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            <front>

                <journal-meta>
                                    <journal-id></journal-id>
            <journal-title-group>
                                                                                    <journal-title>Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi</journal-title>
            </journal-title-group>
                            <issn pub-type="ppub">1304-6187</issn>
                                                                                                        <publisher>
                    <publisher-name>Ankara EAH</publisher-name>
                </publisher>
                    </journal-meta>
                <article-meta>
                                        <article-id pub-id-type="doi">10.20492/aeahtd.1293748</article-id>
                                                                <article-categories>
                                            <subj-group  xml:lang="en">
                                                            <subject>Clinical Sciences</subject>
                                                    </subj-group>
                                            <subj-group  xml:lang="tr">
                                                            <subject>Klinik Tıp Bilimleri</subject>
                                                    </subj-group>
                                    </article-categories>
                                                                                                                                                        <title-group>
                                                                                                                        <article-title>Kolorektal Kanser Tanılı Hastaların Karaciğer Metastazlarında Klinik                 Deneyimlerimiz: Cerrahinin Etkinliğinin Önemi</article-title>
                                                                                                                                                                                                <trans-title-group xml:lang="en">
                                    <trans-title>Our Clinical Experiences for Patients Having Colorectal Cancer With Liver Metastases: Importance of Efficient Resection</trans-title>
                                </trans-title-group>
                                                                                                    </title-group>
            
                                                    <contrib-group content-type="authors">
                                                                        <contrib contrib-type="author">
                                                                    <contrib-id contrib-id-type="orcid">
                                        https://orcid.org/0009-0005-8908-3993</contrib-id>
                                                                <name>
                                    <surname>Bulbuloglu</surname>
                                    <given-names>Guney Cem</given-names>
                                </name>
                                                                    <aff>Adana Kozan Devlet Hastanesi</aff>
                                                            </contrib>
                                                    <contrib contrib-type="author">
                                                                    <contrib-id contrib-id-type="orcid">
                                        https://orcid.org/0009-0001-5242-8725</contrib-id>
                                                                <name>
                                    <surname>Bozkurt</surname>
                                    <given-names>Ahmet Çağlar</given-names>
                                </name>
                                                                    <aff>Adana Kozan Devlet Hastanesi</aff>
                                                            </contrib>
                                                    <contrib contrib-type="author">
                                                                    <contrib-id contrib-id-type="orcid">
                                        https://orcid.org/0000-0001-9500-4175</contrib-id>
                                                                <name>
                                    <surname>Kekeç</surname>
                                    <given-names>Yalçın</given-names>
                                </name>
                                                                    <aff>ÇUKUROVA ÜNİVERSİTESİ TIP FAKÜLTESİ</aff>
                                                            </contrib>
                                                                                </contrib-group>
                        
                                        <pub-date pub-type="pub" iso-8601-date="20240121">
                    <day>01</day>
                    <month>21</month>
                    <year>2024</year>
                </pub-date>
                                        <volume>56</volume>
                                        <issue>3</issue>
                                        <fpage>160</fpage>
                                        <lpage>163</lpage>
                        
                        <history>
                                    <date date-type="received" iso-8601-date="20230611">
                        <day>06</day>
                        <month>11</month>
                        <year>2023</year>
                    </date>
                                                    <date date-type="accepted" iso-8601-date="20231014">
                        <day>10</day>
                        <month>14</month>
                        <year>2023</year>
                    </date>
                            </history>
                                        <permissions>
                    <copyright-statement>Copyright © 2003, Medical Journal of Ankara Training and Research Hospital</copyright-statement>
                    <copyright-year>2003</copyright-year>
                    <copyright-holder>Medical Journal of Ankara Training and Research Hospital</copyright-holder>
                </permissions>
            
                                                                                                <abstract><p>Giriş ve Amaç: Kolorektal kanserler, en sık görülen kanser türleri arasında üçüncü sırada yer almaktadır. Klinik seyir sırasında hastaların yaklaşık olarak % 50-60’ında senkron veya metakron uzak metastaz gelişmektedir. Bunlar arasında karaciğer metastazları önemli bir yer tutmaktadır. Kolorektal kanserlerin karaciğer metastazlarının cerrahi rezeksiyonu, hastalıksız sağkalım ve genel sağkalım oranlarını anlamlı düzeyde uzatmakta ve bu nedenle son yıllarda giderek geniş bir uygulama alanı bulmaktadır. Bu              çalışmayla kliniğimizde karaciğer metastazı nedeniyle karaciğer rezeksiyonu uygulanan kolorektal kanser tanılı hastalarda retrospektif bir araştırma yaparak karaciğer  rezeksiyonun genel sağkalım üzerine etkilerini araştırmayı amaçladık.Gereç ve Yöntem: Araştırmada, üniversitemiz Tıp Fakültesi Hastanesi’nde kolorektal kanserlere bağlı karaciğer metastazları nedeniyle karaciğer operasyon uygulanan %47,6’si erkek, %52,4’ü kadın olmak üzere toplam kırk iki hastanın retrospektif olarak değerlendirilmesi ile yapılmıştır. Hasta dosyalarından demografik verilerin yanı sıra patoloji, laboratuvar ve radyolojik tetkikler, aldıkları kemoterapi oranları, primer tümöre, metastaza yönelik uygulanan cerrahi tedavilere ve sağ kalımlara ait veriler elde edilmiş, veriler ki-kare, Mann Whitney-U testi ve Student-t testi kullanılarak değerlendirilmiştir.Bulgular: Olguların ortalama yaşı 56,5 (31-86) idi. Hastaların   %76,2’sının  primer tanısı kolon kanseri iken %23,8’inin primer tanısı rektum karsinomu idi. Hastaların %73,8’inde metakron tümör, %26,2’sında senkron tümör saptanmıştır. Hastaların %42,9’na sağ hepatektomi, %16,7’sına sol hepatektomi, %26,2’sine metastazektomi ve %14,2’sine segmentektomi+metastazektomi ameliyatları uygulanmıştır. Hastaların %73,8’ine R0 rezeksiyon, %14,2’sine R1 rezeksiyon ve %12’sine R2 rezeksiyon yapılmıştır. Ortalama yaşam süreleri incelendiğinde; hastaların %4,8’inin ameliyattan sonraki ilk 12 ayda, %16,7’sinin 12-24 ay sonra, %35,7’sinin 24-60 ay sonra vefat ettiği saptanmıştır. Çalışma yapılırken hastaların %42,8’sinin halen sağ olduğu tespit edilmiştir.  Sonuç: Çalışmamızın sonuçları kolorektal kanser karaciğer metastazlarının cerrahi rezeksiyonunun, genel sağkalım süresinin uzamasına katkı sağladığını göstermektedir. Literatür bilgilerini desteklemektedir. Özellikle R0 rezeksiyon uygulanması ve neoadjuvan kemoterapiye yanıt elde edilmesi tedavide önemli bir yer tutmaktadır.</p></abstract>
                                                                                                                                    <trans-abstract xml:lang="en">
                            <p>Introduction and Purpose: Colorectal cancer is the third most seen cancer type among all cancer types. During clinical course, synchron or metachron distant metastasis occurs at approximately 50-60% of all patients. Liver metastasis is one of the most outstanding among those. Surgical resection on liver metastasis of colorectal cancers prolongs the ratio of non-disease survivals or general survivals at a significant level; and  thus, it is applied at a wider scope recently. With this retrospective study, we aimed to observe effects of liver resection on overall survivals of the patients      with colorectal cancer who had liver resection due to liver metastasis at our clinic.Materials and Method: The study was conducted by retrospectively evaluating a total of forty-two patients, 47.6% male and 52.4% female, who underwent liver surgery due to liver metastases due to colorectal cancers at the Faculty of Medicine Hospital of our university. The demographic data derived from patients records; patology, laboratory and   radiological examinations, chemotherapy rates, surgical treatments for primary tumor and metastasis, and survival data were also acquired, and data were evaluated using chi-square, Mann Whitney-U test and Student-t tests.Results: While the primary diagnosis of 76.2% of the patients was colon cancer, the primary diagnosis of 23.8% was rectal carcinoma. Metachronous tumors were detected in 73.8% of the patients and synchronous tumors in 26.2% of them. Right hepatectomy was performed in 42.9%, left hepatectomy in 16.7%, metastasectomy in 26.2% and segmentectomy+metastasectomy in 14.2% of patients. R0 resection was performed in 73.8% of the patients, R1 resection in 14.2% and R2 resection in 12%. When the average life span is examined; it was determined that 4.8% of the patients died in the first 12 months after the operation, 16.7% after 12-24 months, 35.7% after 24-60 months. During the study, it was determined that 42.8% of the patients were still alive.Conclusion: The results of our study show that surgical resection of colorectal cancer liver metastases contributes to prolonging the overall survival time. It supports literature information. In particular, R0 resection and response to neoadjuvant chemotherapy have an important place in treatment.</p></trans-abstract>
                                                            
            
                                                            <kwd-group>
                                                    <kwd>kolorektal kanser</kwd>
                                                    <kwd>  karaciğer metastazı</kwd>
                                                    <kwd>  karaciğer rezeksiyonu</kwd>
                                                    <kwd>  Ro rezeksiyon</kwd>
                                                    <kwd>  sağkalım</kwd>
                                            </kwd-group>
                                                        
                                                                            <kwd-group xml:lang="en">
                                                    <kwd>colorectal cancer</kwd>
                                                    <kwd>  liver metastases</kwd>
                                                    <kwd>  hepatic resection</kwd>
                                                    <kwd>  R0 resection</kwd>
                                                    <kwd>  survival</kwd>
                                            </kwd-group>
                                                                                                            </article-meta>
    </front>
    <back>
                            <ref-list>
                                    <ref id="ref1">
                        <label>1</label>
                        <mixed-citation publication-type="journal">1-Steven K. Libutti, Leonard B. Saltz, Anil K. Rustgi, Joel E. Tepper
Cancers of the Gastrointestinal Tract: Section 8: Cancer of the Colon.
In Devita (eds). Principles and Practice of Oncology. 7 th edition, Philadelphia,
Lippincot Williams and Wilkins, 2005, pp 1061-1109.</mixed-citation>
                    </ref>
                                    <ref id="ref2">
                        <label>2</label>
                        <mixed-citation publication-type="journal">2-Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2007. CA Cancer
J Clin 2007;57:43-66).</mixed-citation>
                    </ref>
                                    <ref id="ref3">
                        <label>3</label>
                        <mixed-citation publication-type="journal">3-Kemeny N, Fata F. Arterial, portal, or systemic chemotherapy for
patients with hepatic metastasis of colorectal carcinoma. J Hepatobiliary
Pancreat Surg 1999, 6:39-49</mixed-citation>
                    </ref>
                                    <ref id="ref4">
                        <label>4</label>
                        <mixed-citation publication-type="journal">4-Stangl R, Altendorf-Hofmann A, Charnley RM, Scheele J. Factors
influencing the natural history of colorectal liver metastases. Lancet
1994; 343: 1405–1410.</mixed-citation>
                    </ref>
                                    <ref id="ref5">
                        <label>5</label>
                        <mixed-citation publication-type="journal">5-Günel N, Yamaç D, Akçalı Z, Taneri F, Oğuz M. The clinico-pathologic
characteristics of colorectal cancer under 50 years of age; experience
of an oncology center. Tumori 2001; 87;2: 74-77.</mixed-citation>
                    </ref>
                                    <ref id="ref6">
                        <label>6</label>
                        <mixed-citation publication-type="journal">6- Van Cutsem, E., Cervantes, A., Adam, R. et al(2016). ESMO consensus
guidelines for the management of patients with metastatic
colorectal cancer. Annals of Oncology, 2016, 27(8), 1386-1422.</mixed-citation>
                    </ref>
                                    <ref id="ref7">
                        <label>7</label>
                        <mixed-citation publication-type="journal">7-Fong Y. Surgical therapy of hepatic colorectal metastasis. CA Cancer
J Clin 1999;49: 231-255</mixed-citation>
                    </ref>
                                    <ref id="ref8">
                        <label>8</label>
                        <mixed-citation publication-type="journal">8-Jacobson RA, Bhama AR. Evaluation and Management of Colorectal
Cancer Hepatic Metastases. Dis Colon Rectum. 2021 Jul
1;64(7):777-780. doi: 10.1097/DCR.0000000000002103. PMID:
33872286.</mixed-citation>
                    </ref>
                                    <ref id="ref9">
                        <label>9</label>
                        <mixed-citation publication-type="journal">9-McNally SJ, Parks RW. Surgery for colorectal liver metastases. Dig
Surg. 2013;30(4-6):337-47. doi: 10.1159/000351442. Epub 2013</mixed-citation>
                    </ref>
                                    <ref id="ref10">
                        <label>10</label>
                        <mixed-citation publication-type="journal">10-Yamamoto J, Shimada K, Kosuge T, Yamasaki S, Sakamoto M, Fukuda
H. Factors influencing survival of patients undergoing hepatectomy
for colorectal metastases. Br J Surg 1999;86:332- 337.</mixed-citation>
                    </ref>
                                    <ref id="ref11">
                        <label>11</label>
                        <mixed-citation publication-type="journal">11-Hurwitz H, Fehrenbacher L, Cartwright T et al. Bevacizumab (a
monoclonal antibody to vascular endothelial growth factor) prolongs
survival in first-line colorectal cancer (CRC): Results of a phase III trial
of bevacizumab in combination with bolus IFL (irinotecan, 5-fluorouracil,
leucovorin) as first-line therapy in subjects with metastatic CRC.
Proc Am Soc Clin Oncol 2003; 22: (Abstr 3646).</mixed-citation>
                    </ref>
                                    <ref id="ref12">
                        <label>12</label>
                        <mixed-citation publication-type="journal">12-Adam R, Avisar E, Ariche A et al. Five-year survival following hepatic
resection after neoadjuvant therapy for nonresectabl colorectal
cancer. Ann Surg Oncol 2001;8: 347-353.</mixed-citation>
                    </ref>
                                    <ref id="ref13">
                        <label>13</label>
                        <mixed-citation publication-type="journal">13-Iwatsuki S, Starzi T,. Personal experience with 411 hepatic resections.
Ann Surg 1988;208:421-32</mixed-citation>
                    </ref>
                                    <ref id="ref14">
                        <label>14</label>
                        <mixed-citation publication-type="journal">14-Tsai M, Su Y, Ho M,et al. Clinicopathological features and prognosis
in respectable synchronous and metachronous colorectal liver
metastases. Ann Surg Oncol.2007;14;786-794.</mixed-citation>
                    </ref>
                                    <ref id="ref15">
                        <label>15</label>
                        <mixed-citation publication-type="journal">15-Bostancı M. , Yılmaz İ. , Seki A. , Saydam M. , Koşmaz K. , Kaya İ. O.
Senkron kolorektal tümörler: klinik deneyimlerimiz. Ankara Eğitim ve
Araştırma Hastanesi Tıp Dergisi. 2020; 53(3): 183-187.</mixed-citation>
                    </ref>
                                    <ref id="ref16">
                        <label>16</label>
                        <mixed-citation publication-type="journal">16-Muratore A, Zorzi D, Bouzari H, et al. Asemptomatic colorectal
cancer with unresectable liver metastases: immediate colorectal
resection or up-front systemic chemotherapy? Ann Surg Oncol.
2007;14:766-770.</mixed-citation>
                    </ref>
                                    <ref id="ref17">
                        <label>17</label>
                        <mixed-citation publication-type="journal">17-Baddi L, Benson A, 3rd. Adjuvant therapy in stage II colon cancer:
Current Approaches. Oncologist. 2005;10:325-331.</mixed-citation>
                    </ref>
                                    <ref id="ref18">
                        <label>18</label>
                        <mixed-citation publication-type="journal">18-Ensminger WD, Gyves JW. Clinical pathology of hepatic arterial
chemotherapy. Semin Oncol 1983; 10:176-82.</mixed-citation>
                    </ref>
                                    <ref id="ref19">
                        <label>19</label>
                        <mixed-citation publication-type="journal">19-Hughes K, Scheele J, Sugarbaker PH. Surgery for colorectal
cancer metastatic to the liver.
Optimizing the results of treatment. Surg Clin North Am 1989; 69: 39-
359.</mixed-citation>
                    </ref>
                                    <ref id="ref20">
                        <label>20</label>
                        <mixed-citation publication-type="journal">20-Adson MA, Van Heerden JA, Adson MH. Resection of hepatic metastases
from colorectal cancer. Arch Surg 1984; 119:647-51.</mixed-citation>
                    </ref>
                                    <ref id="ref21">
                        <label>21</label>
                        <mixed-citation publication-type="journal">21-Ohlsson B, Stenram U, Tranberg KG. Resection of colorectal liver
metastases: 25-year experience. World J Surg 1998; 22:268-77.</mixed-citation>
                    </ref>
                                    <ref id="ref22">
                        <label>22</label>
                        <mixed-citation publication-type="journal">22-Fong Y, Fortner J, Sun RL, Brennan MF, Blumgart LH. Clinical score
for predicting recurrence after hepatic resection for metastatic colorectal
cancer. Analysis of 1001 consecutive cases. Ann Surg 1999;
230:309-21.</mixed-citation>
                    </ref>
                                    <ref id="ref23">
                        <label>23</label>
                        <mixed-citation publication-type="journal">23-Jacobs M, Mc Donough J, Remine SG. Resection of central hepatic
malignant lesions. Am Surg 2003;69:189-190.</mixed-citation>
                    </ref>
                                    <ref id="ref24">
                        <label>24</label>
                        <mixed-citation publication-type="journal">24-Blumgart LH.Liver resection for benign disease and for liver and
biliary tumos: Hepatic resection. In: Surgery of the Liver and Biliary
Trach (Blumgart LH, Fong Y,eds). Vol:2,3th ed. Philadelphia:W.B. Saunders,
2000:1639-713</mixed-citation>
                    </ref>
                                    <ref id="ref25">
                        <label>25</label>
                        <mixed-citation publication-type="journal">25- Morris VK, Kennedy EB, Baxter NN, et al Treatment of Metastatic
Colorectal Cancer: ASCO Guideline. J Clin Oncol. 2023 Jan
20;41(3):678-700. doi: 10.1200/JCO.22.01690. Epub 2022 Oct 17.
PMID: 36252154.</mixed-citation>
                    </ref>
                            </ref-list>
                    </back>
    </article>
