Wos İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4807
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Item The prognostic value of lymph node ratio in stage IIIC cervical cancer patients triaged to primary treatment by radical hysterectomy with systematic pelvic and para-aortic lymphadenectomy(2020) Aslan, Koray; Meydanli, Mehmet Mutlu; Oz, Murat; Tohma, Yusuf Aytac; Haberal, Ali; Ayhan, Ali; 0000-0001-9418-4733; 0000-0002-1486-7209; 31788991; AAE-6482-2021; AAI-9331-2021; AAJ-5802-2021Objective: The aim of this study was to determine the prognostic value of lymph node ratio (LNR) in women with 2018 International Federation of Gynecology and Obstetrics stage IIIC cervical cancer. Methods: In this retrospective dual-institutional study, a total of 185 node-positive cervical cancer patients who had undergone radical hysterectomy with systematic pelvic and para-aortic lymphadenectomy were included. All of the patients received adjuvant chemoradiation after surgery. LNR was defined as the ratio of positive lymph nodes (LNs) to the total number of LNs removed. The patients were categorized into 2 groups according to LNR; LNR <0.05 and LNR >= 0.05. The prognostic value of LNR was evaluated with univariate log-rank tests and multivariate Cox regression models. Results: A total of 138 patients (74.6%) had stage IIIC1 disease and 47 (25.4%) patients had stage IIIC2 disease. With a median follow-up period of 45.5 months (range 3-135 months), the 5-year disease-free survival (DFS) rate was 62.5% whereas the 5-year overall survival (OS) rate was 70.4% for the entire study population. The 5-year DFS rates for LNR <0.05 and LNR >= 0.05 were 78.2%, and 48.4%, respectively (p<0.001). Additionally, the 5-year OS rates for LNR <0.05 and LNR >= 0.05 were 80.6%, and 61.2%, respectively (p=0.007). On multivariate analysis, LNR.0.05 was associated with a worse DFS (hazard ratio [HR]=2.12; 95% confidence interval [CI]=1.15-3.90 ; p=0.015) and OS (HR=1.95; 95% CI=1.01-3.77; p=0.046) in women with stage IIIC cervical cancer. Conclusions: LNR >= 0.05 seems to be an independent prognostic factor for decreased DFS and OS in stage IIIC cervical carcinoma.Item Enhancer of zeste homologue 2 (EZH2) expression in synovial sarcomas as a promising indicator of prognosis(2017) Ozgun, Gonca; Yalcinkaya, Ulviye; Ugras, Nesrin; Ocakoglu, Gokhan; Deligonul, Adem; Cetintas, Sibel Kahraman; Bilgen, Muhammed Sadik; 28738014Synovial sarcoma (SS) is a type of soft-tissue sarcoma, often linked to poor survival. Although overexpression of enhancer of zeste homologue 2 (EZH2) has been associated with poor prognosis in different tumors, a few studies investigated this link in SS. Here, we analyzed the relationship between EZH2 expression and prognostic factors in SS. We included 29 patients with SS. Immunostaining of EZH2 was performed with (D2C9) XP (TM) Rabbit mAb antibody, and the results were classified as low EZH2 expression (negative or weak expression) and high EZH2 expression category (moderate or strong expression). Analysis of survival in relation to prognostic factors was performed with Kaplan-Meier survival curves and Cox proportional hazard regression analysis. Our sample included 19/29 female and 10/29 male patients, with age range 16-63 years. The tumor diameter ranged from 2 to 15 cm. Necrosis was observed in 15/29 cases. Sixteen cases had > 10 mitoses per 50 high-power fields (HPFs). Out of 29 cases, 14 showed low and 15 had high EZH(2) expression. Statistically significant results were obtained for the association between the presence of metastasis and necrosis (p = 0.042), high EZH2 expression and distant metastasis (p = 0.018), high EZH2 expression and necrosis (p = 0.016), and high EZH2 expression and the tumor size > 5 cm versus tumor size <= 5 cm (p = 0.014). Patients with all of the following: the tumor size <= 5 cm, low EZH2 expression, and without necrosis and distant metastasis had significantly longer survival time. Our results are consistent with previous studies, suggesting that EZH(2) overexpression is an indicator of poor prognosis in SS.Item 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-9974-2021Objective: 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.