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    The effect of chloroquine treatment in malignant astrocytomas on prognosis
    (Tubitak Scientific & Technological Research Council Turkey, 2013) Bulut, Turgay; Ekici, Mehmet Ali; Tucer, Bulent; Basarslan, Seyit Kaan; Kamasak, Kagan; Kurtsoy, Ali
    Aim: To investigate the adjuvant role of the antimutagenic agent chloroquine in the treatment of patients with malignant astrocytomas (MAs). Materials and methods: Clinical research was conducted at the Neurosurgery Clinic of the Erciyes University School of Medicine, from September 2003 to April 2007, on 37 patients diagnosed with MA after tumor resection subsequent to craniotomy. Chloroquine treatment was started on a daily dose of 150 mg, additional to the patients' radiotherapy and chemotherapy protocol, and was continued throughout the 43-month surveillance period. A control group was formed of 81 patients with MA after the craniotomy. Results: While the mean survival time of the patients who were treated with chloroquine was found to be 15 months, during the observation period 7 of these patients (18.9%) were alive throughout. In the control group, 20 patients (35.1%) were alive throughout the observation period and their mean survival time was 17 months. There were no statistical differences between the control and chloroquine groups (P > 0.05). Conclusion: The chloroquine treatment was not been found to be effective for the medical treatment of MAs.
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    Malign Transformation in the Low Grade Astrocytomas and Related Factors
    (Turkish Neurosurgical Soc, 2012) Kamasak, Kaan; Ekici, Mehmet Ali; Gocmez, Cuneyt; Tucer, Bulent; Basarslan, Seyit Kaan; Kurtsoy, Ali
    AIM: Retrospective investigation of prognostic factors in low-grade astrocytomas. MATERIAL and METHODS: In the study, prognostic factors were prospectively identified and assumed to be effective on prognosis, which were reviewed in 67 cases diagnosed as low-grade astrocytoma with craniotomy between May 1998 to December 2005 at Erciyes University Neurosurgery Department. Assessment of demographic, neurologic, radiological, surgical and clinical features of cases and adjuvant therapies and their relationship with prognosis were evaluated. Post-operative cumulative survival of the cases was estimated by using the Kaplan-Meier method. The Log Rank test was used to compare the survival curve of the sub-groups. Multivariate analysis of survival was analyzed by using the Cox regression method. RESULTS: It was seen that malign transformation occurred in 9 patients of subtotal resection group. The difference was statistically significant (p < 0.01). malign transformation was detected in one female (3.2%) and 8 male patients (22.2%). Difference in favor of men was statistically significant (p < 0.05). Malignant transformation was detected in 7 of the patients given post-operative radiotherapy, only 2 patients displayed malign transformation in the group which received no radiotherapy. Comparison of groups revealed a significant difference (p=0.01). CONCLUSION: Detection of higher malign transformation rate in cases underwent radiotherapy than those did not and the statistical significance in this meaning mandates to revise treatment plan regarding radiotherapy.
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    Prognostic factors in cervical spondylotic myelopathy: A clinical prospective study
    (Lippincott Williams and Wilkins, 2015) Göçmez, Cüneyt; Koç, Rahmi Kemal; Tücer, Bülent; Menkü, Ahmet; Kurtsoy, Ali
    Objective: Various factors may affect the surgical outcome in patients with cervical spondylotic myelopathy (CSM). The purpose of the present study was to determine these factors based on preoperative radiologic and clinical data. Methods: A total of 50 patients who underwent surgery for CSM and were followed up for at least 12 months postoperatively were enrolled in the study. The patients' preoperative and final neurologic status was assessed using the Japan Orthopedic Association (JOA) scoring system. JOA scores and prognostic factors such as sex, age, duration of symptoms, sagittal alignment, number of disks compressed, signal intensity on T1-weighted and T2-weighted magnetic resonance (MR) images, and the diameter of the spinal channel were evaluated. Results: The average preoperative and postoperative JOA scores were 10.9±3.4 and 15.0±2.4, respectively. The mean percentage of improvement for patients with CSM was 62.6±25.0% (P<0.05). The effects of sex difference, number of disks involved, and sagittal alignment on prognosis were not statistically significant (P>0.05). However, patients younger than 50 years, with duration of symptoms <1 year and no signal increase on T2-weighted MR images were predicted to have more neurologic improvement (P<0.05). Conclusions: We found that sex, number of degenerated disks, and sagittal alignment had no effect on prognosis. Notably, age below 50 years, duration of symptoms <1 year, and no signal increase on T2-weighted MR images affected surgical outcomes positively.