Browsing by Author "Aliyeva, Khayala"

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    Jinekolojik orijinli kanserlerin kemik metastazlarının oluşumunu etkileyen faktörler, kemik metastazların prognostik olarak önemi ve morbiditelerinin değerlendirilmesi
    (Başkent Üniversitesi Tıp Fakültesi, 2022) Aliyeva, Khayala; Ayhan, Ali
    Amaç: Bu çalışmada jinekolojik kanser tanısı ile takip edilen hastalarda kemik metastaz oluşumunu etkileyen faktörler ve kemik metastazı saptanan hastalarda yaşam süresinin değerlendirilmesi planlandı. Gereç ve Yöntem: Tek merkezli ve retrospektif bir çalışma olarak, ocak 2007 ve mayıs 2022 arasında Başkent Üniversitesi Kadın Hastalıkları ve Doğum Anabilim Dalı Jinekoloji Onkoloji bölümüne başvuran ve jinekolojik kanser tanısı alan hastalar değerlendirildi. Hastaların klinik, patolojik özellikleri, aldıkları tedavilerin jinekolojik kanserlere göre dağılımı gösterildi. Kemik metastazı olan ve olmayan olgular karşılaştırılarak kemik metastaz oluşumunda prediktif faktörler analiz edildi. Kemik metastazı sonrası medyan sağkalım süreleri ve sağkalıma etki eden prognostik faktörler istatistiksel olarak değerlendirildi. Sonuçlar: Kemik metastazı olan ve olmayan olgular karşılaştırıldığında multivaryant analizde serviks kanserinde lenf nodu tutulumu ve ileri evre, endometrium kanserlerinde ise ileri evre hastaların kemik metastazı ile ilişkili olduğu görüldü. Tüm jinekolojik kanserlerin kemik metastazı sonrası medyan sağkalım süresi 10 ay, over kanserlerinde 13.5 ay, endometrium kanserlerinde 9 ay, serviks kanserlerinde 8 ay, uterin sarkomlarda 11 ay, vulva kanserlerinde 6 ay olarak tespit edildi. Kemik metastazı sonrası sağkalıma etkisi araştırılan prognostik faktörlerin univaryant analizinde hiperkalsemi, ALP yüksekliği, ekstraskletal metastaz ve diğer hematojen metastaz durumu kemik metastazı sonrası sağkalımla ilişkili olduğu, multivaryant analizde ise hiperkalsemi ve alkalen fosfataz (ALP) yüksekliğinin sağkalımı etkileyen bağımsız değişken olduğu görüldü. Jinekolojik kanser tanılı kemik metastazı prediktif ve prognostik faktörlerine sahip olan hastaların daha yakın takip edilmesi gerektiğini düşünmekteyiz. Bu çalışmanın sonuçları ve literatür incelendiğinde daha fazla hasta içeren ve multisentirik çalışmaya ihtiyaç olduğu düşünülmektedir. Objective: In this study, it was planned to evaluate the factors affecting the formation of bone metastases in patients under observation with a diagnosis of gynecological cancer and life expectancy in patients with bone metastases. Material and Methods: Patients who applied in the Baskent University Department of Gynecological Oncology from January 2007 to May 2022 and were diagnosed with gynecological cancer were evaluated as a single-center and retrospective study. The clinical and pathological characteristics of the patients and the distribution of the treatment they received depending on the gynecological cancer were shown. The prognostic factors for the formation of bone metastases were analyzed by comparing cases with and without bone metastases, the median survival time after bone metastases and prognostic factors affecting survival were statistically evaluated. Results: When comparing cases with and without bone metastases, multivariate analysis showed that lymph node involvement and advanced cervical and advanced endometrial cancer were associated with bone metastases. Median survival after bone metastasis for all gynecological cancers was 10 months, 13.5 months for ovarian cancer, 9 months for endometrial cancer, 8 months for cervical cancer, 11 months for uterine sarcoma and 6 months for vulvar cancer. In an univariate analysis of prognostic factors, the effect of which was investigated on survival after bone metastasis, hypercalcemia, high levels of alkaline phosphatase, extrascletal metastasis and other hematogenous metastases were associated with survival after bone metastasis, while in multivariate analysis, hypercalcemia and high levels of ALP are independent variables affecting survival. We believe that patients with bone metastases and prognostic factors for a diagnosis of gynecologic cancer should be observed more carefully in terms of bone metastasis. In reviewing the results of this study and the literature, there is an opinion that a multicenter research with a large number of patients is required.
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    Survival In Recurrent Ovarian Cancer Patients Before And After The Bevacizumab Era: An Observational Single-Centre Study
    (2022) Akilli, Huseyin; Rahatli, Samed; Aliyeva, Khayala; Altundag, Ozden; Kuscu, Ulku Esra; Ayhan, Ali; https://orcid.org/0000-0002-5240-8441; https://orcid.org/0000-0003-0197-6622; 35260031; AAX-3230-2020; W-9219-2019
    A retrospective observational study was carried out in Baskent University School of Medicine, Ankara, Turkey. Recurrent ovarian cancer patients treated between 2007 and 2017 were divided into two groups according to their bevacizumab status. The primary endpoints were overall survival (OS) and safety. Three hundred and ninety-six patients enrolled in this study, 200 (50.5%) received bevacizumab while 196 (49.5%) patients never received bevacizumab. The median follow-up time was 48.2 and 47.6 months, respectively. The 5-year OS was 61% and 46%, respectively (p=.007). In multivariate analysis, only platinum-sensitivity (HR: 3.75, 95% CI: 3.0-5.32; p<.001) was identified as independent prognostic factors. In subgroup analyses according to platinum status, bevacizumab did not affect the 5 year OS in platinum sensitive patients (64% versus 68% p=.28) but increased survival in platinum resistant patients (36% versus 44%, p=.00). The rate of grade III-IV haematologic toxicities was 13.7% in the bevacizumab group and 11% in the other group (p=.6).Impact Statement What is already known on this subject? Bevacizumab increases the progression-free survival in platinum-sensitive and resistant recurrent ovarian cancer patients without changing overall survival. What do the results of this study add? Bevacizumab did not affect OS in platinum sensitive recurrent ovarian cancer patients however improved OS in platinum resistant patients with mild toxicity. What are the implications of these findings for clinical practice and/or further research? This study emphasised the crucial role of bevacizumab in the treatment of recurrent ovarian cancer patients.