Cytoreductive Surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are techniques developed for curative treatment of peritoneal carcinomatosis (PC). Studies have shown that CRS + HIPEC provides a survival advantage in PC, and long-term survival can be achieved in selected cases. This study aimed to evaluate CRS + HIPEC cases performed for curative purposes and to examine the prognostic factors. PC patients who underwent CRS + HIPEC with curative intent between January 2011 and September 2022 were included. Demographic, clinical, and pathological findings, procedure-specific parameters, complications, mortality, progression-free survival (PFS), and overall survival (OS) were analyzed. Optimal cytoreduction was achieved in 70% of the patients. The median PFS for the entire series was 9.2 months, while the median OS was 20.5 months, with a 3-year OS rate of 36%. Appendiceal origin, cytoreduction score, absence of lymph node metastasis, and absence of complications were factors associated with a positive impact on both PFS and OS. In multivariate analysis, cytoreduction score emerged as the sole independent factor influencing both PFS and OS. Considering the results in our series, cases of PC in which complete cytoreduction can be achieved should be evaluated for CRS + HIPEC.

Background: Laparoscopic cholecystectomy (LC) is one of the most frequently performed operations in surgical practice. Despite increasing experience and technological advances, conversion to open surgery is still necessary in some cases. Although several studies have identified factors associated with increased risk of conversion, debates continue in the literature. This study aimed to evaluate the factors affecting the risk of conversion to open cholecystectomy. Materials and Methods: Patients who underwent surgery for cholelithiasis between 2020 and 2023 were analyzed retrospectively. Patients who underwent open cholecystectomy, those who had cholecystectomy as part of another surgical procedure, and patients with gallbladder malignancy (except incidental cases) were excluded from the study. Patients were analyzed based on demographic, clinical, laboratory, radiological, and histopathological data. This study was registered at ClinicalTrials.gov (NCT06244589). Results: A total of 1695 patients were included in the study. The median age was 50 years, and 66.6% of patients were female. Conversion from LC to open surgery occurred in 44 patients (2.6%). Multivariate analysis identified male sex, a history of major abdominal surgery, the need for emergency surgery due to acute cholecystitis, an elevated leukocyte count, and gallbladder wall thickening on abdominal ultrasonography as independent risk factors for conversion to open cholecystectomy. Conclusion: Male gender, previous major abdominal surgery, emergency surgery due to acute cholecystitis, high leukocyte count, and gallbladder wall thickening on abdominal ultrasonography are independent risk factors for conversion from LC to open surgery. It should be kept in mind in the treatment of patients planned for LC.

Background: Subtotal gastrectomy is frequently performed for distally located gastric tumors and carries a lower risk of postoperative complications compared to total gastrectomy. However, due to the submucosal spread pattern and worse prognosis of poorly cohesive carcinoma (PCC), some authors advocate for routine total gastrectomy. This study aimed to compare the outcomes of subtotal versus total gastrectomy in patients with mid- and distal-located gastric PCC. Methods: This single-center retrospective study included patients who underwent resection for gastric PCC between 2012 and 2024. Exclusion criteria were systemic metastasis, palliative surgery, and tumors located in the proximal one-third of the stomach. Patients were analyzed based on demographic, clinical, pathological, and survival data. Results: A total of 154 patients were included. The median age was 62 years (range: 36–87), and 83 patients (53.9%) were male. Subtotal gastrectomy was performed in 70 patients (45.5%). The median pathological tumor diameter was 60 mm (IQR: 40–90). Over a median follow-up of 79 months, 33 locoregional and 81 systemic recurrences were observed among 146 patients, and 53 patients (36.3%) were alive at the time of last follow-up. Pathological stage was the only independent factor associated with overall survival, while the type of surgery (subtotal vs. total gastrectomy) did not significantly affect survival outcomes. Conclusion: Our study demonstrated that subtotal gastrectomy yielded oncologic outcomes similar to those achieved with total gastrectomy in mid- and distal gastric poorly cohesive carcinoma cases.

This retrospective study aimed to compare patients eligible for the Z0011 study with and without axillary lymph node dissection (ALND) by overall survival (OS), disease-free survival (DFS), and loco-regional recurrence. We carried out this study with the data from early-stage breast cancer patients (T1, T2, and clinical node-negative) undergoing breast-conserving surgery (BCS) and receiving adjuvant systemic therapy (chemotherapy or endocrine therapy) and adjuvant radiotherapy after sentinel lymph node biopsy (SLNB) at Ankara Oncology Hospital between January 2018–2024. We screened the data from a total of 1,218 patients and selected 126 patients with ALND and 67 patients without ALND. All selected patients satisfied the Z0011 criteria. We excluded mastectomy and metastatic patients, those without SLNB, patients with more than two positive lymph nodes, and those receiving neoadjuvant chemotherapy. Then, we compared groups by OS, DFS, and locoregional recurrence. While the 5-year overall survival was 98.5% (95% CI, 95.8–100.0%) in the Z0011 group, it was 95.2% (95% CI, 92.1–98.3%) in the Z0011-eligible group. The 5-year DFS rate was 97.0% (95% CI, 92.0–99.0%) and 94.4% (95% CI, 91.2–97.0%) in the groups, respectively. We did not discover recurrence in the axial lymph nodes and breast at a mean follow-up of 69 months (67.46–70.43). In summary, the present study demonstrated that the omission of ALND does not exert any significant influence on OS, DFS, and locoregional recurrence among patients satisfying the ACOSOG Z0011 criteria.