Turkish Journal of Surgery最新文献

{"title":"Assessing and managing benign breast lesions leading to mastalgia: A review of 840 patients.","authors":"Yüksel Doğan, Adnan Mesut Dede, Muzaffer Çapar, Semra Salimoğlu Coşkun, Elif Ceren Dede","doi":"10.47717/turkjsurg.2025.6451","DOIUrl":"10.47717/turkjsurg.2025.6451","url":null,"abstract":"<p><strong>Objective: </strong>Mastalgia often raises malignancy concerns. This study explores its link to benign breast conditions, and cancer.</p><p><strong>Material and methods: </strong>This retrospective study included 840 patients presenting to the surgical clinic with breast disease between January 2016 and January 2023.</p><p><strong>Results: </strong>This study included 840 patients (800 female, 40 male) presenting with mastalgia, either as an isolated symptom or in combination with other complaints. In 350 cases (41.6%), pain alone was reported; in 410 cases (48.8%), pain with a lump; and in 18 cases (2.1%), pain with nipple discharge. Non-cyclic pain (51.5%) was more common than cyclic pain (42.5%), with pain most frequently localized to the right breast (53.5%), followed by bilateral (23.8%) and left breast (17.8%) pain (p<0.001). A significant association was observed between mastalgia and neck/shoulder pain (10.7%, p<0.001). A family history of breast cancer was present in 16.6% of patients. Histologic analysis revealed fibrocystic changes (42.2%), fibroadenoma (21.1%), and ductal ectasia (11%) as the most common diagnoses. Malignancy was detected in 6 cases (1.3%, including 1 male patient), with a significantly higher prevalence in the pain + lump group (p<0.001). Other findings included mastitis (9 cases), abscess (53 cases), and fat necrosis (4 cases). Patients with suspected malignancy underwent biopsy based on radiologic suspicion (BIRADS 2-4a) and physical examination.</p><p><strong>Conclusion: </strong>Mastalgia is predominantly a benign condition, but non-cyclic pain, particularly when associated with a lump, warrants thorough evaluation to exclude malignancy. The link between mastalgia and fibrocystic changes shows that research is needed into the causes and consequences. It is not a malignancy indicator, accurate diagnosis requires histological and radiological assessments.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"41 2","pages":"160-167"},"PeriodicalIF":0.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Could the HALP score indicate poor prognosis in colorectal cancer patients?","authors":"Ömer Çağlıyan, Hilmi Yazıcı, Ahmet Can Yaşar, Yaşar Çağlar Bekki, Sedat Tan, Erkan Oymacı, Ahmet Mücteba Öztürk, Mehmet Yıldırım","doi":"10.47717/turkjsurg.2025.6760","DOIUrl":"10.47717/turkjsurg.2025.6760","url":null,"abstract":"<p><strong>Objective: </strong>Colorectal cancer (CRC) is a major health problem worldwide. According to estimates for the year 2030, cancer will be the number one cause of death for both genders. CRC is the third most common type of cancer and the second most common cause of cancer-related deaths. Various parameters are needed to provide information about the course and prognosis of the disease.</p><p><strong>Material and methods: </strong>The study included 103 patients diagnosed with CRC between 2017 and 2023. The patients' HALP scores were retrospectively analyzed together with clinical data. The relationship between survival times, disease stage, and treatment response was examined.</p><p><strong>Results: </strong>The obtained data showed that low HALP scores were associated with worse overall survival. Although the HALP score cut-off value was found to be different in various studies conducted on benign or malignant diseases, a low HALP score indicates a poor prognosis. In our study, a HALP score below 23 was found to be associated with low overall survival.</p><p><strong>Conclusion: </strong>This study suggests that a low HALP score is associated with poor prognosis and could serve as a valuable prognostic marker in the clinical management of CRC patients. However, certain limitations must be considered. While albumin is a marker of systemic inflammation and nutritional status, its specificity is limited in acute and chronic inflammatory conditions, which may impact the prognostic value of the HALP score. Further investigation into the biological mechanisms underlying this relationship and the potential of the HALP score in predicting treatment response would enhance its clinical applicability.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"154-159"},"PeriodicalIF":0.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative analysis of preoperative, intraoperative, and tumor characteristics in emergency and elective right-sided colonic surgery.","authors":"Yunushan Furkan Aydoğdu, Emre Gülçek, Çağrı Büyükkasap, Murat Akın","doi":"10.47717/turkjsurg.2025.2025-3-25","DOIUrl":"10.47717/turkjsurg.2025.2025-3-25","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare preoperative, intraoperative, and tumor characteristics between patients undergoing emergency and elective surgery for right-sided colon cancer. Despite the worsened prognosis of emergency colorectal cancer cases, studies on right colon cancer remain limited.</p><p><strong>Material and methods: </strong>This retrospective study included 356 patients who underwent surgery for right-sided colon cancer between January 2015 and April 2023. Patients were categorized into emergency (n=93) and elective (n=263) groups. Demographic data, tumor characteristics, and surgical details were analyzed. Binary logistic regression was applied to identify independent predictors of emergency surgery.</p><p><strong>Results: </strong>Age (p=0.435) and gender distribution (p=0.853) were similar between groups. However, American Society of Anesthesiologists (ASA) scores were higher in the emergency group (p=0.001), while Charlson comorbidity index (CCI) scores showed no significant difference (p=0.169). T4 (p<0.001), N1 (p=0.008), and M1 stages (p<0.001) were significantly more frequent in the emergency group, along with higher tumor perforation rates (34.4% vs. 1.9%, p<0.001). Open surgery was more common in the emergency group (p=0.005). While total lymph node yield was similar (p=0.501), the number of metastatic lymph nodes was higher in the emergency group (p=0.008). Logistic regression identified higher ASA score, advanced T, N, M stages, tumor perforation, and tumor size as predictors of emergency surgery.</p><p><strong>Conclusion: </strong>Patients undergoing emergency surgery for right colon cancer have more advanced disease, higher tumor perforation rates, and poorer prognostic factors. Laparoscopic surgery was less utilized, which indicates technical challenges. Early diagnosis and screening strategies may reduce emergency interventions and improve outcomes.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"168-173"},"PeriodicalIF":0.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-expression of Stem Cell Markers CD133 and CD44 as Predictors of Metastatic Potential of Colorectal Carcinoma.","authors":"Ognen Kostovski, Rubens Jovanovikj, Irena Kostovska","doi":"10.47717/turkjsurg.2025.6837","DOIUrl":"10.47717/turkjsurg.2025.6837","url":null,"abstract":"<p><strong>Objective: </strong>One of the most prevalent cancers in the world is colorectal carcinoma (CRC). Aggressive cancer forms and a poor prognosis are linked to cancer stem cell (CSC) markers. The study aimed to determine whether the co-expression of the CSC markers CD133 and CD44 could predict an increased risk of metastasis in colorectal cancer.</p><p><strong>Material and methods: </strong>Our study included 90 patients with CRC. All patients were divided into two subgroups: Metastatic CRC and non-metastatic CRC. Initially, tumor samples were examined using conventional histological techniques, and then immunohistochemical analysis with monoclonal antibodies against CD133 and CD44 markers was performed.</p><p><strong>Results: </strong>High co-expression of CD133 and CD44 was observed in 71.4% of patients with metastatic disease, compared to 37.9% in patients without distant metastases. Discordant expression of both markers was found in 8% of the subgroup with metastatic CRC and 13.4% of the subset without metastatic CRC. Statistical analyses showed a significant association of increased expression of CD133 and CD44 with the disease stage, T- category, and N- nodal status. With multiple regression analysis, the stage of disease was singled out as the factor with the greatest and statistically significant influence on the expression of CD133 (p<0.0001) and CD44 (p<0.0001).</p><p><strong>Conclusion: </strong>Co-expression of CD133 and CD44 plays an essential role in predicting the metastatic form of CRC. Both stem cell markers can be implemented in standard pathohistological diagnostics and can be useful markers for pre-therapeutic oncology screening.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"41 2","pages":"174-179"},"PeriodicalIF":0.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of pediatric prostatic and retroperitoneal embryonal rhabdomyosarcoma with high Ki-67-case series study.","authors":"Melih Akın, Koray Yalçın, Emel Berfe Bük, Esma Sehoviç, Salih Güler","doi":"10.47717/turkjsurg.2025.6723","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.6723","url":null,"abstract":"<p><p>Embryonal rhabdomyosarcoma (ERMS) is a highly aggressive pediatric malignancy that can develop in various anatomical locations. This case series presents four pediatric patients diagnosed with ERMS, including one with the uncommon presentation of prostatic rhabdomyosarcoma. By analyzing clinical features, treatment strategies, and outcomes, this study aims to provide insights into the challenges of managing this malignancy in different anatomical sites.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computed tomography defined body composition may predict postoperative outcomes and prognosis following gastric cancer surgery.","authors":"Ahmet Akmercan, Tevfik Kıvılcım Uprak, Onur Buğdaycı, Meltem Kurşun, Ali Emre Atıcı","doi":"10.47717/turkjsurg.2025.6744","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.6744","url":null,"abstract":"<p><strong>Objective: </strong>Loss of muscle mass (sarcopenia) and impaired muscle quality (myosteatosis) associated with poor surgical outcomes. This study aimed to evaluate the impact of sarcopenia and myosteatosis on postoperative short-term outcomes and prognosis in patients with gastric cancer.</p><p><strong>Material and methods: </strong>Patients who underwent gastric cancer surgery and had abdominal computed tomography (CT) imaging were included in the study. Skeletal muscle index (SMI) and skeletal muscle density (SMD) were calculated using CT images. Patients were divided into groups based on previously established threshold values: Those with low SMI (indicating sarcopenia) versus those with normal SMI, and those with low SMD (indicating myosteatosis) versus those with normal SMD. Demographics, clinicopathologic characteristics, postoperative outcomes, and survival data were extracted from prospective database.</p><p><strong>Results: </strong>Among the 237 patients, 87 patients (36.7%) had sarcopenia and 139 patients (58.6%) had myosteatosis. Patients with myosteatosis were characterized by older age, poorer preoperative nutritional status, inferior performance status, and extended hospital stays. Higher severe complication incidence was observed among patients with myosteatosis (18% vs. 10.2%, p=0.09). Overall survival of patients with sarcopenia or myosteatosis was significantly lower than that of patients with a normal SMI or SMD (p=0.03, p<0.001 respectively). Myosteatosis was identified as an independent risk factor for overall survival in multivariate analysis (hazard ratio: 2.20, 95% confidence interval: 1.26-3.86, p=0.006).</p><p><strong>Conclusion: </strong>This study indicated sarcopenia or myosteatosis is associated with reduced overall survival. Although there were no significant difference severe complication rates are higher in patients with low SMD than in patients with normal SMD, and reporting of SMD from preoperative CT should be considered in preoperative evaluation.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the secrets of the profunda femoris artery: A cadaveric journey with morphometric insights.","authors":"Athikayala Gopikrisshna Dhaminirithika, Hannahsugirthabai Rajilarajendran, Gowthaman Kavinnilavan, P Indra","doi":"10.47717/turkjsurg.2025.6571","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.6571","url":null,"abstract":"<p><strong>Objective: </strong>Profunda femoris artery (PFA), a branch of femoral artery primarily supplies blood to skin, muscles of the inner thigh and proximal femur and plays a significant role in collateral blood supply. This study aimed to investigate the origin, branching pattern and morphometries of PFA in cadavers.</p><p><strong>Material and methods: </strong>Lower limbs of male and female cadavers (n=41) were analyzed for origin of PFA, lateral circumflex artery (LCFA) and medial circumflex artery (MCFA), distance from mid-inguinal point, course, branching pattern and their external calibers. Data were tabulated and analyzed using SPSS.</p><p><strong>Results: </strong>The PFA showed origins that are posterolateral, posteromedial, and posterior. The distance between PFA and the midpoint of the inguinal ligament was (L=3.7-6.2; mean =5.19±0.7 cm; R=3.2-6.2 cm, mean =4.74±0.9 cm). The origin of MCFA was medial (R=61%, L=52%) and posteromedial (R=39%, L=48%); LCFA was lateral (R=100%, L=78%) and posterolateral (R=0%, L=22%). The average diameter of PFA, MCFA, & LCFA was (L=5.04, 2.9, 2.8 cm and R=5.4, 3.09, 3.71 cm). The paired t-test with a significant p-value (95% confidence) demonstrated that differences in the diameters of the arteries at the specified levels between the left and right limbs could have clinical implications, such as differences in blood flow or susceptibility to vascular conditions.</p><p><strong>Conclusion: </strong>To reduce intra-operative and post-operative complications in the femoral region branches during diagnostic and surgical procedures, it is essential to comprehend the normal and variant positions and distances of the PFA's origin and its circumflex branches.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cholecystectomy associated vasculobiliary injuries: Incidence and impact on surgical repair outcomes.","authors":"Saurabh Singla, Rakesh Kumar Singh, Saket Kumar, Umakant Prasad, Manish Mandal, Sanjay Kumar","doi":"10.47717/turkjsurg.2025.6577","DOIUrl":"10.47717/turkjsurg.2025.6577","url":null,"abstract":"<p><strong>Objective: </strong>Bile duct injury with concomitant vascular injury is a common complication of cholecystectomy. The influence of concomitant vascular injury on the presentation and management of bile duct injury remains debatable. This study aimed to determine the incidence of concomitant vascular injury in patients with post-cholecystectomy bile duct injury and its impact on presentation and short-term outcomes following biliary repair.</p><p><strong>Material and methods: </strong>This prospective study was done between November 2019 and December 2022. Patients presenting with post-cholecystectomy bile duct injury were investigated to detect vascular injury using computed tomography angiography. A comparative analysis of clinical presentation, and results of biliary reconstruction was performed on patients with and without concomitant vascular injury. McDonald criteria were used to grade the outcome of biliary reconstruction in these patients.</p><p><strong>Results: </strong>We studied 48 patients with bile duct injury of which 19 (39%) patients had concomitant vascular injury on imaging. Concomitant vascular injury was found in 87% and 42% of patients with Strasberg type 4 and type 3 injury, respectively. At presentation, the incidence of liver abscesses was significantly higher in patients with concomitant vascular injury. After two years of biliary repair, 75% of patients had McDonald Grade A status, irrespective of whether vascular injury was present.</p><p><strong>Conclusion: </strong>Approximately 39% of patients with biliary injury had concomitant vascular injury. A higher grade of biliary injury was associated with increased chances of concomitant vascular injury. The presence of vascular injury did not correlate with increased operative morbidity, prolonged hospital stay, or inferior outcomes of delayed biliary repair.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"41 1","pages":"24-30"},"PeriodicalIF":0.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of early and delayed cholecystectomy for acute gallstone-related disease.","authors":"Mathew Vithayathil, Cissy Yong, Khaled Dawas","doi":"10.47717/turkjsurg.2025.6568","DOIUrl":"10.47717/turkjsurg.2025.6568","url":null,"abstract":"<p><strong>Objective: </strong>Laparoscopic cholecystectomy is the definitive treatment for gallstone-related disease. Early laparoscopic cholecystectomy (ELC) is recommended for management of acute gallstone-related disease, as delayed laparoscopic cholecystectomy (DLC) is associated with recurrent presentations and complications. This series evaluated the outcomes of ELC and DLC in patients presenting acutely to secondary care.</p><p><strong>Material and methods: </strong>All cholecystectomies performed for patients presenting with acute gallstone-related disease including biliary colic, acute cholecystitis, gallstone pancreatitis and obstructive jaundice over a 24-month period were included. Clinical outcomes including hospital stay, peri-operative complications, re-presentation of gallstone-related disease, and repeat hospital admissions and imaging were recorded for ELC and DLC cases.</p><p><strong>Results: </strong>Of 105 cholecystectomies performed, only 6.7% were ELC. The mean time from index presentation to cholecystectomy was 3.4 days and 119.6 days for ELC and DLC, respectively. Over one-third of patients (38.8%) undergoing DLC experienced recurrent gallstone-related disease between index presentation and surgery. Re-admission to hospital for gallstone-related symptoms was seen in 25.5% of patients. The mean additional inpatient stay for readmission for gallstone-related disease in the DLC group was 3.3 days, with 30.6% requiring repeat imaging.</p><p><strong>Conclusion: </strong>DLC is associated with significant recurrence of gallstone-related complications. Re-admission to hospital incurs additional inpatient stay, and investigation, leading to a negative impact on patients' health and additional financial burden.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"41 1","pages":"19-23"},"PeriodicalIF":0.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical significance of para-aortic lymph node metastasis for prognosis in patients with pancreaticobiliary cancer who underwent radical surgical resections.","authors":"Atsushi Nanashima, Junichi Arai, Masahide Hiyoshi, Naoya Imamura, Takeomi Hamada, Yuki Tsuchimochi, Ikko Shimizu, Takahiro Ochiai, Hiroshi Kawakami, Yuichiro Sato, Wada Takashi","doi":"10.47717/turkjsurg.2025.6587","DOIUrl":"10.47717/turkjsurg.2025.6587","url":null,"abstract":"<p><strong>Objective: </strong>To elucidate surgical strategies for patients undergoing radical resection, in cases where solitary distant lymph node metastasis is identified intraoperatively, we investigated the prognostic significance of para-aortic lymph node (PALN) metastases and other regional lymph node (RLN) metastases in pancreatic carcinomas (PC) and biliary duct cancers (BDC).</p><p><strong>Material and methods: </strong>This study retrospectively analyzed data from 181 PC patients and 116 BDC patients who underwent radical resections at two institutions between 1994 and 2021.</p><p><strong>Results: </strong>Among PC patients, metastases were observed in RLN and PALN in 54% and 9% of cases, respectively. Similarly, RLN and PALN metastases were present among BDC patients in 39% and 9% of cases, respectively. Survival analysis revealed that patients with BDC and PALN metastases exhibited significantly reduced disease-free (DFS) and overall survival (OS) compared to those without PALN involvement. Multivariate analysis identified PALN metastasis as an independent predictor of OS in BDC patients (p<0.05), while RLN metastasis was independently associated with DFS (p<0.05). Additional clinicopathological factors associated with PALN and RLN metastases were also identified. Preoperative serum levels of Duke Pancreas II monoclonal antibody were significantly elevated in patients with PALN metastases. Histological findings of lymphatic or perineural infiltration and hepatic or pancreatic invasion were independently associated with RLN metastases.</p><p><strong>Conclusion: </strong>Based on these findings, radical resection may be considered for PC patients with isolated PALN metastases only in the absence of additional adverse prognostic factors. Prospective clinical trials are warranted to further refine the criteria for surgical intervention when solitary PALN metastases are detected intraoperatively.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"41 1","pages":"5-18"},"PeriodicalIF":0.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}