TR-Dizin İndeksli Açık & Kapalı Erişimli Yayınlar
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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 Outcome of sacrospinous ligament fixation with conventional instruments in the treatment of Stage 3-4 vaginal vault prolapse(2019) Sahin, Hanifi; Yalcin, Ibrahim; Sahin, Eda Adeviye; Sari, Mustafa Erkan; Ayhan, AliPurpose: The objective of this study was to investigate the effectiveness of the sacrospinous ligament fixation (SSLF) at 12 months following the operation. Materials and Methods: This retrospective study included patients diagnosed with vaginal vault prolapse and underwent SSLF between January 2014 and May 2017. The subjective evaluation was performed according to the Patient Global Impression of Improvement (PGI-I). The objective success rate at the end of 12 months was evaluated, and the Pelvic Organ Prolapse-Quantification System (POP-Q) Stage 0 or 1 was considered as a successful outcome. The effectiveness of the operation and the complication rates were evaluated during one-year follow-up. Results: A total of 26 patients were included in the study. Twelve patients (46.2%) underwent unilateral SSLF and 14 patients (53.8%) bilateral SSLF operation. At 12 months, the objective and subjective success rates were 100% and 100%, respectively. There was a significant difference between the unilateral and bilateral SSLF groups in terms of the operation time and intraoperative bleeding. After one-year follow-up, only three patients (11.3%) complained about mild gluteal pain. Conclusion: The suspension of the vagina to the unilateral or bilateral sacrospinous ligament was an effective and safe surgical method in patients with post-hysterectomy vaginal vault prolapse.Item Paraaortic Lymph Node Dissection in Endometrial Cancer; Is It Necessary?(2014) Dizdar, Omer; Oguz, Arzu; Kucukoztas, Nadire; Dursun, Polat; Altundag, Ozden; Ayhan, AliItem Problematic Areas Related to Sexual Life of Individuals with Gynecological Cancer: A qualitative Study in Turkey(2015) Pinar, Gul; Pinar, Tevfik; Akalin, Ayse; Saydam, Tulay; Ayhan, AliThis study was conducted to examine problematic areas related to sexual life of individuals with gynecological cancer. Qualitative phenomenological research design was used in the study. The data were collected through "Semistructured In-depth Interview Form" and "Individual Information Form" with 30 women diagnosed with gynecological cancer. In-depth interview technique was used for obtaining data related to sexual problem areas of women. The data obtained were evaluated by content analysis. Average age of women who participated in the study was 46.70 +/- 10.66 (min=30, max=67), and women who were followed for the diagnosis of endometrium cancer (53.3%), ovarian cancer (36.7%), cervical cancer (10%). It was determined that there were significant changes in sexual lives of the individuals following the illness, and that body image, role of sexuality, sexual functions and reproduction ability, which are the four important components of sexual health, were affected unfavorably to a great extent. It was determined in this study that individuals with gynecological cancer face multidimensional problems regarding sexual life. Adoption of holistic approach by health professionals in the evaluation of sexual problems of women and attempting to solve the problem are of significance.Item Prognostic Factors Affecting Survival in Patients with Ovarian Cancer: A 5-Year Experience in an University Hospital(2017) Ayhan, Ali; Pinar, Guel; Pinar, Tevfik; Durukan, Ayse; AAJ-5802-2021The aim if this study is to explore the impact of the various prognostic factors on overall survival in women with ovarian cancer (00). Patients diagnosed with gynecologic malignancy in Gynecology Clinic of Baskent University Medicine Faculty between 2010 and 2015 included to study. Patients with ovarian (n= 112) cancers examined retrospectively. Kaplan-Meier, Univariate and Multivariate Cox regression model were performed to estimate for associations of potential variables with survival factors. The mean patient age was 56.4 y, range 20-80. The overall survival was 94.3%, 83.4%, 66.4%, 54.7% and 42.8% at 1, 2 3, 4 and 5 years respectively (60.5 months, range 43-68). 3-year disease-free survival was 25.3% (18.3 months, range 17-20). Multivariate analysis of patients indicated that stage, histology, grade, age at diagnosis, comorbidity, recurrence, BMI, menopausal status and regional distance were independent prognostic factors on survival (p< 0.05). In conclusion, these results will presents a framework to identify fundamental causes in survival for OC.