Browsing by Author "Gemalmaz, H"

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    Can We Predict the Surgical Margin Positivity in Patients Treated with Radical Prostatectomy? A Multicenter Cohort of Turkish Association of Uro-Oncology
    Bolat, D; Eskicorapci, S; Karabulut, E; Baltaci, S; Yildirim, A; Sözen, S; Ates, F; Sekerci, ÇA; Kurtulus, F; Dirim, A; Muezzioglu, T; Can, C; Bozlu, M; Gemalmaz, H; Ekici, S; Özen, H; Turkeri, L
    Objective To analyze the parameters that predict the surgical margin positivity after radical prostatectomy for localized prostate cancer. Materials and Methods In this multicenter study, the data of 1607 consecutive patients undergoing radical prostatectomy for localized prostate cancer in 12 different clinics in Turkey between 1993-2011 were assessed. Patients who had neoadjuvant treatment were excluded. We assessed the relationship between potential predictive factors and surgical margin status after radical prostatectomy such as age, cancer characteristics, history of transurethral prostate resection, surgical experience and nerve-sparing technique by using univariate and multivariate Cox regression analyses and t test. Results The overall surgical margin positivity rate was 22.6% (359 patients). In univariate analyses, preoperative prostate specific antigen level, clinical stage, biopsy Gleason score, percentage of tumor involvement per biopsy specimen, transurethral prostate resection history, surgical experience and nerve-sparing technique were significantly associated with positive surgical margin rate. In multivariate analyses, preoperative prostate specific antigen level (OR: 1.03, p=0.06), percentage of tumor involvement per biopsy specimen (OR: 7,14, p<0,001), surgical experience (OR: 2.35, p=0.011) and unilateral nerve-sparing technique (OR: 1.81, p=0.018) were independent predictive factors for surgical margin positivity. Conclusion Preoperative prostate specific antigen level, percentage of tumor involvement per biopsy specimen, surgical experience and nerve-sparing technique are the most important predictive factors of surgical margin positivity in patients undergoing radical prostatectomy for localized prostate cancer.
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    Development of a quality of life scale specific for patients with benign prostatic hyperplasia
    Cam, K; Muezzinoglu, T; Aydemir, O; Buyukalpelli, R; Toktas, G; Gemalmaz, H
    The improvement of quality of life (QoL) should be the major concern in any proposed treatment modality for any disorder. The objective of this study was to develop a new easy to use benign prostatic hyperplasia (BPH)-specific QoL scale that may guide the treatment policy in BPH. A total of 118 items addressing BPH-specific QoL were produced. After an elimination process, a 20-question scale was developed. This new scale, Short Form (SF)-36 and International Prostate Symptom Score (IPSS), was then administered to 50 healthy men (control group), and 108 BPH patients who received medical or surgical treatment. Reliability assessment consisted of internal consistency evaluation by the Cronbach's alpha reliability test. In construct validity, factor analysis was performed using principal component analysis with Varimax rotation. Response to change of this new form was also evaluated. Cronbach's alpha coefficient of this scale was found to be 0.8464. Item-total correlation coefficients were between 0.3298 and 0.7886 (p < 0.0001). Factor analysis for construct validity revealed four factors. The correlation coefficients were found to be r = 0.801 (p < 0.0001) with the total IPSS, and this new QoL scale had a relatively sufficient correlation with all domains of the SF-36. Moreover, a QoL score obtained by the summation of individual grades of each item may provide valuable information just like total IPSS. The mean QoL score was 4.96 +/- A 9.58 and 20.28 +/- A 9.14 in controls and BPH patients, respectively (p < 0.0001). Moreover, QoL score significantly improved by both medical and surgical treatment. The new BPH-specific QoL was shown to be reliable and valid.