Branching Patterns and Variations of Facial Artery and Clinical Importance: A Cadaveric Study

Introduction: The facial artery (FA) was observed with distinctive variations and anomalous, which occur during the embryological developmental process due to the ablation of neural crest cells that impact embryonic aortic arch vessels, resulting in distinctive branching patterns. Therefore, this study aimed to investigate the types, clinical importance, localization, and differences of FA in fixed cadavers according to gender and body side. Methods: The current study was conducted on 19 formalin-fixed cadavers (68.4% males, n = 13; 31.6% females, n = 6). The types, variations, prevalence, and distance to nearby surgical landmarks of FA were recorded on both sides. Measurements were taken with a surgical microscope (Zeiss Meditec, Berlin, Germany) and a digital caliper (INCA, DCLA-0605, 0.6–150 mm). Results: Angular type % 73.1 (n = 14, right; n = 19, left), labial type % 5.3 (n = 1, right), alar type % 5.3 (n = 1, right), and nasal type % 5.3 (n = 1, right) were detected. The following parameters were significant according to gender; the distance between the ala of the nose and the origin of the FA on both sides (p = 0.007 right; p = 0.018 left), the diameter of FA at the cheilion (p = 0.019 left), diameters of the superior and inferior labial arteries at their origin (p = 0.031 right; p = 0.025 right) and PO lines. Conclusion: The significant differences in gender according to the distance of the FA and its branches from the origin should be considered to reduce complications during surgery. The differences in studies according to the types and variations of FA may be due to the scale of the study, gender, or study design

Outcomes of Surgery and Craniospinal Radiotherapy for Adult Patients with Medulloblastoma

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Prognostic significance of early complete response in patients with locally advanced rectal cancer undergoing preoperative chemoradiotherapy: Multicentric study of Turkish Society for Radiation Oncology Group (TROD)

Background/Aims: To assess the effect of various parameters on the oncologic outcomes, including the time interval between therapy and surgery (S) in locally advanced rectal cancer (LARC) patients receiving preoperative chemoradiotherapy (CRT). Materials and Methods: The data of 914 LARC patients who received preoperative CRT between 1994 and 2015 were collected retrospectively. Patients received 45-50.4 Gy RT with 5FU based chemotherapy (CT). They all underwent radical resection followed by maintenance CT. Clinical and pathologic variables were compared between the pCR and no-pCR groups. Survival was estimated by the Kaplan-Meier method and Cox proportional hazard model was used in multivariate analysis. Results: After median follow-up of 60.5 (range=12-297.6) months, median overall survival (OS) was 58.75 months and disease-free survival (DFS) 53.32 months. pCR was observed in 18.9\% of all cases. pCR, lymphovascular invasion and metastatic lymph node ratio (mLNR) were significantly associated with OS and DFS on multivariate analysis. The 5-year OS and DFS rates were better in pCR group (95.3\% vs 80.7\% for OS, p<0.0001 and 87.4\% vs 71\% for DFS, p<0.0001). pCR patients with 4-8 weeks interval had lower rates of distant metastasis (9\% vs 20\%, p=0.01) and any recurrences (13.6\% vs 29.6\%, p=0.001) than the remaining. Both OS and DFS were better in favor of pCR achieved at 4-8 week interval time (p<0.0001 for each). Conclusion: pCR after preoperative CRT in LARC correlated with better oncologic outcome. The best OS and DFS durations were achieved in patients who experienced pCR after 4-8-weeks interval before surgery