Browsing by Author "Erdem, Baki"

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Does the primary route of spread have a prognostic significance in stage III non-serous epithelial ovarian cancer?
(2018) Coban, Gonca; Sahin, Hanifi; Meydanli, Mehmet Mutlu; Sari, Mustafa Erkan; Yalcin, Ibrahim; Ozkan, Nazli Topfedaisi; Cuylan, Zeliha Firat; Erdem, Baki; Gungorduk, Kemal; Akbayir, Ozgur; Dede, Murat; Salman, Mustafa Coskun; Gungor, Tayfun; Ayhan, Ali; 0000-0002-3285-5519; 29506569; AAI-9974-2021
Background: The purpose of this retrospective study was to determine the prognosis of non-serous epithelial ovarian cancer (EOC) patients with exclusively retroperitoneal lymph node (LN) metastases, and to compare the prognosis of these women to that of patients who had abdominal peritoneal involvement. Methods: A multicenter, retrospective department database review was performed to identify patients with stage III non-serous EOC at 7 gynecologic oncology centers in Turkey. Demographic, clinicopathological and survival data were collected. The patients were divided into three groups based on the initial sites of disease: 1) the retroperitoneal (RP) group included patients who had positive pelvic and / or para-aortic LNs only. 2) The intraperitoneal (IP) group included patients with > 2 cm IP dissemination outside of the pelvis. These patients all had a negative LN status, 3) The IP / RP group included patients with > 2 cm IP dissemination outside of the pelvis as well as positive LN status. Survival data were compared with regard to the groups. Results: We identified 179 women with stage III non-serous EOC who were treated at 7 participating centers during the study period. The median age of the patients was 53 years, and the median duration of follow-up was 39 months. There were 35 (19.6%) patients in the RP group, 72 (40.2%) in the IP group and 72 (40.2%) in the IP/RP group. The 5-year disease-free survival (DFS) rates for the RP, the IP, and IP/ RP groups were 66.4%, 37.6%, and 25.5%, respectively (p = 0.002). The 5-year overall survival (OS) rate for the RP group was significantly longer when compared to those of the IP, and the IP/RP groups (74.4% vs. 54%, and 36%, respectively; p = 0.011). However, we were not able to define "RP only disease" as an independent prognostic factor for increased DFS or OS. Conclusions: Primary non-serous EOC patients with node-positive-only disease seem to have better survival when compared to those with extra-pelvic peritoneal involvement.
Factors associated with survival after relapse in patients with low-risk endometrial cancer treated with surgery alone
(2017) Haberal, Ali; Celik, Husnu; Coban, Gonca; Ozkan, Nazli Topfedaisi; Meydanli, Mehmet Mutlu; Sari, Mustafa Erkan; Demirkiran, Fuat; Kahramanoglu, Ilker; Bese, Tugan; Arvas, Macit; Sahim, Hanifi; Ozge, Tufan; Yalcin, Omer Tarik; Akbayir, Ozgur; Erdem, Baki; Numanoglu, Ceyhun; Ozgul, Nejat; Boyraz, Gokhan; Salman, Mehmet Coskun; Yuce, Kunter; Dede, Murat; Yenen, Mufit Cemal; Taskin, Salih; Altin, Duygu; Ortac, Ugur Firat; Ayik, Hulya Aydin; Simsek, Tayup; Gungor, Tayfun; Gungorduk, Kemal; Sanci, Muzaffer; Ayhan, Ali; 0000-0002-1486-7209; 0000-0002-3285-5519; 0000-0003-1185-9227; 28657226; AAI-9331-2021; AAJ-5802-2021; AAL-1923-2021; AAI-9974-2021
Objective: To determine factors influencing overall survival following recurrence (OSFR) in women with low-risk endometrial cancer (EC) treated with surgery alone. Methods: A multicenter, retrospective department database review was performed to identify patients with recurrent "low-risk EC" (patients having less than 50% myometrial invasion [MMI] with grade 1 or 2 endometrioid EC) at 10 gynecologic oncology centers in Turkey. Demographic, clinicopathological, and survival data were collected. Results: We identified 67 patients who developed recurrence of their EC after initially being diagnosed and treated for low-risk EC. For the entire study cohort, the median time to recurrence (TTR) was 23 months (95% confidence interval [CI]=11.5-34.5; standard error [SE]=5.8) and the median OSFR was 59 months (95% CI=12.7-105.2; SE=23.5). We observed 32 (47.8%) isolated vaginal recurrences, 6 (9%) nodal failures, 19 (28.4%) peritoneal failures, and 10 (14.9%) hematogenous disseminations. Overall, 45 relapses (67.2%) were loco-regional whereas 22 (32.8%) were extrapelvic. According to the Gynecologic Oncology Group (GOG) Trial-99, 7 (10.4%) out of 67 women with recurrent low-risk EC were qualified as high-intermediate risk (HIR). The 5-year OSFR rate was significantly higher for patients with TTR >= 36 months compared to those with TTR <36 months (74.3% compared to 33%, p=0.001). On multivariate analysis for OSFR, TTR <36 months (hazard ratio [HR]=8.46; 95% CI=1.65-43.36; p=0.010) and presence of HIR criteria (HR=4.62; 95% CI=1.69-12.58; p=0.003) were significant predictors. Conclusion: Low-risk EC patients recurring earlier than 36 months and those carrying HIR criteria seem more likely to succumb to their tumors after recurrence.
Impact of lymph node ratio on survival in stage IIIC endometrioid endometrial cancer: a Turkish Gynecologic Oncology Group study
(2018) Ayhan, Ali; Ozkan, Nazli Topfedaisi; Oz, Murat; Comert, Gunsu Kimyon; Cuylan, Zeliha Fırat; Coban, Gonca; Turkmen, Osman; Erdem, Baki; Sahin, Hanifi; Akbayir, Ozgur; Dede, Murat; Turan, Ahmet Taner; Celik, Husnu; Gungor, Tayfun; Haberal, Ali; Arvas, Macit; Meydanli, Mehmet Mutlu; 29770619
Objective: The purpose of this study was to investigate the prognostic value of lymph node ratio (LNR) in women with stage IIIC endometrioid endometrial cancer (EC). Methods: A multicenter, retrospective department database review was performed to identify patients with stage IIIC pure endometrioid EC at 6 gynecologic oncology centers in Turkey. A total of 207 women were included. LNR, defined as the percentage of positive lymph nodes (LNs) to total nodes recovered, was stratified into 2 groups: LNR1 (<= 0.15), and LNR2 (> 0.15). Kaplan-Meier method was used to generate survival data. Factors predictive of outcome were analyzed using Cox proportional hazards models. Results: One hundred and one (48.8%) were classified as stage IIIC1 and 106 (51.2%) as stage IIIC2. The median age at diagnosis was 58 (range, 30-82) and the median duration of follow-up was 40 months (range, 1-228 months). There were 167 (80.7%) women with LNR <= 0.15, and 40 (19.3%) women with LNR > 0.15. The 5-year progression-free survival (PFS) rates for LNR <= 0.15 and LNR > 0.15 were 76.1%, and 58.5%, respectively (p= 0.045). An increased LNR was associated with a decrease in 5-year overall survival (OS) from 87.0% for LNR <= 0.15 to 62.3% for LNR > 0.15 (p= 0.005). LNR > 0.15 was found to be an independent prognostic factor for both PFS (hazard ratio [HR]= 2.05; 95% confidence interval [CI]= 1.07-3.93; p= 0.03) and OS (HR= 3.35; 95% CI= 1.57-7.19; p= 0.002). Conclusion: LNR seems to be an independent prognostic factor for decreased PFS and OS in stage IIIC pure endometrioid EC.