Scopus İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4809
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Item Is the Oncological Outcome of Early Stage Uterine Carcinosarcoma Different from That of Grade 3 Endometrioid Adenocarcinoma?(2021) Gungorduk, Kemal; Plett, Helmut; Gulseren, Varol; Meydanli, Mutlu; Boyraz, Gokhan; Ozdemir, Isa Aykut; Sahin, Hanifi; Senol, Taylan; Yildirim, Nuri; Turan, Taner; Oge, Tufan; Gokcu, Mehmet; Taskin, Salih; Ayhan, Ali; Ataseven, Beyhan; 33249415; AAJ-5802-2021Aim: The clinicopathologic characteristics, recurrence patterns, and survival of patients with grade 3 endometrial cancer (G3-EAC) and uterine carcinosarcoma (UCS) were compared. Materials and Methods: The medical records of patients treated for G3-EAC and UCS between January 1996 and December 2016 at 11 gynecologic oncology centers in Turkey and Germany were analyzed. Results: Of all patients included in the study, 161 (45.1%) were diagnosed with UCS and 196 (54.9%) with G3-EAC at FIGO stage I-II (early stage) disease. The recurrence rate was higher in patients with UCS than in those with G3-EAC (17.4 vs. 9.2%, p = 0.02). The 5-year disease-free survival (DFS; 75.2 and 80.8%, respectively; p = 0.03) and overall survival (OS; 79.4 and 83.4%, respectively; p = 0.04) rates were significantly lower in the UCS group compared to the G3-EAC group. UCS histology was an independent prognostic factor for decreased 5-year DFS (HR 1.8, 95% CI 1.2-3.2; p = 0.034) and OS (HR 2.7, 95% CI 1.3-6.9; p = 0.041) rates. Conclusions: The recurrence rate was higher in UCS patients than in G3-EAC patients, regardless of disease stage. DFS and OS were of shorter duration in UCS than in G3-EAC patients. Adequate systematic lymphadenectomy and omentectomy were an independent prognostic factor for increased 5-year DFS and OS rates.Item Comparison of two intraoperative examination methods for the diagnosis of sentinel lymph node metastasis in clinically early stage endometrial cancer: A Turkish Gynecologic Oncology Group Study (TRSGO-SLN-003)(2021) Taskin, Salih; Varli, Bulut; Altin, Duygu; Takmaz, Ozguc; Vatanseverc, Dogan; Ersoz, Cevriye Cansiz; Turan, Hasan; Bulutay, Pinar; Zeren, Handan; Havare, Semiha Battal; Karabuk, Emine; Naki, Murat; Gungor, Mete; Kose, Faruk; Ortac, Firat; Arvas, Macit; Ayhan, Ali; Taskiran, Cagatay; 33894621Objective: This study evaluated diagnostic accuracy of intraoperative sentinel lymph node (SLN) frozen section examination and scrape cytology as a possible solution for management of SLN positive patients. Study design: Clinically early-stage endometrial cancer patients who underwent SLN algorithm and intraoperative SLN examination were analyzed. Findings were compared with final pathology results and diagnostic accuracy of frozen section and scrape cytology were evaluated. Results: Of the 208 eligible patients, 100 patients (48 %) had frozen section examination and 108 (52 %) had scrape cytology of the SLN. Intraoperative examination and final pathology were negative for metastasis in 187/208 (90 %) cases. The rest 21 cases had metastatic SLNs according to final pathology. 12 of 21 (57 %) metastases were classified as macrometastasis. Intraoperative examination of SLNs correctly identified 13 cases (true positive) and missed 8 cases (false negative). Five of 8 false negative cases had micrometastasis or isolated tumor cells. Considering identification of macrometastasis, sensitivity and negative predictive value were 85.71 % and 98.94 %, respectively, for the frozen section and 60.00 % and 98.15 %, respectively, for the scrape cytology. Conclusion: Frozen section examination of SLN has higher sensitivity in detecting macrometastasis compared to scrape cytology and it could help the surgeon in decision for further lymphadenectomy intraoperatively. (C) 2021 Elsevier B.V. All rights reserved.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 Recurrence patterns and prognostic factors in lymphovascular space invasion-positive endometrioid endometrial cancer surgically confined to the uterus(2019) Sahin, Hanifi; Meydanli, Mehmet Mutlu; Sari, Mustafa Erkan; Kocaman, Eda; Cuylan, Zeliha Fırat; Yalcin, Ibrahim; Coban, Gonca; Ozen, Ozlem; Sirvan, Levent; Gungor, Tayfun; Ayhan, Ali; 30638487Objective: The purpose of this study was to determine the patterns of failure and prognostic factors for lymphovascular space invasion (LVSI)-positive endometrioid endometrial cancer (EC) patients in the setting of negative lymph nodes (LNs). Materials and methods: A multicenter, retrospective department database review was performed to identify LVSI-positive patients with disease surgically confined to the uterus at two gynecologic oncology centers in Turkey. Demographic, clinicopathological and survival data were collected. Results: We identified 185 LVSI-positive women with negative LNs during the study period. Fifty-five (29.7%) were classified as Stage IA, 94 (50.8%) as Stage IB, and 36 (19.5%) as Stage II. The median age at diagnosis was 59 years and the median duration of follow-up was 44 months. The total number of the recurrences was 12 (6.5%). We observed 5 (2.9%) loco-regional recurrences, 3 (1.5%) retroperitoneal failures, and 4 (2.0%) distant relapses. The 5-year progression-free survival (PFS) was 86.1% while the 5-year overall survival (OS) rate was 87.7%. Grade 3 histology (Hazard Ratio [HR] 2.9, 95% Confidence Interval [CI] 1.02-8.50; p = 0.04), cervical stromal invasion (HR 4.5, 95% CI 1.61-12.79; p = 0.004) and age > 60 years (HR 5.8, 95% CI 1.62-21.32; p = 0.007) were found to be independent prognostic factors for decreased OS. Adjuvant treatment did not appear as a prognostic factor for OS even in univariate analysis. Conclusion: The recurrence rate among LVSI-positive endometrioid EC patients is low in the setting of negative LNs. However, one out of three patients with a recurrence experiences distant relapses which usually portend worse outcomes. (C) 2018 Taiwan Association of Obstetrics & Gynecology. Publishing services by Elsevier B.V.Item Oncological Outcomes of Stage IIIA Endometrioid Type Endometrial Cancer: A Multicenter Study(2019) Sahin, Hanifi; Yalcin, Ibrahim; Sari, Mustafa Erkan; Sahin, Eda Adeviye; Aslan, Koray; Aglamis, Ozgur; Gulseren, Varol; Gungorduk, Kemal; Meydanli, Mehmet Mutlu; Ayhan, AliThe objective of this retrospective study was to evaluate Stage IIIA endometrioid type endometrial carcinomas (ECCs) and to analyze clinical and pathological determinants of prognosis in three tertiary hospitals between January 2007 and January 2017. Forty-seven patients with a median age of 61 (range: 31 to 76) years were diagnosed with Stage IIIA disease. Median follow-up was 45 (range: 6 to 116) months. The five-year disease-free survival (DFS) rate was 57.2%, and the overall survival (OS) rate was 59.7%. In the univariate analysis, age and grade of the disease (1-2 versus 3) disease were found to be significant factors for DFS. Univariate analysis also revealed the presence of cervical stromal involvement and grade of the disease were associated with decreased OS. In the multivariate analysis, however, only patients with an advanced histological grade had a reduced risk for OS (hazard ratio [FIR] 2.9; 95% confidence interval [CI] 1.020-8.615; p= 0.040). In conclusion, histological grade seems to be an independent prognostic factor for OS in patients with Stage IIIA ECCs.Item Good Outcomes of Patients with Stage IB Endometrial Cancer with Surgery Alone(2014) Rahatli, Samed; Dizdar, Omer; Kucukoztas, Nadire; Oguz, Arzu; Yalcin, Selim; Ozen, Ozlem; Reyhan, Nihan Haberal; Tarhan, Cagla; Yildiz, Ferah; Dursun, Polat; Altundag, Ozden; Ayhan, AliBackground: Most patients with endometrial cancer have stage I disease. Adjuvant therapy in stage IB (formerly IC) endometrial cancer is controversial, treatment options including observation or brachytherapy/radiotherapy in grade 1-3 patients with or without chemotherapy. The purpose of this study was to assess the outcomes of our patients with stage IB endometrioid endometrial cancer. Materials and Methods: Sixty two patients with stage IB endometrial cancer and endometrioid histology were retrospectively evaluated. All patients were initially treated surgically by the same surgeon with comprehensive staging, i.e. total abdominal hysterectomy, bilateral salphingooopherectomy, bilateral pelvic and paraaortic lymph node dissection and omentectomy. Adjuvant radiotherapy was discussed with patients and utilized by those who accepted. Adjuvant chemotherapy was not given to any of the patients. Results: Median age was 62 (range, 42-95). Ninety percent of the patients had grade 1-2 disease. Thirteen patients (21%) received intra vaginal brachytherapy (IVBT) and one received whole pelvic radiotherapy (WPRT). Median follow-up time was 46 months (range, 9-77 months). Three patients experienced recurrence (4.8%), two of them died on follow-up and one was still alive at last visit. Two patients with recurrence had FIGO grade 2 tumors and one had a grade 3 tumor. Two patients (3.2%) died without evidence of recurrent disease. Relapse free survival at 5 years was 94.4% and overall survival was 93.1%. Conclusions: Patients with stage IB disease in our study demonstrated relatively low recurrence rates with this stage of endometrial cancer.