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Background: In this study, we aimed to evaluate the factors that contribute to survival outcomes in patients with thymoma treated with multimodal approaches. Methods: A total of 203 patients (105 males, 98 females; median age: 49 years; range, 17 to 77 years) with Masaoka-Koga Stage II-IV thymoma between January 2002 and December 2018 were retrospectively analyzed. Data including diagnosis of myasthenia gravis, diagnosis of diabetes mellitus, disease stage, histological type of tumor, capsule invasion and surgical margin status, lymphadenectomy, adjuvant radiotherapy or chemotherapy, time from surgery to the first day of adjuvant treatment, length of hospital stay, and overall and disease-free survival rates were recorded. Results: Of the patients, 91 had Stage II, 67 had Stage III, and 45 had Stage IV disease. A total of 123 patients (61%) had myasthenia gravis. Seventy-six patients received adjuvant radiotherapy and 48 patients received either neoadjuvant (n=35) or adjuvant (n=25) chemotherapy. Higher disease stage, presence of R1 resection, and treatment with chemotherapy were significant factors for decreased disease-free survival time. Older age, higher disease stage, longer postoperative hospital stay, chemotherapy, and disease recurrence were effective contributors to decreased overall survival time. Adjuvant radiotherapy had a statistically significant positive effect on overall survival only in patients with completely resected Stage IV disease (five-year overall survival: 94.7% vs. 79.1%, respectively; p=0.015). In the multivariate analysis, older age (hazard ratio: 4.26), higher disease stage (hazard ratio: 2.95), and longer hospitalization time (hazard ratio: 3.81) were significant prognostic factors for overall survival. Patients with local recurrence who underwent complete resection had a survival time comparable to non-recurrent patients (p=0.753). Conclusion: For patients with thymoma, higher disease stage, age ≥50 years, longer hospitalization, and need for chemotherapy are associated with worse survival rates. Adjuvant chemotherapy has a positive impact on Stage IV disease. Resection of recurrent lesions has a valuable impact on survival., Amaç: Bu çalışmada, multimodal yaklaşımlar ile tedavi edilen timoma hastalarının sağkalım sonuçlarına katkıda bulunan faktörler değerlendirildi. Ça¬lış¬ma pla¬nı: Ocak 2002 - Aralık 2018 tarihleri arasında Masaoka-Koga Evre II-IV timomalı toplam 203 hasta (105 erkek, 98 kadın; medyan yaş: 49 yıl; dağılım, 17-77 yıl) retrospektif olarak incelendi. Myastenia gravis tanısı, diabetes mellitus tanısı, hastalık evresi, tümörün histolojik türü, kapsül invazyonu ve cerrahi sınır durumu, lenfadenektomi, adjuvan radyoterapi veya kemoterapi, cerrahiden adjuvan tedavinin ilk gününe kadar geçen süre, hastanede yatış süresi ve genel ve hastalıksız sağkalım oranları kaydedildi. Bulgular: Hastaların 91’inde Evre II, 67’sinde Evre III ve 45’inde Evre IV hastalık izlendi. Toplam 123 hastada (%61) myastenia gravis vardı. Yetmiş altı hastaya adjuvan radyoterapi ve 48 hastaya neoadjuvan (n=35) veya adjuvan (n=25) kemoterapi verildi. Yüksek hastalık evresi, R1 rezeksiyon varlığı ve kemoterapi azalmış hastalıksız sağkalım süresinin anlamlı faktörleriydi. İleri yaş, yüksek hastalık evresi, ameliyat sonrası uzun süreli hastane yatışı, kemoterapi ve hastalık nüksü genel sağkalım süresinin azalmasına katkıda bulunan faktörlerdi. Yalnızca tam rezeke Evre IV hastalığı olan hastalarda, adjuvan radyoterapinin genel sağkalım üzerinde istatistiksel olarak anlamlı bir pozitif etkisi vardı (beş yıllık genel sağkalım: sırasıyla %79.1’e kıyasla %94.7; p=0.015). Çok değişkenli analizde ileri yaş (risk oranı: 4.26), yüksek hastalık evresi (risk oranı: 2.95) ve daha uzun hastanede yatış süresi (risk oranı: 3.81) genel sağkalımın anlamlı prognostik faktörleriydi. Tam rezeksiyon uygulanmış lokal nüks saptanan hastalardaki sağkalım süresi, hiç nüks saptanmayan hastalar ile benzer bulundu (p=0.753). So¬nuç: Timomalı hastalarda yüksek hastalık evresi, ≥50 yaş, daha uzun süreli hastanede yatış ve kemoterapi ihtiyacı, daha kötü sağkalım oranları ile ilişkilidir. Adjuvan radyoterapi, Evre IV hastalık üzerinde olumlu etkiye sahiptir. Tekrarlayan lezyonların rezeksiyonunun sağkalım üzerinde önemli bir etkisi vardır.

Objectives: The aim of this study was to evaluate the impact of maximum standard uptake value (SUVmax) of the primary tumor and locoregional metastatic lymph node in predicting survival in patients with the preoperative rectal adenocarcinoma. Methods: One hundred and fifteen patients [mean age ± standard deviation (SD): 58.7±11.4 years] with biopsy-proven rectal adenocarcinoma underwent 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) imaging for the staging were included in this study. All patients were followed-up for a minimum of 12 months (mean ± SD: 29.7±13.5 months). Tumor-node-metastasis 2017 clinical staging, SUVmax of the primary rectal tumor and locoregional lymph nodes on the PET/CT studies were evaluated. Results: All patients had increased FDG activity of the primary tumor. The mean ± SD SUVmax of the primary tumor and locoregional metastatic lymph node were 21.0±9.1 and 4.6±2.8, respectively. Primary tumor SUVmax did not have an effect on predicting survival (p=0.525) however locoregional metastatic lymph node SUVmax had an effect (p