Wos İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4807
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Item Factors affecting parametrial involvement in cervical cancer patients with tumor size <= 4 cm and selection of low-risk patient group(2021) Akilli, Huseyin; Tohma, Yusuf Aytac; Gunakan, Emre; Kucukyildiz, Irem; Tunc, Mehmet; Haberal, Nihan Reyhan; Ayhan, Ali; 0000-0002-5240-8441; 0000-0001-9418-4733; 0000-0001-8854-8190; 0000-0001-9852-9911; 33506671; AAX-3230-2020; AAE-6482-2021; ABI-1707-2020; AAK-4587-2021Objective: The primary aim of this study was to evaluate the factors affecting parametrial involvement in cervical cancer patients with tumor size <= 4 cm and selection of the low-risk patient group based on long-term oncologic outcomes. Material and Methods: Cervical cancer patients operated in the gynecologic oncology division between 2007 and 2013 were retrospectively evaluated. One-hundred and sixty-eight patients with tumor size <= 4 cm were identified. Of these, 159 (86.8%) underwent radical hysterectomy plus pelvic-para- aortic lymphadenectomy and nine (13.2%) underwent fertility-sparing surgery [radical trachelectomy (n= 7); large conization (n=2)]. Factors affecting parametrial invasion, including lymphovascular space invasion (LVSI), deep stromal invasion (DSI), lymph node metastases, and tumor size, were evaluated. Statistical analyses were performed using SPSS 23.0 (IBM Corp., Armonk, NY, USA). Results: Median age was 49.5 years and median tumor size was 2.5 cm ( 0.45-4 cm). In both univariate and multivariate analyses, the risk of parametrial involvement was increased with LVSI with a hazard ratio (HR) of 3.45 [95% confidence interval (CI): 1.1-10.8] and DSI with a HR of 4.1 (95% CI: 1.18-14.8), while tumor size of <= 2 cm was only significant in univariate analyses. Furthermore, 26 early-stage patients were identified with low-risk factors and they had no parametrial involvement, lymph node metastases, recurrence, or death from disease over 77 months. Conclusion: Parametrial involvement in low-risk cervical cancer is very rare and less radical procedures may be safe in these patients.Item Fertility preservation in early-stage endometrial cancer and endometrial intraepithelial neoplasia: A single-center experience(2020) Ayhan, Ali; Tohma, Yusuf Aytac; Tunc, Mehmet; 0000-0001-9418-4733; 32416890; AAJ-5802-2021; AAE-6482-2021; AAC-4013-2021Objective: The purpose of this study was to define the pregnancy and oncologic outcomes after fertility-sparing treatment of atypical hyperplasia (AH)/endometrial intraepithelial neoplasia (EIN) and early-stage endometrioid endometrial cancer (EEC). Materials and methods: The retrospective cohort study included patients who had applied to Baskent University's Ankara Hospital between January 2007 and October 2018 with either AH/EIN (n: 27; Group A) or EEC (n: 30; Group B), and who had the desire to preserve their fertility. The medical records of all patients included in the study were reviewed retrospectively from the hospital records. Results: There were 2 (7.4%) and 5 (16.7%) recurrences, whereby one patient from Group A and two patients from Group B underwent staging surgery. In Group A, 8 patients attempted pregnancy after their treatment and 4 of them (50%) became pregnant, while 3 of them (37.5%) had a live birth. In Group B, there were 17 patients who wanted to become pregnant following treatment of the disease; 8 of them (47%) became pregnant after treatment, 5 of them (16.6%) had a live birth, 1 experienced intrauterine exitus (at 21st gestational week, 350 g), and 2 currently have ongoing pregnancies. Conclusion: Hysteroscopic resection of visible lesions and full endometrial curettage prior to hormonal therapy as a fertility-preserving approach for women of reproductive age with endometrial malignancies can achieve promising oncologic and obstetric responses. (C) 2020 Taiwan Association of Obstetrics & Gynecology. Publishing services by Elsevier B.V.