden E.; Turkeri L.; Bozkurt O.; Ucer O.; Baltaci S.
    Objectives: To investigate the predictors of acute kidney injury (AKI) after partial nephrectomy and the impact of AKI stage on long-term kidney function. Methods: Data of 1055 patients who underwent partial nephrectomy between January 2008 and January 2018 at seven separate tertiary centres were analysed. AKI was defined according to AKI Network criteria. The association between pre-operative and perioperative factors and AKI was evaluated using logistic regression analysis. Recovery of at least 90% of baseline glomerular filtration rate 1 year after partial nephrectomy, change of 1 year glomerular filtration rate compared with baseline glomerular filtration rate and stage ≥3 chronic kidney disease (CKD) progression were assessed according to the stage of AKI. Results: AKI was recorded in 281 (26.7%) of 1055 patients after partial nephrectomy, and of these patients, 197 (70.1%) had stage 1, 77 (27.4%) had stage 2 and 7 (2.5%) had stage 3. Higher tumour complexity and baseline glomerular filtration rate were independent predictors for AKI. The proportion of recovering 90% of baseline glomerular filtration rate at 1 year for any patient who had stage ≤1 vs stage 2-3 of AKI was 78.2% (95% CI: 73.2%-83.7%) and 23.8% (95% CI: 14.7%-38.7%), respectively (P <.001). The risk of stage ≥3 CKD progression for any patient who had stage ≤1 vs stage 2-3 of AKI was 6.2% (95% CI: 4.1%-9.2%) and 63.1% (95% CI: 52.5%-75.6%), respectively (P <.001). Conclusions: AKI adversely affects renal function in the long-term after partial nephrectomy and stage 2-3 significantly increases the risk of CKD in the long term. © 2021 John Wiley & Sons Ltd.
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    How accurate is radiological imaging for perirenal fat and renal vein invasion in renal cell carcinoma?
    (John Wiley and Sons Inc, 2021) Ucer O.; Muezzinoglu T.; Ozden E.; Aslan G.; Izol V.; Bayazit Y.; Altan M.; Akdogan B.; Ozen H.; Sozen S.; Cetin S.; Suer E.; Esen B.; Baltaci S.
    Objective: To evaluate the accuracy of radiological staging, especially renal venous and perirenal fat invasion, in renal cell carcinoma (RCC). Material and Methods: Data of 4823 renal tumour patients from Renal Tumor Database of Association of Uro-oncology in Turkey were evaluated. Of 4823 patients, 3309 RCC patients had complete radiological, and histopathological data were included to this study. The Pearson chi-squared test (χ2) was used to compare radiological and histopathological stages. Results: The mean (SD) age of 3309 patients was 58 (12.3). Preoperative radiological imaging was performed using computed tomography (CT) (n = 2510, 75.8%) or magnetic resonance imaging (MRI) (n = 799, 24.2%). There was a substantial concordance between radiological and pathological staging (к = 0.52, P <.001). Sensitivities of radiological staging in stages I, II, III and IV were 90.7%, 67.3%, 27.7% and 64.2%, respectively. The sensitivity in stage III was lower than the other stages. Subanalysis of stage IIIa cases revealed that, for perirenal fat invasion and renal vein invasion, sensitivity values were 15.4% and 11.3%, respectively. Conclusions: There was a substantial concordance between radiological (CT and/or MRI) and pathological T staging in RCC. However, this is not true for T3 cases. Sensitivity of preoperative radiological imaging in patients with pT3a tumours is insufficient and lower than the other stages. Consequently, preoperative imaging in patients with T3 RCC has to be improved, in order to better inform the patients regarding prognosis of their disease. © 2021 John Wiley & Sons Ltd
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    Sextant Biopsy-Based Criteria for Clinically Insignificant Prostate Cancer Are Also Valid for the 12-Core Prostate Biopsy Scheme: A Multicenter Study of Urooncology Association, Turkey
    (S. Karger AG, 2022) Çelik S.; Klzllay F.; Yörükoǧlu K.; Aslan G.; Ozen H.; Akdogan B.; Sozen S.; Baltaci S.; Muezzinoglu T.; Izol V.; Bayazlt Y.; Narter F.; Türkeri L.
    Background: Epstein criteria based on sextant biopsy are assumed to be valid for 12-core biopsies. However, very scarce information is present in the current literature to support this view. Objectives: To investigate the validity of Epstein criteria for clinically insignificant prostate cancer (PCa) in a cohort of the currently utilized 12-core prostate biopsy (TRUS-Bx) scheme in patients with low-risk and intermediate-risk PCa. Method: Pathological findings were separately evaluated in the areas matching the sextant biopsy (6-core paramedian) scheme and in all 12-core schemes. Patients were divided into 2 groups according to the final pathology report of RP as true clinically significant PCa (sPCa) and insignificant PCa (insPCa) groups. Predictive factors (including Epstein criteria) and cutoff values for the presence of insPCa were separately evaluated for 6- and 12-core TRUS-Bx schemes. Then, different predictive models based on Epstein criteria with or without additional biopsy findings were created. Results: A total of 442 patients were evaluated. PSA density, biopsy GS, percentage of tumor and number of positive cores, PNI, and HG-PIN were independent predictive factors for insPCa in both TRUS-Bx schemes. For the 12-core scheme, the best cutoff values of tumor percentage and number of positive cores were found to be ≤50% (OR: 3.662) and 1.5 cores (OR: 2.194), respectively. The best predictive model was found to be that which added 3 additional factors (PNI and HG-PIN absence and number of positive cores) to Epstein criteria (OR: 6.041). Conclusions: Using a cutoff value of "1"for the number of positive biopsy cores and absence of biopsy PNI and HG-PIN findings can be more useful for improving the prediction model of the Epstein criteria in the 12-core biopsy scheme. © 2021 Authors.
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    Effect of pelvic lymph node dissection and its extent on oncological outcomes in intermediate-risk prostate cancer patients: A multicenter study of the Turkish Uro-oncology Association
    (John Wiley and Sons Inc, 2022) Izol V.; Ok F.; Aslan G.; Akdogan B.; Sozen S.; Ozden E.; Celik O.; Muezzinoglu T.; Turkeri L.; Akdogan N.; Baltaci S.
    Background: Pelvic lymph node dissection (PLND) is the gold standard method for lymph node staging in prostate cancer. We aimed to evaluate the effect of PLND combined with radical prostatectomy (RP) on oncological outcomes in D'Amico intermediate-risk prostate cancer (IRPC) patients. Methods: Patients with D'Amico IRPC were included in the study. In the overall cohort and subgroups (biopsy International Society of Urological Pathology [ISUP] grade group 2 and 3), patients were divided into two groups as PLND and no-PLND. More extensive PLND, defined as a number of removed nodes (NRN) ≥ 75th percentile. Results: After exclusion, a total of 631 patients were included: 351 (55.6%) had PLND and 280 (44.4%) had no-PLND. The mean age was 63.1 ± 3.60 years. The median NRN was 8.0 (1.0–40.0). The mean follow-up period was 47.7 ± 37.5 months. The lymph node involvement (LNI) rate was 5.7% in the overall cohort, 3.9% in ISUP grade 2, and 10.8% in ISUP grade 3. Patients with PLND were associated with more aggressive clinicopathologic characteristics but no significant difference in biochemical recurrence-free survival (BCRFS) was found between patients with PLND and no-PLND (p = 0.642). In the subgroup analysis for ISUP grades 2 and 3, no significant difference in BCRFS outcomes was found in patients with PLND and No-PLND (p = 0.680 and p = 0.922). Also, PLND extent had no effect on BCRFS (p = 0.569). The multivariable Cox regression model adjusted for preoperative tumor characteristics revealed that prostate specific antigen (PSA) (HR: 1.18, 95% CI: 1.01–1.25; p = 0.048) was an independent predictor of biochemical recurrence (BCR). The optimum cut-off value for PSA, which can predict BCRFS, was assigned to be 7.81 ng/ml, with an AUC of 0.63 (95% CI: 0.571–0.688). The highest sensitivity and specificity were 0.667 and 0.549. Conclusion: Overall and cancer-specific survival analyzes were not evaluated because not enough events were observed. Neither PLND nor its extent improved BCRFS outcomes in IRPC. The LNI rate is low in patients with biopsy ISUP grade 2 and the BCR rate is low in those with PSA < 7.81 ng/dl so PLND can be omitted in these IRPC patients. © 2022 Wiley Periodicals LLC.
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    Oncological Outcomes of Patients with Non-Clear Cell Renal Cell Cancers: Subtypes of Unclassified and Translocation Renal Cell Cancers
    (Urology and Nephrology Research Centre, 2023) Gokalp F.; Celik S.; Sozen T.S.; Ozen A.H.; Aslan G.; Izol V.; Baltaci S.; Muezzinoglu T.; Akdogan B.; Suer E.; Tinay I.
    Purpose: We aimed to compare oncological outcomes in the two rare subtypes, unclassified renal cell cancer (unRCC) and translocation RCC (tRCC), vs clear cell RCC (ccRCC).Materials and Methods: Between 2004 and 2019, from Turkish Urooncology Society Database, we identified 2324 patients for histological subtypes including 80 unRCC (3.4%), 19 tRCC (0.8%) and 2225 ccRCC (95.8%).Results: The overall (15.8%) and cancer-specific mortalities (11.1%) were found to be higher in tRCC group and the recurrence free mortality (13.8%) was found to be higher in unRCC group. Larger pathological tumor size (p = 0.012) and advanced pathological T stage (p = 0.042) were independent predictive factors on overall mortality in patients with unRCC tumors.Conclusion: The oncological outcomes of the unRCC and tRCC are worse than ccRCC and pathological tumor size and pathological stage are predictive factors for mortality in the unRCC © 2023, Urology Journal.All Rights Reserved.
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    Oncological Outcomes of Chromophobe Versus Clear Cell Renal Cell Carcinoma: Results from A Contemporary Turkish Patient Cohort
    (Urology and Nephrology Research Centre, 2024) Cetin T.; Celik S.; Sozen S.; Ozen H.; Akdogan B.; Aslan G.; Baltaci S.; Suer E.; Bayazit Y.; Izol V.; Muezzinoglu T.; Gokalp F.; Tinay I.
    Purpose: To compare the oncological outcomes of clear cell RCC (ccRCC), which is common in renal cell carcinomas (RCC), and chromophobic RCC (chRCC), which is less common, and to define the factors affecting survival in the Turkish patient population for both RCC subclassifications. Materials and Methods: Patients with a pathologically confirmed RCC diagnosis after radical or partial nephrectomy in the Turkish Urooncology Association (TUOA), Urological Cancers Database-Kidney (UroCaD-K), were retrospectively reviewed. Patients with ccRCC and chRCC were included in the study. Primary outcomes of this study are recurrence-free survival (RFS), overall survival (OS) and cancer-specific survival (CSS) for each histological subtype. Results: Data from 5300 patients in the TUOA UroCaD-K are reviewed and a total of 2560 patients (2225 in the ccRCC group and 335 in the chRCC group) are included in the final analysis. In the comparison of the groups, tumor size was greater both radiologically and pathologically in chRCC (p=0.019 vs 0.002 respectively). Recurrence-free survival (RFS), overall survival (OS) and cancer-specific survival (CSS) rates are worse in ccRCC subgroup. In the evaluation of risk factors; pathological stage, local invasion and Fuhrmann grade were found to be significant for recurrence in ccRCC. Age, body mass index and pathological stage were the risk factors affecting overall mortality (OM). Pathological tumor size was an independent risk factor for recurrence in chRCC, while age was analyzed as the only parameter affecting OM. Conclusion: chRCC oncological data and OS, CSS and RFS rates were found to be better than ccRCC in the Turkish patient population. © (2024), (Urology and Nephrology Research Centre). All Rights Reserved.