Researcher: Esen, Tarık
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Esen, Tarık
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Publication Metadata only Robot-assisted radical prostatectomy: initial results of a single experienced open surgeon in the learning curve(Mary Ann Liebert, Inc, 2011) Tefekli, Ahmet; Musaoğlu, Ahmet; Cezayirli, Fatin; Esen, Tarık; Faculty Member; School of Medicine; 50536N/APublication Metadata only Fluorescence-guided extended pelvic lymphadenectomy during robotic radical prostatectomy(Springernature) N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; Özkan, Arif; Köseoğlu, Ersin; Canda, Abdullah Erdem; Çil, Barbaros Erhan; Aykanat, İbrahim Can; Sarıkaya, Ahmet Furkan; Tarım, Kayhan; Armutlu, Ayşe; Kulaç, İbrahim; Barçın, Erinç; Falay, Fikri Okan; Kordan, Yakup; Baydar, Dilek Ertoy; Balbay, Mevlana Derya; Esen, Tarık; Doctor; Faculty Member; Faculty Member; Faculty Member; Doctor; Researcher; Researcher; Teaching Faculty; Faculty Member; Undergraduate Student; Teaching Faculty; Faculty Member; Faculty Member; Faculty Member; Faculty Member; N/A; School of Medicine; 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; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; N/A; N/A; N/A; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; 350876; 116202; 169993; N/A; 327615; 327605; 133567; 170305; N/A; 246484; 157552; 8025; 153320; 50536We evaluated and described the impact of prostatic indocyanine green (ICG) injection on extended pelvic lymph node (LN) dissection (ePLND) in robotic-assisted radical prostatectomy (RARP). Between January 2019 and December 2021, we included consecutive 50 PCa patients who underwent ePLND during RARP with (n = 25) or without (n = 25) prostatic ICG injection. ICG injection was performed during abdominal port placement and robot docking. Pelvic LNs reflecting green color were initially excised and then the template was completed. The outcomes of two groups were compared. Overall, nine (36%) and five (20%) of the patients had metastatic LN involvement in the ICG and non-ICG groups, respectively. Of the 509 dissected LNs in the ICG group, 122 (23.9%) were fluorescence active. 20 LNs (3.9%) were metastatic in this group, 9 (45%) of which were ICG+. 408 LNs were resected on the non-ICG group with 8(1.9%) being metastatic. Eight (88.9%) of nine pN+ patients were florescent positive in the ICG group. Out of six patients with pN+ disease, Ga68 PSMA-PET/CT detected positive LNs preoperatively. In addition to preoperative Ga68 PSMA-PET/CT investigation, ICG-guided ePLND might increase identification and removal of metastatic LNs duirng RARP. Improvements in staging and oncologic outcomes may also be seen in intermediate- and high-risk patients.Publication Metadata only The role of T2-weighted images in assessing the grade of extraprostatic extension of the prostate carcinoma(Springer, 2020) Onay, Aslihan; Ertas, Gokhan; Vural, Metin; Colak, Evrim; Bakir, Baris; Esen, Tarık; Faculty Member; School of Medicine; 50536Purpose Extraprostatic extension (EPE) is an unfavorable prognostic factor and the grade of EPE is also shown to be correlated with the prognosis of prostate cancer. The current study assessed the value of prostate magnetic resonance imaging (MRI) in measuring the radial distance (RD) of EPE and the role of T2 WI signs in predicting the grade of EPE. Materials and methods A total of 110 patients who underwent prostate MRI before radical prostatectomy are enrolled in this retrospective study. Eighty-four patients have organ confined disease and the remaining twenty-six patients have EPE all verified by histopathology. Prostate MRI examinations were conducted with 3T MRI scanner and phased array coil with the following sequences: T2 WI, T1 WI, DCE, DWI with ADC mapping, and high b-value at b = 1500 s/mm(2). The likelihood of EPE with 5-point Likert scale was assigned, several MRI features were extracted for each dominant tumor identified by using T2 WI. Tumors with Likert scales 4-5 were evaluated further to obtain MRI-based RD. The relationship between pathological and MRI-determined RD was tested. Univariate and multivariate logistic regression models were developed to detect the grade of pathological EPE. The inputs were among the 2 clinical parameters and 4 MRI features. Results There is a moderate correlation between pathological RD and MRI-determined RD (rho = 0.45, P < 0.01). In univariate and multivariate models, MRI features and clinical parameters possess varying significance levels (univariate models; P = 0.048-0.788, multivariate models; P = 0.173-0.769). Multivariate models perform better than the univariate models by offering fair to good performances (AUC = 0.69-0.85). The multivariate model that employs the MRI features offers better performance than the model employs clinical parameters (AUC = 0.81 versus 0.69). Conclusion Co-existence of T2 WI signs provide higher diagnostic value even than clinical parameters in predicting the grade of EPE. Combined use of clinical parameters and MRI features deliver slightly superior performance than MRI features alone.Publication Metadata only Gardnerella vaginalis: Is it an underestimated cause of urinary symptoms in males?(DOC Design and Informatics, 2022) Kılıç, Mert; Beşli, Yeşim; Palaoğlu, Erhan Kerim; N/A; Köseoğlu, Ersin; Esen, Tarık; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 350876; 50536Objective: This study aimed to investigate the detection rate of Gardnerella vaginalis by multiplex PCR test in the genitourinary samples of male patients with suspected urethritis and related symptoms. Materials and Methods: A total of 144 male patients who presented to our department between February 2021 and October 2021, either with urinary symptoms or concerns following unprotected sex, were included in the study. A total of 128 (88.9%) first-void urine samples, 15 (10.4%) urethral swabs, and one (0.7%) semen sample were obtained. NeoPlex STI-14 Detection Multiplex PCR Kit (GeneMatrix Inc. Seongnam, South Korea) was used to investigate any of the following pathogens: Candida albicans, Chlamydia trachomatis, G. vaginalis, Mycoplasma genitalium, Mycoplasma hominis, Neisseria gonorrhoeae, Trichomonas vaginalis, Ureaplasma parvum, Ureaplasma urealyticum, herpes simplex virus type 1 (HSV-1), herpes simplex virus type 2 (HSV-2), Treponema pallidum, Streptococcus agalactiae, and Haemophilus ducreyi. The patients with positive results for G. vaginalis were retrospectively analyzed. Results: The patients’ median age was 37 (range: 21 to 71 years old). G. vaginalis was the most frequently detected microorganism (n=23; 15.9%). Other microorganisms found in order of frequency were U. urealyticum (n=19; 13.2%), U. parvum (n=15; 10.4%), C. trachomatis (n=11; 7.6%), M. genitalium (n=8; 5.6%), HSV-2 (n= 7; 4.9%), N. gonorrhoeae (n=6; 4.2), HSV-1 (n=2; 1.4%), M. hominis (n=1, 0.7%), and C. albicans (n=1, 0.7%). Fifteen patients (65%) were positive for one or two microbial agents together with G. vaginalis, while in eight patients (35%), G. vaginalis was the only isolated agent. Six of these eight patients and 14 of the remaining 15 were symptomatic. Conclusion: With the introduction of multiplex PCR tests, including those for G. vaginalis, we can expect a higher detection rate of these species of bacteria in male genitourinary samples, which could be the cause of unexplained urinary/urethral symptoms.Publication Metadata only The role of the size and number of index lesion in the diagnosis of clinically significant prostate cancer in patients with PI-RADS 4 lesions who underwent in-bore MRI-guided prostate biopsy(Springer, 2023) Kilic, Mert; Madendere, Serdar; Vural, Metin; N/A; Köseoğlu, Ersin; Esen, Tarık; Balbay, Mevlana Derya; Faculty Member; Faculty Member; Faculty Member; School of Medicine; School of Medicine; School of Medicine; 350876; 50536; 153320Purpose To evaluate the contribution of the size and number of the sampled lesions to the diagnosis of clinically significant prostate cancer (CSPC) in patients who had PI-RADS 4 lesions. Methods In this retrospective study, a total of 159 patients who had PI-RADS 4 lesions and underwent In-bore MRI-Guided prostate biopsy were included. Patients with a lesion classified as Grade Group 2 and above were considered to have CSPC. Univariate and multivariate regression analyses were used to evaluate the factors affecting the diagnosis of prostate cancer (PCa) and CSPC. Results A great majority (86.8%) of the patients were biopsy-naive. About three-fourths (71.7%) had PCa, and half (54.1%) had CSPC. When the patients were divided into three groups according to the index lesion size (< 5 mm, 5-10 mm, and > 10 mm), the prevalence of PCa was 64.3, 67.5, and 82.4% and the prevalence of CSPC was 42.9, 51.2, and 64.7%, respectively. In multivariate analysis, age, index lesion size, prostate volume (< 50 ml) and being biopsy-naive were found significant for PCa, while age and prostate volume (< 50 ml) were significant for CSPC. Conclusion The number of lesions was found to be insignificant in predicting PCa and CSPC. While the size of PI-RADS 4 lesions was significant in predicting PCa, it had no significance in detecting CSPC.Publication Metadata only Is robotic transperitoneal partial nephrectomy safe in the management of cystic renal cell masses? Outcomes of an ERUS multicenter study including 216 patients(ELSEVIER, 2021) Mottrie, A.; Challacombe, B.; Montorsi, F.; Ener, K.; Ploumidis, A.; Larcher, A.; Decaestecker, K.; De Luyk, N.; Buffi, N.; Uleri, A.; Gallina, A.; De Naeyer, G.; Guazzoni, G.; Fernando, A.; Briganti, A.; Cestari, A.; Catterwell, R.; Van Praet, C.; Capitanio, U.; Pappas, A.; N/A; Canda, Abdullah Erdem; Kordan, Yakup; Esen, Tarık; Balbay, Mevlana Derya; Faculty Member; Faculty Member; Faculty Member; Faculty Member; N/A; School of Medicine; School of Medicine; School of Medicine; School of Medicine; N/A; 116202; 157552; 50536; 153320N/APublication Metadata only Can SUVmax values of Ga-68-PSMA PET/CT scan predict the clinically significant prostate cancer?(Lippincott Williams and Wilkins (LWW), 2019) Demirci, Emre; Kabasakal, Levent; Sahin, Onur E.; Akgun, Elife; Gultekin, Mehmet Hamza; Doganca, Tunkut; Tuna, Mustafa B.; Obek, Can; Kural, Ali R.; Kılıç, Mert; N/A; Esen, Tarık; Faculty Member; School of Medicine; 50536Purpose The intensity of prostate-specific membrane antigen (PSMA) expression increases as the tumor grade increases and the uptake of Ga-68-PSMA is higher in high-grade tumors. The aim of the present study was to evaluate the correlation of preoperative tracer uptake of primary tumor to Gleason Score in patients who underwent prostatectomy. Patients and methods We retrospectively evaluated 141 patients who had Ga-68-PSMA positron emission tomography/computed tomography (PET/CT) imaging and who underwent prostatectomy. All patients had a diagnosis of prostate cancer on the basis of 10-24 cores transrectal ultrasound-guided biopsy (TRUS-Bx). Histological assessment was performed according to the New Contemporary Prostate Cancer Grading System. All patients had a prostate-specific antigen (PSA) level measurement within maximum of 28 days before Ga-68-PSMA PET/CT. Region of interests were drawn manually around the prostate gland, avoiding the bladder activity, to calculate the maximum standardized uptake values (SUVmax) values. Results The median PSA values for all patients were 10.0 ng/ml. PSA values for low-risk patients were significantly lower than those of high-risk patients (P<0.001). There were 41.1% upgrades and 7.8% downgrades following prostatectomy in terms of Grade Groups. According to the final pathology reports, 21% (n=16) of patients moved from a low-risk level (grade groups 1+2) to a high-risk level (grade groups 3+4+5). The median SUVmax value was 8.8, ranging from 2.1 to 62.4. There was a strong correlation between SUVmax values and grade groups (Pearson rho=0.66) (P<0.001). The mean SUVmax values of high-risk patients were significantly higher than those of low-risk patients (18.9 +/- 12.1 vs. 7.16 +/- 6.2, respectively) (P<0.001). Receiver operation characteristic curve analysis of SUVmax at the cut-off value of 9.1 showed a high sensitivity (78%) and specificity (81%) for detection of high risk disease. Conclusion SUVmax values correlate significantly with the grade groups of the primary tumor. The intraprostatic accumulation sites may predict clinically significant cancer and potentially serve as a target for biopsy sampling in conjunction with mpMRI in selected patients.Publication Metadata only Staged, open, no-ischemia nephron-sparing surgery for bilateral-multiple kidney tumors in a patient with Birt-Hogg-Dube Syndrome(Hindawi Ltd, 2012) Tefekli, Ahmet; Akkaya, Ayşe Deniz; Peker, Kamil; Gümüş, Terman; Vural, Metin; Cezayirli, Fatin; Musaoğlu, Ahmet; Esen, Tarık; Faculty Member; School of Medicine; 50536Hereditary kidney cancer patients with bilateralmultiple kidney tumors represent challenges in the era of rapidly growing minimal invasive treatment techniques. Birt-Hogg-Dube Syndrome (BHDS) is an autosomal dominant genodermatosis characterized by a triad of benign skin tumors (fibrofolliculomas, trichodiscomas, acrochordons) together with an increased risk of developing malignant renal tumors and pulmonary disease such as pneumothoraces and multiple lung cysts. The morbidity and mortality of the affected patients is determined by the presence of the kidney tumors, which tend to be multifocal and bilateral, as observed in other hereditary kidney cancer syndromes like von Hippel-Lindau disease, familial leiomyomatosis, and hereditary papillary renal cell carcinoma. Herein, a patient with BHDS, presenting with synchronous bilateral multiple kidney tumors, is reported. The report describes the management of kidney tumors with two-stage open nephron-sparing surgery in which the nonvascular clamping technique was utilized.Publication Metadata only Local salvage treatment of post-brachytherapy recurrent prostate cancer via theranostic application of PSMA-labeled lutetium-177(CIG Media Group, Lp, 2018) Uçar, Burcu; N/A; N/A; N/A; N/A; N/A; Demirkol, Mehmet Onur; Kiremit, Murat Can; Acar, Ömer; Falay, Fikri Okan; Esen, Tarık; Faculty Member; Faculty Member; Faculty Member; Teaching Faculty; Faculty Member; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; 108964; 222920; 237530; 246484; 50536Both radical prostatectomy (RP) and radiotherapy (RT) are effective treatment alternatives of localized prostate cancer (PCa). However, 10% to 50% and 20% to 65% of the patients will experience biochemical recurrence within 15 years following RP and RT, respectively. According to the results of watchful waiting policy, the median time from biochemical recurrence to development of distant metastases is 3 years, more or less, which pushes clinicians to apply further curative local salvage therapy (LST). LST via various surgical (salvage RP) and non-surgical (high-intensity focused ultrasound, re-brachytherapy, cryotherapy, etc.) options can be offered in this setting. We present a case of locally recurrent PCa after brachytherapy. Considering our patients' body habitus, relatively young age, and marital status (just recently married), sexual side effects of androgen deprivation therapy, local adhesions induced by brachytherapy and prior abdominopelvic surgeries, the lack of institutional experience on cryotherapy/high-intensity focused ultrasound, and the risk of metastatic progression associated with watchful waiting, theranostic application of lutetium-177-labeled prostate-specific membrane antigen imaging and therapy was offered. To the best of our knowledge, this case represents the first example of the successful theranostic application of lutetium-177-labeled prostate-specific membrane antigen, as a LST option in the setting of locally recurrent PCa following curative intent brachytherapy for organ-confined PCa. (C) 2017 Elsevier Inc. All rights reserved.Publication Metadata only Radical nephroureterectomy for UTUC conferred survival benefits irrespective of age and comorbidities(Springer, 2022) Teoh, Jeremy Yuen-Chun; Ng, Chi-Fai; Eto, Masatoshi; Chiruvella, Mallikarjuna; Capitanio, Umberto; Zeng, Guohua; Lechevallier, Eric; Andonian, Sero; de la Rosette, Jean; N/A; Esen, Tarık; Faculty Member; N/A; School of Medicine; N/A; 50536Purpose We investigated the effects of age, American Society of Anesthesiologists Physical Status Classification (ASA) grading and Charlson Comorbidity Index (CCI) on the survival outcomes of upper tract urothelial carcinoma (UTUC). Methods The CROES-UTUC registry was an international, multicenter study on patients with UTUC. Primary outcomes were overall survival (OS) and disease-free survival (DFS). Kaplan-Meier and multivariate Cox regression analyses were performed by stratifying patients according to their age (<= 70 and > 70 years old) and ASA grade (I-II and III-V)/CCI (0-1 and >= 2). Results A total of 2352 patients were included in this study. Patients aged <= 70 years with ASA grading of I-II (p = 0.002), and patients aged <= 70 years with a CCI of 0-1 (p = 0.002) had the best OS. Upon multivariate analysis, both in patients aged <= 70 and > 70 years, ASA grading and CCI were not significantly associated with OS. Patients aged <= 70 years with ASA grading of III-IV (p = 0.024) had the best DFS. When stratified according to age and CCI, no significant difference in DFS was noted. Upon multivariate analysis, radical nephroureterectomy (RNU) was significantly associated with better DFS in patients aged <= 70 and > 70 years; CCI of >= 3 was significantly associated with worse DFS in patients <= 70 years; ASA grading was not associated with DFS in patients aged <= 70 and > 70 years. Conclusions A high ASA grading and CCI should not be considered contraindications for RNU. RNU should be considered even in elderly patients when it is deemed feasible and achievable after a geriatric assessment.