Browsing by Author "Gultekin, Murat"

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Differences fin Geographical Distribution and Risk Factors for Urinary Incontinence in Turkey: Analysis of 6,473 Women
(2014) Dursun, Polat; Dogan, Nasuh Utku; Kolusari, Ali; Dogan, Selen; Ugur, Mete Gurol; Komurcu, Ozge; Altuntas, Baris; Gultekin, Murat; Celik, Nilufer Yigit; Karaca, Mehmet; Guzel, Ahmet Baris; Cim, Numan; Ege, Serhat; Koc, Onder; Yigit, Filiz Altinok; https://orcid.org/0000-0001-5139-364X; 24051428
Objective: To assess the prevalence, types and risk factors for urinary incontinence (UI) and to evaluate the impact of incontinence on quality of life by using validated and objective questionnaires in the western and eastern parts of Turkey. Methods: In this multicenter observational study, 6,473 women from 38 cities in the western and eastern parts of Turkey were included. UI was assessed by ICIQ-SF (International Consultation on Incontinence Questionnaire Short Form) and IIQ-7 (Incontinence Impact Questionnaire). Results: The UI rate was 20.9% (10% for stress, 8.3% overactive bladder and 2.6% for mixed type). In all, stress incontinence was the most common type. The rate of UI in women residing in the west was higher than in women living in the east (p < 0.001). ICIQ scores were comparable in the two groups but women in the west scored higher in each item of the IIQ. Age >40 years (p < 0.001), number of siblings >5 (p < 0.001) and low educational status (p < 0.001) increased the rate of incontinence. In binary logistic regression analysis menopausal status, age >40 years, number of siblings >5, being overweight, region of residence, and educational status were associated with UI. Conclusion: The rate of UI in women residing in the western part of Turkey was higher than women living in the east. Residing in a different geographical region (in our case living either in the western or eastern part of Turkey) seemed to be an independent risk factor for UI. Moreover, UI deteriorates quality of life and more attention should be paid to this vulnerable population. (C) 2013 S.Karger AG, Basel
Evaluation of Colposcopy After the Addition of Human Papillomavirus Testing to the Turkish Cervical Cancer Screening Program
(2023) Gunes, Ali Can; Ozgul, Nejat; Turkyilmaz, Murat; Kara, Fatih; Unlu, Fahriye; Ayhan, Ali; Gultekin, Murat; 37994572
Objective: To evaluate colposcopy performance following the human papillomavirus (HPV) DNA screening program in Turkey. Methods: Women aged 30-65 years are screened for cervical cancer every 5 years, with individuals positive for HPV 16 and/or 18 or other high-risk HPV types with abnormal cytology referred for colposcopy. Both HPV test and cytology are obtained at the same visit. If HPV is negative, cytology will not be assessed. However, if HPV is positive, both cytology and HPV genotyping will be performed. Colposcopy-require was defined as HPV 16/18 positivity or abnormal smear results with any hrHPV positivity, and the remaining patients (normal smear with hrHPV positivity other than HPV 16/18) were grouped as colposcopy non-required. National data on colposcopy outcomes and unnecessary performance rates in February 2018-2019 were evaluated via a questionnaire. Results: A total of 9808 patients were included, divided based on colposcopy requirement: 5751 (58.6%) patients required colposcopy and 4057 (41.4%) did not. Unnecessary colposcopy was performed on 90.1% of the non-required group (3657 of 4057 patients). In the colposcopy-required group, 4455 patients (79.9%) underwent punch biopsy; 3194 (57.1%), endocervical curettage (ECC); and 421 (7.5%), "see and treat" in the non-required group, the results were 2790 (76.3%), 1957 (53.2%), and 211 (5.7%), respectively. A total of 746 cervical intraepithelial neoplasia (CIN)-3 isolates were detected, including 702 using existing screening and triage with 94.1% sensitivity (702/746). Multiple biopsies were taken in 69.8% (n = 3110) of patients from the colposcopy-required group and 63.7% (n = 1777) from the non-required group. The ECC samples included 19 cervical cancers and 212 >= CIN-3 lesions in the colposcopy-required group, and four cancers and 41 >= CIN-3 lesions in the non-required group. The proportion of >= CIN-3 lesions detected by ECC only was 4.7% (35 of 746 >= CIN-3 lesions). Conclusion: Our results showed high rates of unnecessary colposcopies, and a high percentage of multiple and random punch biopsies and ECC.
Frontline fighters: the continued fight against COVID-19
(2020) Akilli, Huseyin; Celik, Husnu; Taskiran, Cagatay; Bilir, Esra; Gultekin, Murat; 0000-0003-4499-6543; 32447293; J-3456-2015
Is the extent of lymphadenectomy a prognostic factor in International Federation of Gynecology and Obstetrics stage II endometrioid endometrial cancer?
(2021) Cuylan, Zeliha Firat; Akilli, Huseyin; Gungorduk, Kemal; Demirkiran, Fuat; Oz, Murat; Salman, Mehmet Coskun; Sozen, Hamdullah; Celik, Husnu; Gokcu, Mehmet; Bese, Tugan; Meydanli, Mehmet Mutlu; Ozgul, Nejat; Topuz, Samet; Kuscu, Esra; Kuru, Oguzhan; Gokmen, Sibel; Gultekin, Murat; Ayhan, Ali; 33426779
Aim This study aimed to evaluate the prognostic significance of adequate lymph node dissection (LND) (>= 10 pelvic lymph nodes (LNs) and >= 5 paraaortic LNs removed) in patients with International Federation of Gynecology and Obstetrics (FIGO) stage II endometrioid endometrial cancer (EEC). Methods A multicenter department database review was performed to identify patients who had been operated and diagnosed with stage II EEC at seven centers in Turkey retrospectively. Demographic, clinicopathological, and survival data were collected and analyzed. Results We identified 284 women with stage II EEC. There were 170 (59.9%) patients in the adequate lymph node dissection (LND) group and 114 (40.1%) in the inadequate LND group. The 5-year overall survival (OS) rate of the inadequate LND group was significantly lower than that of the adequate LND group (84.1% vs. 89.1%, respectively; p = 0.028). In multivariate analysis, presence of lymphovascular space invasion (LVSI) (hazard ratio [HR]: 2.39, 95% confidence interval [CI]: 1.23-4.63; p = 0.009), age >= 60 (HR: 3.30, 95% CI: 1.65-6.57; p = 0.001], and absence of adjuvant therapy (HR: 2.74, 95% CI: 1.40-5.35; p = 0.003) remained as independent risk factors for decreased 5-year disease-free survival (DFS). Inadequate LND (HR: 2.34, 95% CI: 1.18-4.63; p < 0.001), age >= 60 (HR: 2.67, 95% CI: 1.25-5.72; p = 0.011), and absence of adjuvant therapy (HR: 4.95, 95% CI: 2.28-10.73; p < 0.001) were independent prognostic factors for decreased 5-year OS in multivariate analysis. Conclusion Adequate LND and adjuvant therapy were significant for the improvement of outcomes in FIGO stage II EEC patients. Furthermore, LVSI was associated with worse 5-year DFS rate in stage II EEC.
OPEC Study: An International Multicenter Study Of Ovarian Preservation In Endometrial Cancers
(2022) Akgor, Utku; Ayhan, Ali; Shushkevich, Alexander; Ozdal, Bulent; Angelou, Kyveli; Akbayir, Ozgur; Kaidarova, Dilyara; Ulrikh, Elena; Stepanyan, Artem; Ortac, Firat; Aliyev, Shamistan; Ozgul, Nejat; Taranenka, Siarhei; Haberal, Ali; Salman, Coskun; Seyhan, Alper; Selcuk, Ilker; Haidopoulos, Dimitrios; Akilli, Huseyin; Bolatbekova, Raikhan; Alaverdyan, Areg; Taskin, Salih; Murshudova, Sabina; Batur, Meltem; Berlev, Igor; Gultekin, Murat; https://orcid.org/0000-0002-5240-8441; 35323994; AAX-3230-2020
Objective To evaluate the feasibility and oncological safety of ovarian preservation in early stage endometrial adenocarcinoma (EC) patients aged 40 and below. Methods A total of 11 institutions from eight countries participated in the study. 169 of 5898 patients aged <= 40 years were eligible for the study. Patients with EC treated between March 2007 and January 2019 were retrospectively assessed. Results The median duration of follow-up after EC diagnosis was 59 months (4-187). Among 169 participants, ovarian preservation surgery (OPS) was performed in 54 (31.9%), and BSO was performed in 115 (68.1%) patients. Although patients younger than 30 years of age were more likely to have OPS than patients aged 30 to 40 years (20.4% vs. 9.6%, P = 0.021), there was no significant difference by the mean age. There were no other relevant baseline differences between OPS and BSO groups. The Kaplan-Meier analysis revealed no difference in either the overall survival (P = 0.955) or recurrence-free survival (P = 0.068) among patients who underwent OPS, and BSO. Conclusion OPS appears to be safe without having any adverse impact on survival in women aged <= 40 years with FIGO Stage I EC.
SATEN III-Splitting Adjuvant Treatment of stage III ENdometrial cancers: an international, multicenter study
(2019) Kahramanoglu, Ilker; Meydanli, Mehmet Mutlu; Taranenka, Siarhei; Ayhan, Ali; Salman, Coskun; Sanci, Muzaffer; Demirkan, Fuat; Ortac, Fırat; Haidopoulos, Dimitrios; Sukhin, Vladyslav; Kaidarova, Dilyara; Stepanyan, Artem; Farazaneh, Farah; Aliyev, Shamistan; Ulrikh, Elena; Kurdiani, Dina; Yalcin, Ibrahim; Mavrichev, Siarhei; Akilli, Huseyin; Sari, Mustafa Erkan; Pletnev, Andrei; Aslan, Koray; Bese, Tugan; Kairbayev, Murat; Vlachos, Dimitrios; Gultekin, Murat; 31481453
Introduction The purposes of this study were to compare adjuvant treatment modalities and to determine prognostic factors in stage III endometrioid endometrial cancer (EC). Methods SATEN III was a retrospective study involving 13 centers from 10 countries. Patients who had been operated on between 1998 and 2018 and diagnosed with stage III endometrioid EC were analyzed. Results A total of 990 women were identified; 317 with stage IIIA, 18 with stage IIIB, and 655 with stage IIIC diseases. The median follow-up was 42 months. The 5-year disease-free survival (DFS) of patients with stage III EC by adjuvant treatment modality was 68.5% for radiotherapy (RT), 54.6% for chemotherapy (CT), and 69.4% for chemoradiation (CRT) (p=0.11). The 5-year overall survival (OS) for those patients was 75.6% for RT, 75% for CT, and 80.7% for CRT (p=0.48). For patients with stage IIIA disease treated by RT versus CT versus CRT, the 5-year OS rates were 75.6%, 75.0%, and 80.7%, respectively (p=0.48). Negative peritoneal cytology (HR: 0.45, 95% CI: 0.23 to 0.86; p=0.02) and performance of lymphadenectomy (HR: 0.33, 95% CI: 0.16 to 0.77, p=0.001) were independent predictors for improved OS for stage IIIA EC. For women with stage IIIC EC treated by RT, CT, and CRT, the 5-year OS rates were 78.9%, 67.0%, and 69.8%, respectively (p=0.08). Independent prognostic factors for better OS for stage IIIC disease were age <60 (HR: 0.50, 95%CI: 0.36 to 0.69, p<0.001), grade 1 or 2 disease (HR: 0.59, 95% CI: 0.37 to 0.94, p=0.014; and HR: 0.65, 95%CI: 0.46 to 0.91, p=0.014, respectively), absence of cervical stromal involvement (HR: 063, 95% CI: 0.46 to 0.86, p=0.004) and performance of para-aortic lymphadenectomy (HR: 0.52, 95% CI: 0.35 to 0.72, p<0.001). Discussion Although not statistically significant, CRT seemed to be a better adjuvant treatment option for stage IIIA endometrioid EC. Systematic lymphadenectomy seemed to improve survival outcomes in stage III endometrioid EC.