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 Prognostic Factors in Squamous Cell Carcinoma of the Vulva: a Retrospective Multicenter Study(2020) Kuru, Oguzhan; Akgor, Utku; Cakir, Ilker; Tosun, Ozgur; Yuksel, Ilkbal Temel; Ulker, Volkan; Meydanli, Mutlu; Sanci, Muzaffer; Gokcu, Mehmet; Topuz, Samet; Yildiz, Ferah; Sakinci, Mehmet; Salman, Mehmet Coskun; Ozgul, Nejat; Yuce, Kunter; Ayhan, Ali; AAJ-5802-2021The study aim to determine the clinicopathological factors for disease-free survival (DFS) and overall survival (OS) in women with vulvar cancer and to analyze the the possible effect of metformin on survival of the patients. From 2011 to 2017, medical records of 142 patients who underwent primary radical surgery for VC at 6 referral centers in Turkey were collected, retrospectively. The median age of the cohort was 67.0 years. 124 patients underwent radical surgery and inguinofemoral lymphadenectomy. The overall recurrence rate was 33.8% within a median follow-up time of 22 months. Five-year DFS and OS rates were 55.8% and 62.6%, respectively. Multivariate analysis showed surgical margin (HR:6.4, p= 0.017 for DFS; HR: 13.6, p=0.009 for OS) and lymph node metastasis (HR: 4.1, p= 0.014 for DFS; HR: 6.3, p= 0.020 for OS) were the independent prognostic factors. There was no statistically difference in DFS and OS for patients who had used metformin.Item The prognostic significance of stage I ovarian clear cell and endometrioid carcinomas arising from endometriotic cysts: is it a myth?(2019) Ayhan, Ali; Akilli, Huseyin; Haberal, Nihan; 30315413PurposeThe aim of this study was to determine the clinicopathologic features and the prognostic significance of Stage I ovarian clear cell and endometrioid carcinomas arising from endometriotic cysts.Materials and methodsPatients with either Stage I ovarian clear cell or endometrioid carcinoma were divided into three groups. *Group 1: Patients with cancers arising from endometriotic cysts *Group 2: Patients with ovarian and pelvic endometriosis *Group 3: Patients without endometriosis Patient characteristics (overall survival and disease-free survival) were compared between groups.ResultsOf the 78 patients who participated in this study, 39 were in group 1, 13 were in group 2, and 26 were in group 3. The mean age in groups 1, 2, and 3 were 46years, 54years, and 48years, respectively (p=0.39). Tumoral characteristics, including capsule rupture, positive cytology, grade, and the presence of synchronous endometrial cancer were similar in both groups. The 5-year overall survival rate in groups 1, 2, and 3 were 100, 90, and 93%, respectively (p=0.4). Moreover, the recurrence rates did not differ significantly between groups. Furthermore, subgroup analysis of clear cell carcinoma and endometrioid adenocarcinoma separately showed no effect of endometriosis on disease-free survival (DFS) or overall survival (OS).ConclusionClear cell or endometrioid ovarian carcinoma arising from ovarian and/or pelvic endometriosis shares the same clinicopathologic characteristics with their counterparts that do not arise from endometriosis and patients have similar overall and disease-free survival.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 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.