Neutrophil/Lymphocyte Ratio, Platelet/Lymphocyte Ratio, and Mean Platelet Volume for Detection of Resectable Pancreas Cancer

Several biomarkers have been preferred for the early diagnosis of pancreatic adenocancer (PAC), but most are not ready to be included as part of the routine diagnostic algorithm because they still lack sensitivity, specificity or reproducibility. CA19-9 is the most widely used serum-based marker for the diagnosis and follow-up of pancreatic cancer. However, CA19-9 lacks sensitivity for early or small-diameter pancreatic cancers. For more than 3 decades, information on neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), mean platelet volume (MPV) has been widely available to health care practitioners, as part of the data provided in the full blood count. However, these biomarkers have more than used in the routine. The present chapter shares the prognostic significance of the hematological parameters in the light of our own findings and recent studies in the literature

Laparoscopic Surgery for Gastric Cancer

In patients with gastric cancer, surgical resection is the only treatment that can offer cure or increase long-term survival. With the accumulation of experience in laparoscopic radical gastrectomy and the progress in surgical instruments, laparoscopic surgery for gastric cancer has gained popularity despite initial concerns regarding safety and oncological adequacy. As a result, laparoscopic technique has been widely applied in gastric cancer. Different meta-analyses showed that laparoscopic procedures are associated with less blood loss but longer operation time. Many studies have reported outcomes of laparoscopic surgery for early gastric cancer, but several authors also have shown that a laparoscopic approach can also be used in cases of advanced gastric cancer. We therefore conducted this study to expand our experience and to evaluate laparoscopic gastrectomy step by step in the light of recent reports while defining key points and surgical technique

Effects of nivolumab in peritoneal carcinamatosis of malign melanoma in mouse model

<div><p>Abstract Purpose: To evaluate the efficacy of nivolumab and comparison with dacarbazine (DTIC) on peritoneal carcinomatosis of malignant melanoma in mouse model. Methods: Mouse skin melanoma cells was injected under the capsule of the peritoneal surface in the left side of the abdomen. On postoperative day ten, mouses randomised into three groups. Group 1: Control, Group 2: HIPEC (Hyperthermic intraperitoneal chemotherapy) with DTIC and Group 3: HIPEC with Nivolumab. After the sacrification on postoperative day fifteen, peritoneum evaluated macroscopically and histopathologically by using peritoneal regression grading score (PRGS). Results: In the 15th day exploration, all animals developed extensive intraperitoneal tumor growth in Group 1. In Group 2 and Group 3 median tumor size was 0.7±0.3cm and 0.3±0.2cm respectively (p: 0.023). Peritoneal carcinomatosis index (PCI) were significantly lower in Group 3 than other groups (p: 0.019). The lowest total tumor nodules in group 3 was 4 ± 2. The PGRS score was found significantly lower in Group 3 than other groups (p: 0.03). Lymphocytic response rate was found higher in the Group 3. Conclusions: It has been found that nivolumab significantly better than DTIC on peritoneal metastases of malign melanoma in mouse models. Nivolumab treatment gives promising results with pathological evidence in the treatment of metastatic disease of malignant melanoma.</p></div

Unusual Presentation of Hydatid Cyst in Breast with Magnetic Resonance Imaging Findings

We report a case of 59-year-old woman with a painful left breast mass, compatible with types II-III hydatid cyst. Lesion was evaluated with mammography, ultrasound, computed tomography, and magnetic resonance imaging modalities. Magnetic resonance imaging had important diagnostic role with demonstrating characteristic features of the lesion and had capability of showing complications. Surgery also confirmed the diagnosis of a hydatid cyst

Local thrombolytic therapy in acute mesenteric ischemia

BACKGROUND: The aim of the study was to evaluate the local thrombolytic therapy (LTT) in combination with laparoscopy, in management of acute mesenteric ischemia (AMI). METHODS: From January 2000 to January 2010, patients who were admitted to the hospital with AMI due to acute arterial occlusion were analysed retrospectively. Patients presenting with acute abdomen with a suspicion of AMI were evaluated with computerized tomography angiography (CTA). Patients who had findigs of AMI on CTA, were underwent selective mesenteric angiography and LTT eventhough without peritoneal signs. LTT was carried out before or after laparoscopy or laparotomy, and initiated with recombinant plasminogen activator. RESULTS: LTT was performed in 13 (17.1%), out of 76 patients. From the remaining patients, 56 underwent necrotic bowel resection and 7 underwent tromboembolectomy. The median age was 62 years (45–87). The median duration of symptoms was 24 h. Four (30.7%) patients presented within 24 h onset of symptoms, whilst 9 (69.3%) patients presented after 24 h onset of symptoms. There were 5 (39.5%) patients, who presented with abdominal pain without peritoneal signs on physical examination and 8 (61.5%) patients, who had peritoneal signs. The mortality rate was 20% (1/5) in the first group who presented without peritoneal signs, whilst it was 62.5% (5/8) in the remaining. CONCLUSION: Early intervention in AMI is the key to better results. CTA combined with early laparoscopy and LTT may have beneficial effects at this setting

Short-term Quality of Life after Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

WOS: 000438781200010Introduction: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have been increasingly performed in many advanced centers of our country. Short-term quality of life (QoL) after the CRS with HIPEC was investigated in Turkish population. The purpose of our study was to investigate the QoL in patients operated for peritoneal carcinomatosis (PC). Methods: Retrospectively collected data from 42 consecutive patients, who had undergone CRS and HIPEC, and 92 abdominal malignancy patients after oncological surgery without CRS and HIPEC were selected in the study between 2012 and 2015. A Turkish version of the European Organization for Research and Treatment of Cancer questionnaire (QLQ-C30) was used at the 6th month following surgery for the QoL assessment. Statistical analysis was done with one sample t-test, and p0.05). Conclusion: Short-term QoL after the CRS with HIPEC patients and without the CRS+HIPEC oncologic patients is found to be similar in Turkish population