Fakülteler / Faculties
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Item Importance of Laparoscopy in Predicting Complete Cytoreduction at Advanced Stage Ovarian Cancer(2022) Durdag, Gulsen Dogan; Alemdaroglu, Songul; Baran, Safak Yilmaz; Serbetcioglu, Gonca Coban; Ozmete, Ozlem; Ezer, Ali; Celik, Husnu; https://orcid.org/0000-0003-4335-6659Purpose Laparoscopy has been used in evaluation of ovarian cancer to assess the extent and surgical resectability of the disease, and to avoid futile laparotomy, where primary cytoreduction is not suitable. Aim of this study is to investigate the contribution of laparoscopy in predicting 'no gross residue' in advanced stage ovarian cancer. Methods Data of advanced stage ovarian cancer patients, who underwent diagnostic laparoscopy for prediction of complete cytoreduction due to an alternative model, are analyzed retrospectively. Accordingly, in the absence of obvious mesenteric retraction or extensive tumoral implants on small intestine in laparoscopic assessment, cases were deemed surgically resectable, and the operation was continued with laparotomy to achieve complete cytoreduction. Clinical features of the patients, surgical details, complete and optimal cytoreduction rates, and perioperative complications were evaluated. Results Out of 243 patients with advanced stage ovarian/tubal/peritoneal cancer, laparoscopy was performed at 93 patients, 77 of whom underwent primary cytoreduction subsequently. Complete cytoreduction (no gross residue) and optimal cytoreduction (< 1 cm residual tumor) rates were 75.3 and 100%, respectively. None of the patients had suboptimal surgery. Morbidity and mortality rates were acceptable. Conclusion Laparoscopic evaluation prior to cytoreductive surgery can highly contribute to prediction of complete or optimal cytoreduction in suitable patients. However, experience and skills of the surgeon, as well as technical equipment of the center, may affect surgery; therefore, the model to predict residual tumor should be individualized according to the set up and the surgical team of each center.Item The clinical outcomes of ovarian cancer in patients with brain metastasis(2021) Simsek, Seda Yuksel; Guler, Ozan Cem; Durdag, Gulsen Dogan; Sari, Sezin Yuce; Gultekin, Melis; Yildiz, Ferah; Celik, Husnu; Erbay, Gurcan; Onal, Huseyin Cem; 0000-0003-3191-9776; AAK-7016-2021Objective: To present the clinical characteristics and treatment outcomes of patients with ovarian cancer with brain metastasis. Methods: This study was designed as a retrospective observational study. Patients' data were obtained from hospital records. Patients who were diagnosed with brain metastatic ovarian cancer in two tertiary referral centers between 2012 and 2020 were included in the study. Results: In total, there were 56 patients diagnosed as having brain metastatic ovarian cancer. The median age was 56 years, 91% of patients were at an advanced stage at initial diagnosis. The median time from the initial diagnosis to brain metastasis was 34.0 months. Sixty-seven percent of patients were determined as having multiple brain metastatic lesions. Whole brain radiotherapy (WBRT) , stereotactic radiosurgery (SRS) and combined approach were utilized as primary treatment. The 1 and 2-year survival rates were 38% and 17%, respectively. Patient age and tumor histology were found to be significant prognostic factors that impact the survival in univariate analyses. The 1-year survival of patients aged younger than 55 years was 49.2%, and 28.2% for patients aged over 55 years (p = 0.04). Patients with nonserous histology had significantly longer one year overall survival compared to serous histology (61.4% vs 29.8%) (p= 0.01). Conclusion: The brain is one of the rarest locations for ovarian cancer metastasis. Radiotherapeutic approaches are the mainstay of treatment but survival rates are low. Age and tumor histology were determined as significant parameters that affected survival rates.