Wos İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4807
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Item Clinical Outcomes of Patients with High-Grade Ovarian Carcinoma Arising in Endometriosis Compared to Ovarian High-Grade Serous Carcinoma(2021) Yalcin, Ibrahim; Sahin, Hanifi; Sari, Mustafa Erkan; Haberal, Asuman Nihan; Sahin, Eda Adeviye; Celik, Husnu; Meydanli, Mehmet Mutlu; Ayhan, Ali; 0000-0003-1185-9227Purpose To compare the prognoses of women with high-grade ovarian carcinoma arising in endometriosis (OCAE) to those of women with ovarian high-grade serous carcinoma (HGSC) Material and Methods This multicenter, retrospective, case-control study included patients with OCAE at two gynecologic oncology centers in Turkey between January 2006 and December 2016. Of a total of 202 women with a diagnosis of OCAE, 70 women with high-grade OCAE were included. Each case high-grade OCAE was attributed to two women with ovarian HGSC. Survival analysis was performed using the Kaplan-Meier method. Results Eleven patients with high-grade OCAE had recurrent disease (15.7%) when compared to 47 patients (33.6%) with HGSC (p = 0.008). The 5-year disease-free survival (DFS) rate of the patients having high-grade OCAE was significantly higher than the women with HGSC (78.3% vs. 56.2%; p = 0.007, respectively). According to the 5-year overall survival (OS) rates, there was no significant difference between high-grade OCAE and HGSC (79.5% vs. 70.1%; p = 0.210, respectively). Conclusion Although this retrospective study demonstrated a significant decrease in recurrence rate and an increase in the 5-year DFS rate in patients with high-grade OCAE, OS rates of the patients with HGSC and high-grade OCAE seem to be similar.Item Does Polyp-Originated Growing have Prognostic Significance for Stage 1 Endometrioid-Type Endometrial Cancer?(2020) Kucukyildiz, Irem Alyazici; Gunakan, Emre; Akilli, Huseyin; Haberal, Asuman Nihan; Kuscu, Esra; Haberal, Ali; Ayhan, Ali; 0000-0002-5240-8441; 0000-0002-0992-6980; 0000-0001-9852-9911; 0000-0002-1486-7209; AAX-3230-2020; AAI-8792-2021; AAK-4587-2021; AAI-9331-2021Purpose Endometrioid-type endometrial cancer is usually diagnosed in the early stages and has a good prognosis. Patients with stage 1 disease have survival rates over 95%. Tumor factors affect survival in these patients, but polyp-originated growing has not been sufficiently discussed in the literature. This study aimed to determine the effect of polyp-originated growing in stage 1 endometrioid-type endometrial cancer and to provide a review of the literature. Methods This study includes 318 stage 1 endometrioid-type endometrial cancer patients. The patients were divided into two groups based on the tumor origin. Group I included patients with polyp-originated growing tumors, and Group II included patients with endometrial surface-originated growing tumors. Results Groups I and II included 39 and 279 patients, respectively. The general properties of the patients were similar; there were no significant differences. The univariate survival analyses showed that overall survival for Groups I and II was 65.5 and 83.6 months, respectively; this difference was statistically significant (p = 0.002). The multivariate analysis of age, maximum tumor diameter, tumor origin, lymphovascular space involvement, myometrial invasion depth and tumor grade showed that polyp-originated growing was independently and significantly associated with overall survival (HR 4.05; 95% CI 1.2-13.5; p = 0.023). Conclusion Polyp-originated growing may be a prognostic factor for early stage endometrioid-type endometrial cancer. The prognostic effect of polyp-originated growing is not well known, and further investigation is necessary.Item Relation of Preoperative and Postoperative Echocardiographic Parameters With Rejection and Mortality in Liver Transplant Patients(2020) Yilmaz, Kerem Can; Ciftci, Orcun; Akgun, Arzu Neslihan; Muderrisoglu, Haldun; Boyacioglu, Sedat; Haberal, Asuman Nihan; Moray, Gokhan; Haberal, Mehmet; 0000-0001-8926-9142; 0000-0002-9635-6313; 0000-0003-2498-7287; 0000-0002-9370-1126; 0000-0001-9852-9911; 0000-0002-3462-7632; 29790458; W-5233-2018; AAG-8233-2020; AAJ-1331-2021; AAE-1041-2021; AAE-7637-2021; AAK-4587-2021; AAJ-8097-2021Objectives: Survival in liver transplant after end-stage liver disease is associated with major cardiac functions. In a significant number of patients with end-stage liver disease, cardiac dysfunctions may be observed, which can include high-output heart failure, cardiac valve disease, and pulmonary venous and arterial hypertension. All of these affect perioperative survival. The aim of our study was to determine whether preoperative and postoperative echocardiographic parameters, specifically right heart-related tricuspid regurgitation, estimated systolic pulmonary arterial pressure, and tricuspid annular plane systolic excursion, are associated with rejection and mortality in liver transplant patients. Materials and Methods: Adult patients (> 18 years old) who underwent liver transplant at our center between January 2011 and March 2017 were included in the study, with 64 patients retrospectively screened. The echocardiographic images that were taken immediately before and immediately after liver transplant were evaluated. The patients were divided into 2 groups according to rejection data and mortality. All parameters were analyzed for both variables. Results: For the 24 patients with liver rejection and 40 patients without liver rejection, there were no statistically significant differences in terms of demographic data, echocardiographic parameters, and laboratory data. However, when patients were evaluated according to survival, there was a statistically significant difference between these 2 groups concerning the echocardiography parameters of systolic pulmonary arterial pressure (P = .005), tricuspid annular plane systolic excursion (P = .001), and postoperative right ventricular width (P = .01). Conclusions: Echocardiography, being a simple and easily accessible technique that is reliable in excluding pulmonary hypertension diagnosis, can be used as a guide in the evaluation of right ventricular function and tricuspid regurgitation, particularly in patients who are not hemodynamically stable before and after liver transplant.Item Incidence and outcome of occult uterine sarcoma: A multi-centre study of 18604 operations performed for presumed uterine leiomyoma(2020) Yorganci, Aycag; Meydanli, Mehmet Mutlu; Kadioglu, Nezaket; Taskin, Salih; Kayikcioglu, Fulya; Altin, Duygu; Atasoy, Latife; Haberal, Asuman Nihan; Kinay, Tugba; Akgul, Mehmet Akif; Tapisiz, Omer Lutfi; Evliyaoglu, Ozlem; Tekin, Ozlem Moraloglu; Ortac, U. Firat; Ayhan, Ali; 0000-0001-9852-9911; 0000-0001-7369-5470; 31499285; AAJ-5802-2021; AAK-4587-2021; AAI-8793-2021Item Oncological and obstetric outcomes after fertility-sparing radical abdominal trachelectomy for early stage cervical cancer: a tertiary centre's 10 years' experience(2019) Ayhan, Ali; Tohma, Yusuf Aytac; Sahin, Hanifi; Kocaman, Eda; Tunc, Mehmet; Haberal, Asuman Nihan; 0000-0001-9418-4733; 30371139; AAE-6482-2021The aim of this study is to present our clinical experience about fertility-sparing procedures in early stage cervical cancer and its obstetrical and oncological outcomes. Between the years 2006 and 2016, a total of 22 early stage cervical cancer patients who underwent a fertility-sparing radical abdominal trachelectomy in our clinic were retrospectively analysed. The median age was 33 (range: 28-39) years. The median follow-up was 47 (range: 22-125) months. Five patients (22.7%) had Stage IA1, three patients had (13.6%) Stage IA2, and 14 patients (63.6%) had Stage IB1 disease. Only one patient had a recurrence. A pregnancy was obtained in five patients (22.7%) and one of them (20%) had a live birth. A pregnancy was obtained spontaneously in two patients (40%), whereas assisted reproductive techniques were used in three of the patients (60%). A miscarriage occurred in two patients (40%), and one of them was within the first trimester and the other was within the second trimester.Item A novel prediction method for lymph node involvement in endometrial cancer: machine learning(2019) Gunakan, Emre; Atan, Suat; Haberal, Asuman Nihan; Kucukyildiz, Irem Alyazici; Gokce, Ehad; Ayhan, Ali; 30718313Objective The necessity of lymphadenectomy and the prediction of lymph node involvement (LNI) in endometrial cancer (EC) have been hotly-debated questions in recent years. Machine learning is a broad field that can produce results and estimations. In this study we constructed prediction models for EC patients using the Naive Bayes machine learning algorithm for LNI prediction. Methods The study assessed 762 patients with EC. Algorithm models were based on the following histopathological factors: V1: final histology; V2: presence of lymphovascular space invasion (LVSI); V3: grade; V4: tumor diameter; V5: depth of myometrial invasion (MI); V6: cervical glandular stromal invasion (CGSI); V7: tubal or ovarian involvement; and V8: pelvic LNI. Logistic regression analysis was also used to evaluate the independent factors affecting LNI. Results The mean age of patients was 59.1 years. LNI was detected in 102 (13.4%) patients. Para-aortic LNI (PaLNI) was detected in 54 (7.1%) patients, of which four patients had isolated PaLNI. The accuracy rate of the algorithm models was found to be between 84.2% and 88.9% and 85.0% and 97.6% for LNI and PaLNI, respectively. In multivariate analysis, the histologic type, LVSI, depth of MI, and CGSI were independently and significantly associated with LNI (p<0.001 for all). Conclusions Machine learning may have a place in the decision tree for the management of EC. This is a preliminary report about the use of a new statistical technique. Larger studies with the addition of sentinel lymph node status, laboratory findings, or imaging results with machine learning algorithms may herald a new era in the management of EC.Item Oncologic outcomes in patients undergoing maximal or optimal cytoreductive surgery for Stage 3C serous ovarian, tubal or peritoneal carcinomas(2019) Gurkan, Damla; Akin, Aylin Ceren; Sahin, Hanifi; Tohma, Yusuf Aytac; Sahin, Eda Adeviye; Gunakan, Emre; Iflazoglu, Nidal; Haberal, Asuman Nihan; Ayhan, Ali; 0000-0001-9418-4733; 31482736The aim of this study was to evaluate overall survival (OS) and disease-free survival (DFS) of patients with Stage 3C serous ovarian, tubal and peritoneal carcinomas. A retrospective analysis of 111 patients who underwent maximal or optimal cytoreductive surgery was performed. Patients were divided into three groups as ovarian cancer (n = 47), tubal cancer (n = 24) and peritoneal cancer (n = 40). Median follow-up was 30 months. There was no significant difference in DFS and OS among the groups. Complete cytoreduction was an independent prognostic factor for DFS in all groups (HR 2.3, 95% CI 1.14-4.93; p=.020). Positive peritoneal cytology (HR 2.2, 95% CI 1.02-4.78; p=.044), and retroperitoneal lymph node involvement (HR 2.3, 95% CI1.11-4.89; p=.025) were independent risk factors for decreased OS, and extended cytoreduction (HR 2.7, 95% CI 1.05-6.99; p=.039) were independent risk factors for increased OS. In conclusion, these malignancies should be considered a single entity during treatment.IMPACT STATEMENT What is already known on this subject? Epithelial ovarian cancer is the second most common gynaecological cancer in women worldwide. There are different histological types including ovarian, tubal and peritoneal carcinomas in which malignant cells form in the tissue covering the ovary or lining the fallopian tube of peritoneum. Recent data have supported the view that these malignancies should be considered a single entity and should be treated the same way. What the results of this study add? In the present study, we evaluated overall survival and disease-free survival of patients with Stage 3C ovarian, tubal and peritoneal cancer undergoing maximal or optimal cytoreductive surgery. We found similar oncologic outcomes in all patient groups. To the best of our knowledge, this is the first study to compare oncologic outcomes of these similar and often confused malignancies in the literature. We, therefore, believe that the present study provides additional information to the body of knowledge on this topic. s are of these findings for clinical practice and/or further research? This study is important, as it indicates similar oncologic outcomes in patients undergoing maximal or optimal cytoreductive surgery for Stage 3C ovarian, tubal and peritoneal cancer. Based on these findings, clinicians should keep in mind that these malignancies should be considered a single clinical entity and be treated the same way. We believe that our study would pave the way for further studies regarding this subject.