Researcher:
Bozkurt, Emre

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Emre

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Bozkurt

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Now showing 1 - 10 of 13
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    Publication
    Efficacy and perioperative safety of different future liver remnant modulation techniques: a systematic review and network meta-analysis
    (Elsevier B.V., 2024) Sijberden, Jasper P.; Kasai, Meidai; Abu Hilal, Mohammad; Bozkurt, Emre; KoƧ University Hospital
    Background: In daily clinical practice, different future liver remnant (FLR) modulation techniques are increasingly used to allow a liver resection in patients with insufficient FLR volume. This systematic review and network meta-analysis aims to compare the efficacy and perioperative safety of portal vein ligation (PVL), portal vein embolization (PVE), liver venous deprivation (LVD) and associating liver partition and portal vein ligation for staged hepatectomy (ALPPS). Methods: A literature search for studies comparing liver resections following different FLR modulation techniques was performed in MEDLINE, Embase and Cochrane Central, and pairwise and network meta-analyses were conducted. Results: Overall, 23 studies comprising 1557 patients were included. LVD achieved the greatest increase in FLR (17.32 %, 95% CI 2.49ā€“32.15), while ALPPS was most effective in preventing dropout before the completion hepatectomy (OR 0.29, 95% CI 0.15ā€“0.55). PVL tended to be associated with a longer time to completion hepatectomy (MD 5.78 days, 95% CI -0.67ā€“12.23). Liver failure occurred less frequently after LVD, compared to PVE (OR 0.35, 95% CI 0.14ā€“0.87) and ALPPS (OR 0.28, 95% CI 0.09ā€“0.85). Discussion: ALPPS and LVD seem superior to PVE and PVL in terms of achieved FLR increase and subsequent treatment completion. LVD was associated with lower rates of post hepatectomy liver failure, compared to both PVE and ALPPS. A summary of the protocol has been prospectively registered in the PROSPERO database (CRD42022321474). Ā© 2024 International Hepato-Pancreato-Biliary Association Inc.
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    Intra-ampullary papillary tubular neoplasm (IAPN): clinicopathologic analysis of 72 cases highlights the distinctive characteristics
    (Elsevier Science Inc, 2023) Tarcan, Zeynep; Akar, Kadriye; Bagci, Pelin; Bozkurtlar, Emine; Ozkan, Hulya Sahin; Ozcan, Kerem; Balci, Serdar; Yilmaz, Serpil; Bilge, Orhan; Basturk, Olca; Esmer, Rohat; Saka, Burcu; Armutlu, Ayşe; Kapran, Yersu; MeriƧƶz, Ƈisel Aydın; Cengiz, Duygu; GĆ¼rses, Bengi; Alper, Emrah; Tellioğlu, GĆ¼rkan; Bozkurt, Emre; Adsay, Nazmi Volkan; School of Medicine; KoƧ University Hospital
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    Sagittal (duct-centric) grossing of whipple specimens as a novel approach that combines the benefits of the axial and bivalving methods and provides more detailed documentation of anatomic variations and pathologic conditions: radiologic-pathologic correlative analysis of 61 cases
    (Elsevier Science Inc, 2023) Kurt, Ozgur; Kayim, Hatice Goksu; Bilge, Orhan; Basturk, Olca; Tezcan, Nuray; Cengiz, Duygu; Esmer, Rohat; Aktaş, Berk Kaan; Armutlu, Ayşe; Saka, Burcu; Kapran, Yersu; Karakaya, Afak Durur; Bozkurt, Emre; Tellioğlu, GĆ¼rkan; Alper, Emrah; GĆ¼rses, Bengi; School of Medicine; KoƧ University Hospital
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    The pathologic characteristics at the primary resected tumor for pancreatic neuroendocrine tumors (pannets) that proved to have metastatic behavior
    (Elsevier Science Inc, 2023) Eren, Ozgur; Bagci, Pelin; Balci, Serdar; Sokmensuer, Cenk; Xue, Yue; Pehlivanoglu, Burcin; Reid, Michelle; Maithel, Shishir; Kooby, David; Sarmiento, Juan; Bilge, Orhan; Basturk, Olca; Bozkurt, Emre; Esmer, Rohat; Saka, Burcu; Armutlu, Ayşe; Kapran, Yersu; GĆ¼rses, Bengi; Tellioğlu, GĆ¼rkan; Adsay, Nazmi Volkan; School of Medicine; KoƧ University Hospital
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    Multimodal assessment after total neoadjuvant therapy versus standard neoadjuvant chemoradiotherapy in locally advanced rectal cancer accurately predicts complete responders
    (Springer, 2023) GĆ¼rbĆ¼z, BĆ¼lent; Ɩzoran, Emre; Ɩzata, Ä°brahim Halil; Uymaz, Derya Salim; Omarov, Nail; Bozkurt, Emre; TĆ¼fekƧi, Tutku; Karahan, Salih Nafiz; SelƧukbiricik, Fatih; BƶlĆ¼kbaşı, Yasemin; Taşkın, Orhun Ć‡Ä±ÄŸ; GĆ¼rses, Bengi; RencĆ¼zoğulları, Ahmet; Buğra, Dursun; Balık, Emre; School of Medicine; KoƧ University Hospital
    Purpose This study aimed to compare local regrowth rates after total neoadjuvant therapy (TNT) versus standard neoadjuvant chemoradiotherapy (SNCRT) in locally advanced rectal cancer (LARC) patients that were strictly selected and assessed with a multimodal approach. Secondary outcomes were 4-year disease-free (DFS) and overall survival (OS) rates.Methods Locally advanced rectal cancer patients without distant metastases treated at Koc Healthcare Group between January 2014 and January 2021 were included. Patients were assessed for complete response with a combination of digital rectal exam, endoscopy, and magnetic resonance imaging with a dedicated rectum protocol. The systemic evaluation was performed with an upper abdomen MRI using intravenous hepatobiliary contrast agent and a thorax CT.Results Of the 270 patients with LARC, 182 fulfilled the inclusion criteria. Ninety-seven (53.3%) underwent TNT, while 85 (46.7%) underwent SNCRT. A cumulative combination of pathological and sustained clinical complete response was significantly higher in the TNT group than in the SNCRT (45.4% vs. 20.0%, p < 0.0001). After a median follow-up of 48 months, seven patients in the W & W group had regrowth [TNT: 4 (10.8%) vs. SNCRT: 3 (23.1%), p = 0.357]. Based on pathological examination, complete/near complete mesorectum rates (p = 1.000) and circumferential resection margin positivity rates (p = 1.000) were similar between the groups. The 4-year DFS and OS rates were comparable. The patients with clinical or pathological complete response had significantly longer overall survival (p = 0.017) regardless of the type of neoadjuvant treatment.Conclusions Multimodal assessment after TNT effectively detects complete responders, resulting in low local recurrence and increased cumulative complete response rates. However, these outcomes did not translate into a survival advantage.
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    Laparoscopic versus open right hepatectomy for colorectal liver metastases after portal vein embolization: international multicentre study
    (Oxford University Press, 2024) Sijberden, Jasper P.; Langella, Serena; Cipriani, Federica; Collado-Roura, Francesc; Morrison-Jones, Victoria; GƶrgeƧ, Burak; Zozaya, Gabriel; Lanari, Jacopo; Aghayan, Davit; De Meyere, Celine; Fuks, David; Zimmiti, Giuseppe; Ielpo, Benedetto; Efanov, Mikhail; Sutcliffe, Robert P.; Russolillo, Nadia; Gomez-Artacho, Miquel; Ratti, Francesca; D'Hondt, Mathieu; Edwin, Bjorn; Cillo, Umberto; Rotellar, Fernando; Besselink, Marc G.; Primrose, John N.; Lopez-Ben, Santi; Aldrighetti, Luca A.; Ferrero, Alessandro; Abu Hilal, Mohammad; N/A; Bozkurt, Emre; School of Medicine; KoƧ University Hospital
    Background Laparoscopic liver surgery is increasingly used for more challenging procedures. The aim of this study was to assess the feasibility and oncological safety of laparoscopic right hepatectomy for colorectal liver metastases after portal vein embolization. Methods This was an international retrospective multicentre study of patients with colorectal liver metastases who underwent open or laparoscopic right and extended right hepatectomy after portal vein embolization between 2004 and 2020. The perioperative and oncological outcomes for patients who underwent laparoscopic and open approaches were compared using propensity score matching. Results Of 338 patients, 84 patients underwent a laparoscopic procedure and 254 patients underwent an open procedure. Patients in the laparoscopic group less often underwent extended right hepatectomy (18% versus 34.6% (P = 0.004)), procedures in the setting of a two-stage hepatectomy (42% versus 65% (P < 0.001)), and major concurrent procedures (4% versus 16.1% (P = 0.003)). After propensity score matching, 78 patients remained in each group. The laparoscopic approach was associated with longer operating and Pringle times (330 versus 258.5 min (P < 0.001) and 65 versus 30 min (P = 0.001) respectively) and a shorter length of stay (7 versus 8 days (P = 0.011)). The R0 resection rate was not different (71% for the laparoscopic approach versus 60% for the open approach (P = 0.230)). The median disease-free survival was 12 (95% c.i. 10 to 20) months for the laparoscopic approach versus 20 (95% c.i. 13 to 31) months for the open approach (P = 0.145). The median overall survival was 28 (95% c.i. 22 to 48) months for the laparoscopic approach versus 42 (95% c.i. 35 to 52) months for the open approach (P = 0.614). Conclusion The advantages of a laparoscopic over an open approach for (extended) right hepatectomy for colorectal liver metastases after portal vein embolization are limited.
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    Intra-ampullary papillary tubular neoplasm (IAPN): clinicopathologic analysis of 72 cases highlights the distinctive characteristics of a poorly recognized entity
    (LIPPINCOTT WILLIAMS & WILKINS, 2024) Tarcan, Zeynep C.; Akar, Kadriye E.; Bağcı, Pelin; Bozkurtlar, Emine; Ɩzkan, HĆ¼lya Şahin; Ɩzcan, Kerem; Balcı, Serdar; Yılmaz, Serpil; Bilge, Orhan; Cheng, Jeanette D.; BaştĆ¼rk, Olca; Esmer, Rohat; Saka, Burcu; Armutlu, Ayşe; Taşkın, Orhun Ć‡Ä±ÄŸ; Kapran, Yersu; MeriƧƶz, Ƈisel Aydın; Cengiz, Duygu; GĆ¼rses, Bengi; Alper, Emrah; Tellioğlu, GĆ¼rkan; Bozkurt, Emre; Adsay, Nazmi Volkan; School of Medicine; KoƧ University Hospital
    The guidelines recently recognized the intra-ampullary papillary tubular neoplasm (IAPN) as a distinct tumor entity. However, the data on IAPN and its distinction from other ampullary tumors remain limited. A detailed clinicopathologic analysis of 72 previously unpublished IAPNs was performed. The patients were: male/female=1.8;mean age=67 years (range: 42 to 86 y);mean size=2.3 cm. Gross-microscopic correlation was crucial. From the duodenal perspective, the ampulla was typically raised symmetrically, with a patulous orifice, and was otherwise covered by stretched normal duodenal mucosa. However, in 6 cases, the protrusion of the intra-ampullary tumor to the duodenal surface gave the impression of an "ampullary-duodenal tumor," with the accurate diagnosis of IAPN established only by microscopic correlation illustrating the abrupt ending of the lesion at the edge of the ampulla. Microscopically, the preinvasive component often revealed mixed phenotypes (44.4% predominantly nonintestinal). The invasion was common (94%), typically small (mean=1.2 cm), primarily pancreatobiliary-type (75%), and showed aggressive features (lymphovascular invasion in 66%, perineural invasion in 41%, high budding in 30%). In 6 cases, the preinvasive component was pure intestinal, but the invasive component was pancreatobiliary. LN metastasis was identified in 42% (32% in those with <= 1 cm invasion). The prognosis was significantly better than ampullary-ductal carcinomas (median: 69 vs. 41 months;3-year: 68% vs. 55%;and 5-year: 51% vs. 35%, P=0.047). In conclusion, unlike ampullary-duodenal carcinomas, IAPNs are often (44.4%) predominantly nonintestinal and commonly (94%) invasive, displaying aggressive features and LN metastasis even when minimally invasive, all of which render them less amenable to ampullectomy. However, their prognosis is still better than that of the "ampullary-ductal" carcinomas, with which IAPNs are currently grouped in CAP protocols (while IAPNs are kindreds of intraductal tumors of the pancreatobiliary tract, the latter represents the ampullary counterpart of pancreatic adenocarcinoma/cholangiocarcinoma).
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    Primary angiosarcoma of the pancreas - a case report and review of the literature
    (Taylor and Francis, 2024) Bozkurt, Emre; Yığman, Samet; Adsay, Nazmi Volkan; GĆ¼rses, Bengi; Tellioğlu, GĆ¼rkan; Bilge, Orhan; School of Medicine; KoƧ University Hospital
    BackgroundAngiosarcomas are malignant neoplasms that originate from endothelial cells.The symptoms exhibit a non-specific nature, and achieving a preoperative diagnosis is frequently challenging. They are seldom encountered in the abdomen, and their occurrence in the pancreas is even rarer.Methods Here we document a 67-year-old man with pancreatic angiosarcoma and analyse the literature to outline the clinicopathologic characteristics of this rare phenomenon.ResultsThis patient with family history of pancreas cancer presented with abdominal pain, and the CT-scan revealed a 4 cm mass at the neck of the pancreas but CA19-9 was normal. Radiologic findings were unusual for ordinary pancreas cancer. Fine-needle aspiration biopsy through endoscopic ultrasound revealed "undifferentiated malignant cells for which the diagnosis of "carcinoma" was favoured. Total pancreatectomy, splenectomy and portal vein reconstruction were performed and epithelioid angiosarcoma were diagnosed. Despite an uneventful postoperative period, discharge on postoperative day 8 without any complications, as well as diligent post-discharge clinical care, the patient died 65 days postoperatively, attributed to the presence of extensive metastasis. A comprehensive literature search has identified a limited number of documented cases of primary pancreatic angiosarcoma, with only ten cases reported to date.ConclusionsPancreatic angiosarcomas are very rare and prone to misdiagnosis. The formation of a more demarcated but high-grade tumour with necrosis is a feature that distinguishes angiosarcomas from ordinary carcinomas of this organ. Pathologic diagnosis is also highly challenging closely resembling undifferentiated carcinomas. Angiosarcomas are highly aggressive when they occur in the pancreas. Prompt diagnosis at an early stage is crucial as surgery with curative intent serves as the primary treatment approach. Surgery with curative intent is the mainstay treatment for pancreatic angiosarcoma when diagnosed at an early stage.Oncological treatment options should be taken into consideration according to the follow-up data.Why does this paper matter?This article is important in that it is the most comprehensive review of the literature on pancreatic angiosarcoma, which is a very rare pathology, from the perspective of radiology, pathology and surgery.
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    Centrally-necrotic/hyalinizing demarcated (CND) carcinomas of the pancreas: a clinico-pathologically distinct group with divergent metaplastic patterns and high-grade characteristics
    (Elsevier, 2022) Bagci, Pelin; Altinmakas, Emre; Pehlivanoglu, Burcin; Bozkurtlar, Emine; Reid, Michelle; Cheng, Jeanette; Luchini, Claudio; Scarpa, Aldo; Basturk, Olca; N/A; Cengiz, Duygu; Saka, Burcu; Bozkurt, Emre; Armutlu, Ayşe; MeriƧƶz, Ƈisel Aydın; Alper, Emrah; Tellioğlu, GĆ¼rkan; GĆ¼rses, Bengi; Adsay, Nazmi Volkan; Other; Faculty Member; Doctor; Teaching Faculty; Teaching Faculty; Faculty Member; Faculty Member; Faculty Member; Faculty Member; School of Medicine; School of Medicine; N/A; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; KoƧ University Hospital; N/A; KoƧ University Hospital; N/A; N/A; N/A; N/A; N/A; N/A; 296729; 222921; N/A; 133567; 162418; 220444; 230736; 113169; 286248
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    Safety and feasibility of laparoscopic right or extended right hemi hepatectomy following modulation of the future liver remnant in patients with colorectal liver metastases: a systematic review
    (Mary Ann Liebert, Inc., 2023) Sijberden, Jasper P.; Abu Hilal, Mohammad; N/A; Bozkurt, Emre; Doctor; N/A; KoƧ University Hospital; N/A
    Background: major hepatectomies after future liver remnant (FLR) modulation are technically demanding procedures, especially when performed as minimally invasive surgery. The aim of this systematic review is to assess current evidence regarding the safety and feasibility of laparoscopic right or extended right hemihepatectomies after FLR modulation. Materials and Methods: the Medline, PubMed, Cochrane Library, and Embase databases were searched for studies involving laparoscopic right or extended right hemihepatectomies after FLR modulation, from their inception to December 2021. Two reviewers independently selected eligible articles and assessed their quality using the Newcastle-Ottawa Quality Assessment Scale (NOS). Baseline characteristics and outcomes were extracted from the included studies and summarized. Results: six studies were included. In these studies, the median length of stay after the second stage ranged from 4.5 to 15.5 days and postoperative complication rates between 4.5% and 42.8%. Overall, 7.4% of patients developed liver failure, and 90-day mortality occurred in 3.2% of patients. The R0 resection rate was 93.5%. Only one study reported long-term outcomes, describing comparable 3-year overall survival rates following laparoscopic and open surgery (80% versus 54%, P = .154). Conclusions: the current evidence is scarce, but it suggests that in experienced centers, laparoscopic right or extended right hemihepatectomy, following FLR modulation, is a safe and feasible procedure.