Scopus İndeksli Yayınlar Koleksiyonu

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Author: search.filters.author.Simsek, Tayup

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    High-grade endometrial stromal sarcoma versus undifferentiated uterine sarcoma: a Turkish uterine sarcoma group study-001
    (2021) Ayhan, Ali; Tunc, Mehmet; Boran, Nurettin; Khatib, Ghanim; Gokcu, Mehmet; Simsek, Tayup; Ozen, Ozlem Isiksacan; Toptas, Tayfun; Yalcin, Ibrahim; Meydanli, Mehmet Mutlu; https://orcid.org/0000-0002-9082-1317; 33392719; AAK-4468-2021
    Objective Prognostic factors associated with high-grade endometrial stromal sarcoma (HGESS) and undifferentiated uterine sarcoma (UUS) have not been distinctly determined due to the repetitive changes in the World Health Organization (WHO) classification. We aimed to compare clinicopathologic features and outcomes of patients with HGESS with those of patients with UUS. Methods A multi-institutional, retrospective, cohort study was conducted including 71 patients, who underwent surgery at 13 centers from 2008 to 2017. An experienced gynecopathologist from each institution re-evaluated the slides of their own cases according to the WHO2014 classification. Factors associated with refractory/progressive disease, recurrence or death were examined using logistic regression analyses. Kaplan-Meier method and log-rank test were used for survival comparisons. Results The median disease-free survival (DFS) for HGESS and UUS was 12 months and 6 months, respectively. While the median overall survival was not reached in HGESS group, it was 22 months in the UUS group. Kaplan-Meier analyses revealed that patients with UUS had a significantly poorer DFS than those with HGESS (p = 0.016), although OS did not differ between the groups (p = 0.135). Lymphovascular-space involvement (LVSI) was the sole significant factor associated with progression, recurrence or death for HGESS (Hazard ratio: 9.353, 95% confidence interval: 2.539-34.457, p = 0.001), whereas no significant independent factor was found for UUS. Conclusions UUS has a more aggressive behavior than HGESS. While no significant predictor of prognosis was found for UUS, LVSI is the sole independent prognostic factor for HGESS, with patients 9.3 times more likely to experience refractory/progressive disease, recurrence or death.
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    Low-grade endometrial stromal sarcoma: A Turkish uterine sarcoma group study analyzing prognostic factors and disease outcomes
    (2021) Ayhan, Ali; Toptas, Tayfun; Oz, Murat; Vardar, Mehmet Ali; Kayikcioglu, Fulya; Ozgul, Nejat; Gokcu, Mehmet; Simsek, Tayup; Tunc, Mehmet; Meydanli, Mehmet Mutlu; 0000-0002-8646-0619; 33375988; AAA-6962-2022
    Objective. To investigate factors associated with refractory disease, recurrence, or death as well as disease-free survival (DFS) and overall survival (OS) in low-grade endometrial sarcoma (LGESS). Methods. A multi-institutional, retrospective study was conducted in a total of 124 patients, who received a curative-intent surgery. The exclusion criteria were as follows: i) history of any other invasive disease; ii) neoadjuvant therapy; iii) fertility sparing surgery; iv) a different diagnosis after review of the slides. Results. All patients underwent hysterectomy, 96% had bilateral salpingo-oophorectomy, and 65% had lymphadenectomy. Twelve (14.8%) of 81 patients undergoing lymphadenectomy had lymph node (LN) metastasis. Of those, 8 (9.8%) had pelvic LN metastasis whereas 4 (5.6% ) had isolated paraaortic LN metastasis. Six of 8 (75%) patients with positive pelvic LNs had concurrent paraaortic LN metastasis. Among 124 patients, 3 patients (2.4%) had refractory disease following primary therapy. During a median follow-up of 45.5 months, 27 (22.3%) of 121 patients who achieved complete remission after primary therapy developed recurrence, and 10 patients (8.1%) died of disease. The 3-year DFS and OS were 76.9% and 93.8%, respectively. Stage was the sole independent prognostic factor in the whole cohort. When analyzing factors within subgroups of stage I and stage >= II, there was no significant prognostic factor for stage I; however, lymphadenectomy and adjuvant chemotherapy were significantly associated with disease outcomes for stage >= II. While lymphadenectomy was related with improved DFS, chemotherapy was associated with poor DFS and OS. Conclusion. The risk of LN metastasis at pelvic as well as paraaortic lymphatic basins is not negligible to omit lymphadenectomy in stage >= II LGESS. Moreover, lymphadenectomy provides significant DFS advantage in patients with extrauterine disease. (C) 2020 Elsevier Inc. All rights reserved.
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    Could the Long-Term Oncological Safety of Laparoscopic Surgery in Low-Risk Endometrial Cancer also Be Valid for the High-Intermediate- and High-Risk Patients? A Multi-Center Turkish Gynecologic Oncology Group Study Conducted with 2745 Endometrial Cancer Cases. (TRSGO-End-001)
    (2021) Vardar, Mehmet Ali; Guzel, Ahmet Baris; Taskin, Salih; Gungor, Mete; Ozgul, Nejat; Salman, Coskun; Kucukgoz-Gulec, Umran; Khatib, Ghanim; Taskiran, Cagatay; Duender, Ilkkan; Ortac, Firat; Yuce, Kunter; Terek, Cosan; Simsek, Tayup; Ozsaran, Aydin; Onan, Anil; Coban, Gonca; Topuz, Samet; Demirkiran, Fuat; Takmaz, Ozguc; Kose, M. Faruk; Gocmen, Ahmet; Seydaoglu, Gulsah; Gumurdulu, Derya; Ayhan, Ali; 34898563
    This study was conducted to compare the long-term oncological outcomes of laparotomy and laparoscopic surgeries in endometrial cancer under the light of the 2016 ESMO-ESGO-ESTRO risk classification system, with particular focus on the high-intermediate- and high-risk categories. Using multicentric databases between January 2005 and January 2016, disease-free and overall survivals of 2745 endometrial cancer cases were compared according to the surgery route (laparotomy vs. laparoscopy). The high-intermediate- and high-risk patients were defined with respect to the 2016 ESMO-ESGO-ESTRO risk classification system, and they were analyzed with respect to differences in survival rates. Of the 2745 patients, 1743 (63.5%) were operated by laparotomy, and the remaining were operated with laparoscopy. The total numbers of high-intermediate- and high-risk endometrial cancer cases were 734 (45%) patients in the laparotomy group and 307 (30.7%) patients in the laparoscopy group. Disease-free and overall survivals were not statistically different when compared between laparoscopy and laparotomy groups in terms of low-, intermediate-, high-intermediate- and high-risk endometrial cancer. In conclusion, regardless of the endometrial cancer risk category, long-term oncological outcomes of the laparoscopic approach were found to be comparable to those treated with laparotomy. Our results are encouraging to consider laparoscopic surgery for high-intermediate- and high-risk endometrial cancer cases.
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    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-9974-2021
    Objective: 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.