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    The Results of Liver Transplantation Performed In a Single Center Due To Hepatocellular Carcinoma
    (Duzce Univ, Fac Medicine, 2023) Aslan, Serdar; Yazar, Serafettin; Kargi, Ahmet; Kurnaz, Eray; Sahin, Dilek; Peker, Kemal; Astarcioglu, Ibrahim
    Objective: Hepatocellular cancer (HCC) is the most common malignancy of the hepatobiliary system. There are significant differences in the global spread of HCC. It is the major cause of death in patients with cirrhosis. Its molecular pathogenesis is highly complex and heterogeneous. Major risk factors for the development of HCC are chronic hepatitis B virus (HBV) infection, chronic hepatitis C virus (HCV) infection and alcohol related liver cirrhosis. Hepatocellular cancer is rarely seen in the first 4 decades of life, except in communities where HBV infection is hyperendemic.Methods: The study was conducted by retrospectively scanning the files of 204 patients diagnosed with HCC who applied to Organ Transplantation Center between 21.09.2014 and 13.04.2019. Patients were transplanted liver by being classified according to Milan criteria, San Francisco [University of California San Francisco (UCSF)] criteria, and Barcelona Clinic Liver Cancer (BCLC) criteria.Results: The median age of the patients was 58.03 (range 31 to 72). 170 of the patients were men and 34 of them were female. Liver transplantation (LT) was performed from cadaveric donors to 31 patients and from living donors to 173 patients. There is a significant relationship between the life span of the patients and their gender. Female patients have a longer life expectancy [t (202) = 2.963, p =0.003]. A significant relationship was found between life expectancy and surgical classification [F (3) = 3.008, (p =0.031)].Conclusions: In patients diagnosed with HCC and undergoing LT; the gender being female and the classification method before transplantation affect life expectancy.
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    Should encountering atypia of undetermined significance / follicular lesion of undetermined significance after thyroid biopsy lead to the operation?
    (Prusa Medical Publishing, 2023) Çelebi, Bilgin; Taşdelen, Halil Afşin; Kurnaz, Eray
    Objectives: Nodular goiter is the most common disease of the thyroid gland. Thyroid nodules are malignant in 3-5% cases. To determine the incidence of malignancy in patients defined as atypia of undetermined significance (AUS) or follicular lesion of undetermined significance (FLUS) as a result of fine needle aspiration biopsy (FNAB) and evaluate the clinical, biochemical and sonographic features as possible predictors of malignancy. Methods: Patients who had undergone at least one FNAB and diagnosed as AUS/FLUS from January 2011 to December 2015 were included in the study. Age, gender, benign disease, thyroid stimulating hormone (TSH) level, size, localization, number, time of FNAB, ultrasonography (USG) characteristics, follow-up data on repeated FNAB results and, if surgical excision was performed, final pathological results were analyzed. Results: A total of 5181 thyroid nodules were biopsied in 4089 patients, and the biopsy specimen taken from 611 nodules was diagnosed histopathologically as AUS/FLUS (11.79%). After FNAB, 167 of 611 patients diagnosed with AUS/FLUS were operated. While 65.9% (n = 110) of 167 patients who underwent surgery were made a benign diagnosis; malign diagnosis was made to 34.1% (n = 57). Conclusions: The rate of malignancy in surgically confirmed nodules was 34.1% in this study, which is higher than the Bethesda classification. Due to the high malignancy rate which determined in cytologically diagnosed AUS/FLUS, we think that the repeat decision of the FNAB should be reconsidered and the surgical plan after the first FNAB should be considered more seriously.