ABSTRACT
Objectives: The aim of this study was to evaluate the predictive value of the first postoperative day (POD1) drain fluid amylase in predicting pancreatic fistula formation following pancreaticoduodenectomy (PD). Material and Methods: One-hundred and eighty-five prospective patients undergoing PD between April 2014 and April 2018 were studied retrospectively. Cut-off point to predict the development of POPF was determined by median values for drain fluid amylase of 1883 U/L. Patients were classified into two groups according to POD1 drain fluid amylase values: <1883 U/L (Group 1) and ≥1883 U/L (Group 2). Differences between the groups with clinically relevant POPF and without POPF were evaluated. Results: The incidence of POPF was 17.2%. POD1 amylase level was the strongest predictor of POPF, with levels of higher than 1883 U/L demonstrating the best accuracy (87.5%), sensitivity (78.1%), specificity (89.5%), positive predictive value (60.9%), and negative predictive value (95.1%). One-hundred and forty-four patients (77.8%) had a POD1 drain amylase level of less than 1883 U/L, and POPF developed in only seven (3.7%) cases, whereas in patients with POD1 drain amylase level of 1883 U/L or higher (n= 41), the POPF rate was 31.4% [OR: 22.24, 95% CI (7.930-62.396), p<0.001]. Conclusion: The cut-off point of POD1 drain fluid amylase level (1883 U/L) might predict the clinically relevant POPF with adequate sensitivity and specificity rates in patients undergoing pancreatic resection.
ABSTRACT
Background: The incidence of retropancreatic lymph node metastasis in gastric cancer patients is not negligible. Aim: The aim of present study was to determine the risk factors for retropancreatic lymph node (LN) metastasis and to investigate its clinical significance. Patients and Methods: Clinical pathologic data of 237 patients with gastric cancer between June 2012 and June 2017 were analyzed retrospectively. Results: 14 patients (5.9%) had retropancreatic LN metastases. The median survival of patients with and without retropancreatic LN metastasis was 13.1 and 25.7 months. According to univariate analysis; tumor size ≥ 8 cm, Bormann type III/IV, undifferentiated type, presence of angiolymphatic invasion, depth of invasion (pT4), N3 stage, No. 3, No. 7, No. 8, No. 9, and No. 12p LN metastasis was found to be associated with retropancreatic LN metastasis. According to multivariate analysis; tumor size ≥ 8 cm, Bormann type III/IV, undifferentiated type, pT4, N3 stage, No. 9 LN metastasis, and No. 12p LN metastasis were found to be independent prognostic variables for retropancreatic LN metastasis. Conclusion: Retropancreatic LN metastasis is a poor prognostic factor for gastric cancer. Tumor size (≥ 8 cm), Bormann type III/IV, undifferentiated tumor, pT4, N3 stage, and No. 9 and No. 12p LN metastasis are risk factors for metastasis to retropancreatic lymph node.
ABSTRACT
Background/aim: Primary thyroid lymphoma (PTL) is a very rare thyroid malignancy. It should be diagnosed and treated immediately and accurately. Our aim was to evaluate the diagnostic methods and treatment results for patients with PTL.Materials and methods: We retrospectively evaluated the records of 11 patients with PTL from 2009 to 2015, diagnosed at our institute. Age, sex, stage, histopathologic type, presence of Hashimoto's thyroiditis, diagnostic methods, treatment types, and recurrence were examined.Results: Six patients were female, 5 were male, and the median age of the patients was 61 years (range: 15-76 years). All patients had a large palpable mass in the neck. Fine needle aspirate (FNA) biopsy was performed in all patients; however, it was useful only in the diagnosis of 7 patients. Excisional and surgical biopsy was performed in 4 patients. All patients had non-Hodgkin B-cell lymphoma, including 9 cases of diffuse large B-cell lymphoma (DLBCL), and 2 patients had mucosa-associated lymphoid tissue (MALT) lymphoma. Recurrence was observed in one patient. Median survival was 34 months.Conclusions: The preferred option for the diagnosis of PTL should be FNA biopsy, and the treatment should be decided on according to whether the disease is limited to the thyroid gland or not, its histological type, and its stage.
