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Yayın Accelerated treatment of concomitant empyema and lung cancer by video-assisted thoracoscopic surgery(ELSEVIER DOYMA SL, 2016) Eryigit, Hatice; Orki, Alpay; Unaldi, Mehmet; Ozdemir, Attila; Orki, Tulay; Kosar, Altug; Demirhan, Recep; Arman, BulentBackground: The most common cause of pleural empyema are parapneumonic effusions, and lung cancer is a rare cause of empyema. The aim of the present study is to analyse the results of the thoracoscopic treatment of empyema before definitive oncological treatment. Methods: Retrospective descriptive study of 332 patients including different clinical variables between 2002 and 2010. Results: Among 332 patients with empyema, the etiology of this disease was lung cancer in 11 patients. Ten of these patients were male and one was female (median age, 57.9 years; range, 46-76). The initial treatment was tube thoracostomy in 8 patients and video-assisted thoracoscopic surgery in 3 patients. Thoracoscopic debridement was performed in 4 patients whose tube thoracostomy underperformed because of insufficient drainage. The methods used for diagnosis of lung cancer were fiberoptic bronchoscopy and video-assisted thoracoscopic surgery. Surgical resection was performed on 7 suitable patients following infection control. Postoperative bronchopleural fistula and empyema occurred after pneumonectomy in one case. No operative mortality was observed. The mean survival time was 32.8 months for patients undergoing resection. Conclusions: Empyema could be a rare presentation of lung cancer and those suitable for surgical treatment should undergo standard treatment with reasonable results. (C) 2014 AEC. Published by Elsevier Espana, S.L.U. All rights reserved.Yayın Approach to Empyema Necessitatis(SPRINGER, 2011) Akgul, Asli Gul; Orki, Alpay; Orki, Tulay; Yuksel, Mustafa; Arman, BulentThoracic empyema is a collection of pus in the pleural space. Empyema necessitatis is a rare complication of empyema, characterized by the dissection of pus through the soft tissues of the chest wall and eventually through the skin. We present nine cases of empyema necessitatis, including etiology, duration, and characteristics of clinical history, kind of surgery used, and treatment choices. In a 4-year period nine patients were treated for empyema necessitatis. Six were male and 3 female with an age range of 13-89 years (median = 40 years). Empyema necessitatis was treated with drainage and antibiotherapy or antituberculosis therapy in three patients with the diagnosis of tuberculosis or nonspecific pleuritis. Decortication of the thoracic cavity was used in three patients successfully. Others were treated with open drainage. Final diagnoses were tuberculous empyema in five patients, chronic fibrinous pleuritis in three, and squamous cell carcinoma in one. Except for two patients, one with multisystem failure and one with squamous cell carcinoma, all were discharged with no complications. Surgery plays a critical role in the management of empyema necessitatis in selected patients. Tube drainage, open drainage, and decortication are the choices in variable conditions for obliterating the cavity and regenerating pulmonary function.Yayın Bronchogenic cysts of the lung: report of 29 cases(Elsevier, 2009) Koşar, Altuğ; Tezel, Çağatay; Orki, Alpay; Kiral, Hakan; Arman, BülentBackground:Intrapulmonary bronchogenic cysts are congenital anomalies of the tracheobronchial tree and foregut.The aim of this retrospective study was to review the diagnosis, clinical and histological features, operative techniques,outcomes and follow-up of intrapulmonary bronchogenic cysts treated in a single institute.Methods:Twenty-nine patients with intrapulmonary bronchogenic cysts were treated surgically between 1990 and2005. There were 17 female and 12 male patients and their ages ranged from 7 to 68 years. Patients were divided into twogroups according to surgical procedure. Resection (lobectomy or wedge resection) was performed on Group I (n= 18),and partial excision with de-epithelisation was performed on Group II (n= 11).Results:Twenty-fivepatients(86.2%)weresymptomatic.Coughandsputumwerethemostcommonsymptoms.Twenty-four of the 29 BCs were simple cysts (82.7%) whereas 5 (17.3%) were complicated cysts. Postoperative hospital stay was4.55±0.86 days in group I and 6.54±3.34 days in group II (P= 0.172). Complications in Group I were pneumonia in onecase and wound infection in two cases; prolonged air leakage were observed in two cases of Group II. No statisticaldifference was determined between the complication rates of the two groups (P= 0.91). However a significant differencewas determined between the complication rates of simple and complicated cysts (P= 0.026). Two cases in Group II showedrecurrence, whereas no recurrence occurred in Group I. (P= 0.065) No postoperative mortality was observed in any of thegroups.Conclusions:All bronchogenic cysts should be treated surgically. We believe that partial excision with de-epithelisationmay be an alternative to resection in symptomatic patients with limited respiratory capacity.Yayın Effect of capitonnage and cystotomy on outcome of childhood pulmonary hydatid cysts(National Center for Biotechnology Information, 2006) Koşar, Altuğ; Orki, Alpay; Hacıibrahimoğlu, Gökhan; Kiral, Hakan; Arman, BülentObjective: In this clinical retrospective study cystotomy and capitonnage were compared in patients with childhood pulmonary hydatid cysts with regard to postoperative period. Methods: Between 1990 and 2004, 60 children with pulmonary hydatid cysts were treated surgically. There were 33 boys and 27 girls aged from 3 to 16 years. Cystotomy and closure of bronchial openings were performed in all patients. The patients were divided into 2 groups. While the residual cyst cavity was closed by means of capitonnage in group A (n = 37), cystotomy was applied in group B (n = 23). Results: There was no mortality in either group. Chest tubes were removed after 3.59 +/- 1.04 days in group A and 5.83 +/- 2.84 days in group B. The hospital stay was 4.86 +/- 1.43 days for group A and 7.22 +/- 3.34 days for group B. Prolonged air leak was found in 2 children in group A and 7 children in group B. There was a significant difference between group A and group B with regard to chest tube removal time (P = .001), hospital stay (P = .003), development of prolonged air leak (P = .004), and all complications (P = .031). Follow-up information was available for 49 children, ranging from 13 to 86 months (mean, 56 months). Recurrence was seen in 2 children of group A and 1 child of group B during the follow-up period (P = .698). Conclusion: Capitonnage for pulmonary hydatid cysts is superior to cystotomy because it reduces morbidity (especially prolonged air leak) and hospital stay.Yayın Extrinsic allergic alveolitis as an uncommon diagnostic pitfall in lung cytology(WILEY-BLACKWELL, 2012) Midi, Ahmet; Yener, Nese Arzu; Orki, Alpay; Cubuk, Rahmi; Ersev, AyseHouse paints, the industrial products of toxic chemicals are known to be linked with severe respiratory disturbances especially in inadequately ventilated places. In this study, we aimed to report a biopsy-proven case of extrinsic allergic alveolitis (EAA) who presented with nonspecific respiratory symptoms 1 month after having her whole house interior painted. At CT scanning, we observed the ground glass opacities and the micronodular pattern typical for EAA and also a solid, consolidative lung area, highly suggestive of malignancy. The case initially was misinterpreted as a malignant tumor both radiologically and cytologically at CT-guided transthoracic fine needle aspiration biopsy. The final pathologic diagnosis was given as EAA on frozen section performed during thoracotomy operation. The patient received short-term steroid treatment and has been doing well for the last 7 months after her operation. As a conclusion, when assessing a cytologic material from a patient who has got a solid lung mass and also a history of chemical dye exposure, consolidative mass formation which is a rare form of EAA should always be kept in mind. Another final point is that the appropriate ventilation should be achieved if the exposure with the house paint chemicals is inevitable. Diagn. Cytopathol. 2012. (c) 2011 Wiley Periodicals, Inc.Yayın Feasibility of imprint cytology for evaluation of mediastinal lymph nodes in lung cancer(National Center for Biotechnology Information, 2006) Orki, Alpay; Tezel, Çağatay; Koşar, Altuğ; Ersev, Ayşe Alp; Dudu, Canan; Arman, BülentBackground: Intraoperative evaluation of mediastinal lymph nodes is a necessary step which helps us to decide whether or not to continue the operation of lung cancer. Imprint cytology (IC) can be used as an alternative method in staging. It is a more rapid and simpler procedure than frozen section (FS) analysis. Therefore, we compared the diagnostic accuracy of IC with permanent section on 1050 mediastinal lymph nodes. Methods: A total of 255 non-small cell lung cancer patients who underwent surgical procedure between January 1995 and April 2004 were included. There were 236 males and 19 females with a mean age of 54.2 years (range 26-79 years). In order to obtain lymph node samples mediastinoscopy was performed in 232 (91%), anterior mediastinotomy in 50 (20%) and video-assisted thoracoscopic surgery in 16 (6.3%) patients. During final pathological diagnosis, both imprint and permanent section slides were compared. Results: There were five false-positive and eight false-negative results. The sensitivity, specificity and the predictive values for positive and negative results were 93.1, 99.5, 95.6 and 99.1%, respectively. The overall efficiency was 98.8%. Conclusions: The diagnostic IC is an accurate, reliable, simple and less time-consuming method for evaluation of mediastinal lymph nodes in lung cancer, compared with FS method.Yayın Idiopathic chylothorax in geriatrics: the oldest case report so far(WALTER DE GRUYTER GMBH, 2018) Ipek, Belkiz Ongen; Alasehir, Elcin Akduman; Sitar, Mustafa Erinc; Levent, Ender; Orki, AlpayChylothorax is a rare condition characterized by accumulation of chylous fluid in the pleural space resulting in impaired ductus thoracic integrity. It can be an outcome of a traumatic process, although there are a few non-traumatic and/or idiopathic cases in current literature. In this article, we present the oldest case report so for, who is an 87-year-old woman complaining of acute respiratory distress symptoms with pleural effusion having no trauma history. The patient was analyzed for the disease etiology strenuously. Thoracentesis was performed together with imaging modalities and detailed systemic laboratory tests. Non-surgical treatment was successful as the outcome.Yayın Lung cancer and pregnancy(ELSEVIER IRELAND LTD, 2013) Sariman, Nesrin; Levent, Ender; Yener, Nese Arzu; Orki, Alpay; Saygi, AttilaLung cancer in the pregnant woman is a very rare and dramatic coincidence with poor prognosis. Treatment depends on the gestational week of the pregnancy, patient's medical status, social, personal, familial, and even religious beliefs. We present a case of adenocarcinoma of the lung in a 34-year-old pregnant patient whose initial complaints were cough, dyspnea, fever and fatigue. She was diagnosed with pneumonia at another hospital, and antibiotic therapy was administered. Meanwhile, at 28 weeks she delivered a preterm low-birth-weight baby. Chest X-ray and thorax CT revealed a mass lesion in the upper left lung lobe. After admission to our clinic, needle aspiration of left supraclavicular lymph node and bronchoscopic biopsy from upper lobe bronchus showed a non-small lung cancer; adenocarcinoma. Brain MRI was normal. PET CT revealed multiple bone metastases. Multidisciplinary Tumor Committee at our hospital referred her to the Oncology Department as an advanced stage IV disease. Chemotherapy was administered with paclitaxel and carboplatin for a total of 12 weeks. Reassessment of the patient revealed new bone metastases and crizotinib was administered since her tumor was found positive for EML4-ALK mutations. The treatment was well tolerated. During a follow up period of 6 months her clinical condition was stable and no adverse events were encountered. (c) 2012 Elsevier Ireland Ltd. All rights reserved.Yayın Lung Cancer Surgery Part I: Carcinoid Tumours of the Lung(BENTHAM SCIENCE PUBL, 2013) Kosar, Altug; Orki, Alpay; Orki, Tulay Kayacan; Arman, Bulent; Balci, AEBronchial carcinoid tumours were in the past defined as benign and classified as "bronchial adenomas". Currently bronchial carcinoid tumours are considered to be part of a spectrum of malignant neoplasms with neuroendocrine differentiation. Bronchial carcinoid tumours are classified by pathologic features as typical carcinoid tumours or atypical carcinoid tumours with different clinical course prognosis. The most common symptoms are cough, hemoptysis and recurrent pulmoner infection. Paraneoplastic syndromes are uncommon and include Carcinoid syndrome, Cushing's syndrome, and ectopic growth hormone-releasing hormone secretion. Bronchial carcinoid tumours are generally central location for this reason being visible by bronchoscopy. Endobronchial biopsy via bronchoscopy is safe, with a very low risk of bleeding. Atypical carcinoid tumours affected preferentially patients older than typical carcinoid tumours and demonstrated a more aggressive oncological behaviour with a high percentage of nodal involvement and distant metastases. The primary treatment is complete surgical resection (especially parenchymasparing procedures for typical carcinoid tumours) and formal mediastinal lymph node dissection. Long term prognosis is excellent in typical carcinoid tumours, although it is worse in atypical carcinoid tumours.Yayın Malignant Invasive Thymoma in the Posterior Mediastinum(ELSEVIER SCIENCE INC, 2009) Orki, Alpay; Patlakoglu, Mehmet Suat; Tahaoglu, Canan; Kutlu, Cemal AsimWe present a rare case of malignant invasive thymoma (type A) arising from the posterior mediastinum. A 17-year-old girl was referred to our clinic after detection of a mass on a chest roentgenogram. Thoracoscopy showed a lobulated, pale yellowish mass located in the posterior compartment together with several foci in the lung parenchyma. The tumor and parenchymal foci were totally resected through a left minithoracotomy. Postoperative pathology revealed malignant invasive thymoma type A.Yayın Management of postpneumonic empyemas in children(National Center for Biotechnology Information, 2008) Demirhan, Recep; Koşar, Altuğ; Sancaklı, İrfan; Kiral, Hakan; Orki, Alpay; Arman, BülentObjective: The optimal treatment of children with empyema remains controversial. The purpose of this clinical retrospective study was to assess different treatment options in the management of postpneumonic pediatric empyemas. Methods: From April 1997 to October 2005, 111 consecutive children (57 boys and 54 girls) were managed for pleural empyema. The mean age was 7.07 years (range: 18 months-14 years). Patients were divided into 3 groups depending on the treatment received: group I, chest tube alone (n = 89); group II, chest tube with fibrinolytics (n = 22); group III, thoracotomy with decortication (n = 19, consisting of 9 patients of group I and 10 of group II with unsuccessful treatment results). Results: Chest tube alone, chest tube with fibrinolytics, and thoracotomy with decortication had complete response rates of 89.9%, 54.5%, and 100%, respectively. The hospital stay was 11.46 +/- 3.79 days for group I, 9.08 +/- 2.07 days for group II, and 6.32 +/- 2.54 days for group III. There was no statistically significant difference between group I and group II with regard to hospital stay (P = 0.040). Mild pain occurred in 4 children of group II after streptokinase instillation. Only one atelectasis appeared in group III during the postoperative period. Conclusion: Chest tube drainage is a safe, effective primary treatment of postpneumonic pediatric empyema. In cases where it is insufficient, thoracotomy with decortication can be used successfully with low morbidity and mortality rates.Yayın Mediastinal evrelemede yeni teknikler: video-yardımlı mediastinoskopik lenfadenektomi(Türkiye Klinikleri, 2017) Orki, Alpay; Koşar, Altuğ; Kayacan Orki, TülayAkciğer kanseri dünya genelinde kansere bağlı ölümlerde ilk sırada yer almaktadır. Akciğer kanserinde ana tedavi cerrahidir. En iyi sürvi ve hastalıksız sağ kalım ancak cerrahi rezzeksiyon uygulanabilmiş vakalarda sağlanabilmektedir. Görüntüleme alanındaki tüm gelişmelere rağmen akciğer kanseri tanısı ileri evrelerde konabilmekte ve hastaların ancak %20'sine cerrahi rezeksiyon uygulanabilmektedir. Hastanın prognozunu etkileyen en önemli faktörlerden birisi N faktörüdür. Özellikle N2 hastalıkta sürvi oldukça kısalmaktadır. Bu nedenle cerrahi rezeksiyona uygun hastaların seçilmesinde mediastinal evreleme çok büyük önem taşımaktadır. Standart servikal mediastinoskopi (SCM) akciğer kanserinin mediastinal evrelemesinde altın standarttır. Son iki dekatta video yardımlı mediastinal lenfadenektomi (VAMLA) güvenli bir yöntem olması ve sonuçlarının çok iyi olması nedeni ile kullanımı yaygınlaşmaktadır.Yayın Palpable lesions as a diagnostic tool in patients with thoracic pathology(WILEY-BLACKWELL, 2013) Yener, Nese Arzu; Midi, Ahmet; Cubuk, Rahmi; Orki, Alpay; Onar, Cagatay; Ersev, Ayse; Arman, BulentPalpable lesion(s) noticed in a patient with thoracic disease may be a useful diagnostic tool and it often gives a clue for further management. In this study, we searched the diagnostic value of palpable lesions in patients with thoracic pathology suspected clinically and/or radiologically. We prospectively examined the correlations of clinical/radiologic and pathologic findings of 72 palpable lesions from 68 patients who presented with suspect for a thoracic disease from two tertiary medical centers. Thirty-two lesions (44.4%) were diagnosed as malignant either by fine-needle aspiration (FNA) only or FNA with confirmatory biopsy. The most common malignancy was non-small-cell carcinoma (10) followed by adenocarcinoma (6), and small-cell carcinoma (5). The most common localization of the palpable lesions was cervical region (20.8%) followed by left supraclavicular (13.8%) and anterior chest wall (13.8%). FNA was effective in obtaining an accurate diagnosis in 66.6% of the patients. Tissue confirmation of FNA was performed in 54 patients. The sensitivity, specificity, negative predictive value, and positive predictive value of FNA in distinguishing a malignant lesion from a benign disease for these palpable lesions were 75, 97, 96, and 80, respectively. One false negativity and one false positivity were also found. Abnormal radiologic features were not correlated with having a malignant palpable lesion. Evaluation of the palpable lesions by FNA and tissue biopsy together is effective for initial triage of the patients with suspect for a thoracic pathology. FNA alone is a convenient and easy method for this purpose especially when the material is immediately assessed for specimen adequacy. Diagn. Cytopathol. 2013. (c) 2011 Wiley Periodicals, Inc.Yayın Plevranın soliter fibröz tümörleri(Fırat Üniversitesi Tıp Fakültesi, 2007) Orki, Alpay; Eryiğit, Hatice; Akın, Oral; Patlakoğlu, Suat; Koşar, Altuğ; Hacıibrahimoğlu, Gökhan; Arman, BülentGiriş: Bu çalışmanın amacı plevranın soliter fibröz tümörlerinin klinik davranışını değerlendirerek nadir görülen bu tümörlerin, optimal cerrahi yöntemini belirlemektir. Gereç ve Yöntem: 1997 ve 2004 yılları arasında, kliniğimizde soliter fibröz tümör rezeksiyonu yapılan 6 hastanın kayıtları retrospektif olarak incelendi. Bulgular: Opere edilen altı hastanın yaş ortalaması 42.3 idi. Hiçbir hastada asbest temas öyküsü yoktu. Beş olgu semptomatikti. Tüm olgulara torakotomi yapıldı. Beş hastada tümör viseral plevradan, birinde ise parietal plevradan kaynaklanmaktaydı. Olgularımızda tümör total olarak eksize edildi. Ortalama tümör çapı 14 cm (6-24) idi. Patoloji sonuçları altı olguda da plevranın benign soliter fibröz tümörü olarak raporlandı. Olguların hepsinde komplet rezeksiyon yapıldı. Postoperatif mortalite ve major komplikasyon saptanmadı. Ortalama 53.5 aylık takipte rekürrens gözlenmedi. Sonuç: Plevranın soliter fibröz tümörleri nadir görülen neoplazmalardır ve büyük boyutlara ulaşabilir. Komplet cerrahi rezeksiyon, bu tümörlerin optimal tedavisidir ve büyük kitlelerde malignite akılda tutulmalıdır.Yayın Pneumonectomy in children for destroyed lung: evaluation of 18 cases(Elsevier, 2010) Koşar, Altuğ; Orki, Alpay; Kiral, Hakan; Demirhan, Recep; Arman, BülentBackground. Destroyed lung is an uncommon condition; it describes a nonfunctional lung and is most often caused by inflammatory diseases. Surgical resection is used to resolve or prevent complications and improve quality of life. We reviewed our experience in surgery for destroyed lung in children. Methods. The records of 18 children aged 16 years and younger who had undergone pneumonectomy for destroyed lung between 1991 and 2007 were analyzed retrospectively. Results. Eighteen children, 10 males (55.5%) and 8 females, aged 5 to 16 years, with a mean age of 12.3 underwent pneumonectomy. Cough was the major presenting symptom (n 18, 100%). The median preoperative period for symptoms was 6 years. Radiologic diagnostic methods included chest radiograph, computed tomography, bronchoscopy, and bronchography. Bronchiectasis (n 13), tuberculosis (n 4), and aspergillosis (n 1) were the main pathologies. Five patients had tuberculosis history, and tuberculosis culture was positive in 2 patients. Pneumonectomy was applied to the left side in 14 and right side in 4 patients. There was no mortality. Complication occurred in 3 patients (atelectasis [n 1], fistula and empyema [n 1], and wound infection [n 1]). Atelectasis was treated with bronchoscopy and stoma was needed for another patient for empyema. The mean follow-up was 64.9 months (range, 19 to 164 months). In their follow-up period, scoliosis was found in 1 patient. Conclusions. The morbidity and mortality rates of pneumonectomy are acceptable for selected and well prepared children. Antibiotics and antituberculosis treatment in certain cases and good timing in pneumonectomy are essential. Children grew and developed normally after pneumonectomy.Yayın Pneumorrhachis associated with bronchial asthma, subcutaneous emphysema and pneumomediastinum(Turkish Neurosurgery SOC, 2011) Karaoğlan, Alper; Cal, Mehmet Alpay; Orki, Alpay; Arpaözu, Bekir Muhsin; Çolak, AhmetPneumorrhachis is defined as the presence of air in the epidural space or subarachnoid space. The air may migrate along fascial planes from the posterior mediastinum, through the neural foramina, and into the epidural space. Pneumorrhachis is rare, and even more so in the paediatric population. Pneumorrhachis in itself usually is asymptomatic, does not tend to migrate and reabsorbs spontaneously. The combination of pneumomediastinum with epidural pneumorrhachis without thoracic trauma has rarely been reported in the literature. The present case report describes the presence of pneumomediastinum, subcutaneous emphysema, and pneumorrhachis in a child asthmatic patient who had a history of fever, violent cough.Yayın Primary Pulmonary Mucinous (Colloid) Adenocarcinoma that Arose in the Cavernomyoplasty Area in a Patient with Tuberculosis: A Rare Case Report(DE GRUYTER OPEN LTD, 2017) Yener, Nese A.; Sariman, Nesrin; Atasoy, Mehmet M.; Midi, Ahmet; Orki, AlpayPrimary pulmonary mucinous (colloid) adenocarcinoma is a rare type of lung cancer. Its arising in the cavernomyoplasty area has not been reported before. We here describe a sixty-year-old man with a previous history of multidrug-resistant and surgically-treated tuberculosis who was diagnosed as primary mucinous adenocarcinoma in the cavernomyoplasty site. We discuss the relevant literature on this rare entity.Yayın A rare cause of intercostal neuralgia: Ancient schwannoma of the chest wall(MARMARA UNIV, FAC MEDICINE, 2017) Unsal, Mirac Aysen; Kelten, Bilal; Kosar, Altug; Orki, AlpayIntercostal neuralgia is a rare condition that causes pain along the intercostal nerves. Neural tumors of the chest mostly arise from mediastinum and only less than 5-10% of primary tumors originate from intercostal nerves. These patients are usually asymptomatic. Herein, we report a 42-year-old male patient with severe intercostal neuralgia due to the schwannoma of the chest wall. The patient underwent surgical resection and his histopathological diagnosis was a very rare type of schwannoma: ancient schwannoma. Resecting the tumor relieved his pain.Yayın Relationship of T-stage and nodal metastases according to the up-to-date clinical TNM staging in lung cancer(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2012) Yilmaz, Huri Ozkan; Saygi, Attila; Sariman, Nesrin; Marasli, Dida; Duzgun, Yeliz; Koksal, Hulya; Orki, AlpayBackground: This study aims to evaluate the relationship between the clinical T (cT)-stage and metastases (M) in patients with non-small cell lung cancer (NSCLC), comparing the 6th revised edition (old) and 7th revised edition (new) of the TNM staging system and to assess the potential divergent effects of staging on the course of treatment. Methods: A retrospective analysis of 136 patients (123 males, 13 females; mean age 60.8 years; range 25 to 83 years) who were diagnosed with NSCLC between January 2007 and January 2009 were conducted. Several variables including age, gender, smoking status previous radiological and/or bronchoscopic findings, and diagnostic and screening techniques which were used to diagnose metastases were determined. Clinical staging (cTNM) was assessed using the 6th and 7th revised editions of the TNM staging system. Results: A total of 41 patients (30.1%) had squamous cell carcinoma, 29 (21.3%) had adenocarcinoma and 66 (48.5%) had histologically not otherwise specified NSCLC. Staging was changed for 23 of the patients, while lower stage of disease, compared to baseline, was found in 15 patients, based on the 7th edition of TNM the staging system. The most significant changes were observed in stages 3A and 3B, whereas no difference was seen in stage 1 disease. According to the 6th edition of TNM staging system in terms of M distribution, 72 (%52.9) had no metastases, whereas 64 (%47.1) had metastatic disease. According to the 7th edition in terms of M distribution, one more patient was diagnosed with non-metastatic disease, increasing the number of the patient in this group up to 73 (53.6%). Of 63 patients with metastases, 17 (%12.5) had intrapulmonary metastases (M1a), while 46 (%33.9) had distant metastases (M1b). No significant difference was seen between the groups in terms of N distribution. Different treatment modalities were followed in 11 of 136 patients (8.1%). Conclusion: Our study results showed comparable results in both groups, including 6th edition and 7th edition of the TNM staging system, suggesting a concordance rate of 96.9% (r=0.968; p<0.0001). A poor correlation between T-stage and M score was obtained when the 6th edition of TNM staging system is used (r=0.170; p=0.048), whereas a stronger correlation between T-stage and M score was observed, using the 7th revised edition of the TNM staging system (r=0.190; p=0.027).Yayın A Schwannoma in the Middle Mediastinum Originated from the Phrenic Nerve(SPRINGER INDIA, 2012) Orki, Alpay; Ozdemir, Attila; Ersev, Ayse A.; Kutlu, Cemal A.…
