1
|
Çakır C, Kılıç İÇ, Yüksel D, Karyal YA, Üreyen I, Boyraz G, Durmuş Y, Gültekin M, Özgül N, Karalök MA, Salman MC, Yüce K, Turan AT. Does tumor size have prognostic value in patients undergoing lymphadenectomy in endometrioid-type endometrial cancer confined to the uterine corpus? Turk J Med Sci 2019; 49:1403-1410. [PMID: 31650820 PMCID: PMC7018323 DOI: 10.3906/sag-1902-224] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 07/03/2019] [Indexed: 01/19/2023] Open
Abstract
Background/aim We aimed to define the effect of tumor size on recurrence and survival rates in patients with stage I–II endometrioid-type endometrial cancer. Materials and methods A total of 550 patients who had total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic-paraaortic lymphadenectomy were included. Patients with extrauterine spread, sarcomatous components, or synchronized tumor and those who did not undergo lymphadenectomy or did not have data on tumor size were excluded. Results The median tumor size was 35 mm (range: 3–335 mm). According to the 2009 International Federation of Obstetrics and Gynecology (FIGO) criteria, 245 cases were defined as stage IA, 271 as stage IB, and 34 as stage II. The 5-year disease-free survival (DFS) rate was 92% and the 5-year disease-specific survival (DSS) rate was 99%. The effects of prognostic factors on DFS were evaluated. Older age, stage II disease, deep myometrial invasion, and receiving adjuvant radiotherapy were associated with decreased DFS. There was no statistically significant association between tumor size and DFS. The 5-year DFS for patients with a tumor diameter of <35 mm, which was the median tumor size of the entire group, was 94%, while it was 89% for patients having a tumor diameter of >35 mm (P = 0.128). Conclusion Tumor size was not a risk factor predicting recurrence in patients with stage I or II endometrioid-type endometrial cancer who had lymphadenectomy.
Collapse
Affiliation(s)
- Caner Çakır
- Gynecologic Oncology Clinic, Etlik Zübeyde Hanım Women’s Health Teaching and Research Hospital,University of Health Sciences, Ankara, Turkey
| | - İsmet Çiğdem Kılıç
- Gynecologic Oncology Clinic, Etlik Zübeyde Hanım Women’s Health Teaching and Research Hospital,University of Health Sciences, Ankara, Turkey
| | - Dilek Yüksel
- Gynecologic Oncology Clinic, Etlik Zübeyde Hanım Women’s Health Teaching and Research Hospital,University of Health Sciences, Ankara, Turkey
| | - Yalın Ay Karyal
- Gynecologic Oncology Clinic, Etlik Zübeyde Hanım Women’s Health Teaching and Research Hospital,University of Health Sciences, Ankara, Turkey
| | - Işın Üreyen
- Gynecologic Oncology Clinic, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Gökhan Boyraz
- Gynecologic Oncology Clinic, Etlik Zübeyde Hanım Women’s Health Teaching and Research Hospital,University of Health Sciences, Ankara, Turkey
| | - Yasin Durmuş
- Gynecologic Oncology Clinic, Etlik Zübeyde Hanım Women’s Health Teaching and Research Hospital,University of Health Sciences, Ankara, Turkey
| | - Murat Gültekin
- Gynecologic Oncology Clinic, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Nejat Özgül
- Gynecologic Oncology Clinic, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mustafa Alper Karalök
- Gynecologic Oncology Clinic, Etlik Zübeyde Hanım Women’s Health Teaching and Research Hospital,University of Health Sciences, Ankara, Turkey
| | - Mehmet Coşkun Salman
- Gynecologic Oncology Clinic, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Kunter Yüce
- Gynecologic Oncology Clinic, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ahmet Taner Turan
- Gynecologic Oncology Clinic, Etlik Zübeyde Hanım Women’s Health Teaching and Research Hospital,University of Health Sciences, Ankara, Turkey
| |
Collapse
|
2
|
Kimyon Cömert G, Türkmen O, Boyraz G, Yalçın İ, Altın D, Karalök A, Şahin H, Taşkın S, Başaran D, Fırat Cuylan Z, Koyuncu K, Salman MC, Özgül N, Meydanlı MM, Turan T, Ortaç F, Yüce K. Effect of Adjuvant Therapy on Oncologic Outcomes of Surgically Confirmed Stage I Uterine Carcinosarcoma: a Turkish Gynecologic Oncology Study. Balkan Med J 2019; 36:229-234. [PMID: 30873825 PMCID: PMC6636652 DOI: 10.4274/balkanmedj.galenos.2019.2018.12.75] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background: Uterine carcinosarcoma is rare neoplasm that mostly presents as metastatic disease. Stage is one of the most important prognostic factor, however, the management of the early stage uterine carcinosarcoma is still controversial. Aims: To evaluate prognostic factors, treatment options, and survival outcomes in patients with surgically approved stage I uterine carcinosarcoma. Study Design: Cross-sectional study. Methods: Data of 278 patients with uterine carcinosarcoma obtained from four gynecologic oncology centers were reviewed, and 70 patients with approved stage I uterine carcinosarcoma after comprehensive staging surgery were studied. Results: The median age of the entire cohort was 65 years (range; 39-82). All patients underwent both pelvic and paraaortic lymphadenectomy. Forty-one patients received adjuvant therapy. The median follow-up time was 24 months (range; 1-129). Nineteen (27.1%) patients had disease failure. The 3-year disease-free survival and cancer-specific survival of the entire cohort was 67% and 86%, respectively. In the univariate analysis, only age was significantly associated with disease-free survival (p=0.022). There was no statistical significance for disease-free survival between observation and receiving any type of adjuvant therapy following staging surgery. Advanced age (<75 vs ≥75 years) was the only independent prognostic factor for recurrence (hazard ratio: 3.8, 95% CI=1.10-13.14, p=0.035) in multivariate analysis. None of the factors were significantly associated with cancer-specific survival. Conclusion: Advanced age was the only independent factor for disease-free survival in stage I uterine carcinosarcoma. Performing any adjuvant therapy following comprehensive lymphadenectomy was not related to the improved survival of the stage I disease.
Collapse
Affiliation(s)
- Günsu Kimyon Cömert
- Department of Gynecologic Oncology, Ankara Etlik Zübeyde Hanım Women’s Diseases Training and Research Hospital, Ankara, Turkey
| | - Osman Türkmen
- Department of Gynecologic Oncology, Ankara Etlik Zübeyde Hanım Women’s Diseases Training and Research Hospital, Ankara, Turkey
| | - Gökhan Boyraz
- Department of Gynecologic Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - İbrahim Yalçın
- Department of Gynecologic Oncology, University of Health Sciences, Ankara Zekai Tahir Burak Women’s Health Training and Research Hospital, Ankara, Turkey
| | - Duygu Altın
- Department of Gynecologic Oncology, Ankara University School of Medicine, Ankara, Turkey
| | - Alper Karalök
- Department of Gynecologic Oncology, Ankara Etlik Zübeyde Hanım Women’s Diseases Training and Research Hospital, Ankara, Turkey
| | - Hanifi Şahin
- Department of Gynecologic Oncology, University of Health Sciences, Ankara Zekai Tahir Burak Women’s Health Training and Research Hospital, Ankara, Turkey
| | - Salih Taşkın
- Department of Gynecologic Oncology, Ankara University School of Medicine, Ankara, Turkey
| | - Derman Başaran
- Department of Gynecologic Oncology, Ankara Etlik Zübeyde Hanım Women’s Diseases Training and Research Hospital, Ankara, Turkey
| | - Zeliha Fırat Cuylan
- Department of Gynecologic Oncology, University of Health Sciences, Ankara Zekai Tahir Burak Women’s Health Training and Research Hospital, Ankara, Turkey
| | - Kazibe Koyuncu
- Department of Gynecologic Oncology, Ankara University School of Medicine, Ankara, Turkey
| | - Mehmet Coşkun Salman
- Department of Gynecologic Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Nejat Özgül
- Department of Gynecologic Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mehmet Mutlu Meydanlı
- Department of Gynecologic Oncology, University of Health Sciences, Ankara Zekai Tahir Burak Women’s Health Training and Research Hospital, Ankara, Turkey
| | - Taner Turan
- Department of Gynecologic Oncology, Ankara Etlik Zübeyde Hanım Women’s Diseases Training and Research Hospital, Ankara, Turkey
| | - Fırat Ortaç
- Department of Gynecologic Oncology, Ankara University School of Medicine, Ankara, Turkey
| | - Kunter Yüce
- Department of Gynecologic Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| |
Collapse
|
3
|
Caglayan A, Katlan DC, Tuncer ZS, Yüce K. Evaluation of trace elements associated with antioxidant enzymes in blood of primary epithelial ovarian cancer patients. J Trace Elem Med Biol 2019; 52:254-262. [PMID: 30732891 DOI: 10.1016/j.jtemb.2019.01.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 12/18/2018] [Accepted: 01/15/2019] [Indexed: 02/07/2023]
Abstract
Epithelial ovarian cancer (EOC) has been associated with oxidative stress (OS) due to epithelial inflammation which makes ovaries more vulnerable to the deleterious effects of reactive oxygen species (ROS). However, antioxidant enzymes (AOEs) such as manganese-superoxide dismutase (Mn-SOD), copper,zinc-superoxide dismutase (Cu,Zn-SOD) and glutathione peroxidase (GPx1) protect cells against the biological damage of ROS-induced OS and support cancer prevention by maintaining normal cell cycle progression, inhibiting proliferation, tumor invasion, angiogenesis, inflammation or inducing apoptosis. In the present study, we aimed to measure the levels of trace elements [manganese (Mn), copper (Cu), zinc (Zn) and selenium (Se)] which are structurally and/or functionally associated with the AOEs by inductively coupled plasma/mass-spectrometry (ICP/MS) in blood samples of patients with EOC (M, n = 26) and compare the data with healthy subjects (C, n = 46). Serous EOC (M1, n = 18) data were also evaluated according to the tumor grading [well or moderately well differentiated (G 1-2) vs. poorly differentiated or undifferentiated (G3)] and staging of disease [stage I-II (SI-II) vs. stage III (SIII)]. We obtained; i) The Mn and Se levels of M were significantly lower than C, ii) only Mn levels were changed [(G3(Mn) < G 1-2 (Mn)] in M1, iii) significant correlations were observed between [Cu and Zn levels (r = 0.701, p = 0.036) in G 1-2 and (r = 0.686, p = 0.041) in G3; Cu and Se levels (r = 0.960, p = 0.000) in G3; Mn levels and Mn-SOD expression (r = 0.551, p = 0.006) in M, (r = 0.857, p = 0.007) in G 1-2 and (r = 0.690, p = 0.056) in G3; Se levels and erythrocyte GPx1 activity (r = 0.660, p = 0.053) in G 1-2 ; Se levels and erythrocyte Cu,Zn-SOD activity (r = 0.693, p = 0.038) in G3]. The study revealed that trace elements, particularly low Mn and Se levels along with high Cu/Se ratios might be of value in all histologic subtypes of EOC. Although Mn level was important in terms of discriminating tumor grades, positive correlation between Cu-Se levels was also remarkable in patients with G 1-2 tumors of M1. Moreover, high erythrocyte Cu/Se ratios might be a favourable marker for EOC.
Collapse
Affiliation(s)
- Aydan Caglayan
- Hacettepe University, Faculty of Pharmacy, Department of Toxicology, Ankara 06100, Turkey.
| | - Doruk Cevdi Katlan
- İstanbul Education and Research Hospital, Obstetrics and Gynecology, İstanbul 34020, Turkey.
| | - Zafer Selcuk Tuncer
- Hacettepe University, Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara 06100, Turkey.
| | - Kunter Yüce
- Hacettepe University, Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara 06100, Turkey.
| |
Collapse
|
4
|
Caglayan A, Katlan DC, Selçuk Tuncer Z, Yüce K, Sayal HB, Coşkun Salman M, Kocer-Gumusel B. Impaired antioxidant enzyme functions with increased lipid peroxidation in epithelial ovarian cancer. IUBMB Life 2017; 69:802-813. [PMID: 28884887 DOI: 10.1002/iub.1675] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 07/12/2017] [Indexed: 02/06/2023]
Abstract
We aimed to identify the possible role of oxidant-antioxidant status in epithelial ovarian cancer (EOC) by measuring (a) antioxidant enzyme (AOE) activities [total superoxide dismutase (SODtotal ), manganese-SOD (Mn-SOD), copper,zinc-SOD (Cu,Zn-SOD), catalase (CAT) and glutathione peroxidase (GPx1)], (b) Mn-SOD protein expression, (c) lipid peroxidation markers [malondialdehyde (MDA), 8-epi-prostaglandin-F2α (8-epi-PGF2α)] and by evaluating the possible correlations between tumor biomarkers, reproductive hormone levels and all measured parameters, comprehensively. The data obtained from the patients with EOC (M, n = 26) evaluated according to the histopathological/clinical characteristics of tumors and compared with data of healthy controls [Ctissue (C1) and Cblood/urine (C2), n = 30, respectively). Significantly, low activities of tumor SODtotal (52%), Mn-SOD (42%), Cu,Zn-SOD (55%); high activities of tumor and erythrocyte CAT (66%, 33% respectively) and tumor GPx1 (60%); high levels of tumor Mn-SOD protein expression; tumor MDA (193%) and urinary 8-epi-PGF2α (179%) were observed in serous EOC tumors (M1, n = 18) compared with controls (P < 0.05). However, higher levels of tumor MDA, Mn-SOD protein expression and urinary 8-epi-PGF2α were observed along with lower tumor CAT activity in poorly differentiated or undifferentiated (grade 3, G 3) versus well or moderately well differentiated (grade 1-2, G 1-2) serous EOC tumors. Obtained data indicate the presence of a severe redox imbalance in EOC and draw attention to the criticial role of AOEs in the pathogenesis of the disease. © 2017 IUBMB Life, 69(10):802-813, 2017.
Collapse
Affiliation(s)
- Aydan Caglayan
- Department of Toxicology, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey
| | - Doruk Cevdi Katlan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.,Obstetrics and Gynecology, Suleymaniye Research and Education Hospital, ıstanbul, Turkey
| | - Zafer Selçuk Tuncer
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Kunter Yüce
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Hasan Berkan Sayal
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.,Republic of Turkey Ministry of Health, Malatya Research and Education Hospital, Malatya, Turkey
| | - Mehmet Coşkun Salman
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Belma Kocer-Gumusel
- Department of Toxicology, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey
| |
Collapse
|
5
|
Sarı ME, Meydanlı MM, Türkmen O, Cömert GK, Turan AT, Karalök A, Şahin H, Haberal A, Kocaman E, Akbayır Ö, Erdem B, Numanoğlu C, Güngördük K, Sancı M, Gökçü M, Özgül N, Salman MC, Boyraz G, Yüce K, Güngör T, Taşkın S, Altın D, Ortaç UF, Ayık HA, Şimşek T, Arvas M, Ayhan A. Prognostic factors and treatment outcomes in surgically-staged non-invasive uterine clear cell carcinoma: a Turkish Gynecologic Oncology Group study. J Gynecol Oncol 2017; 28:e49. [PMID: 28541637 PMCID: PMC5447148 DOI: 10.3802/jgo.2017.28.e49] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 03/13/2017] [Accepted: 04/09/2017] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To assess the prognosis of surgically-staged non-invasive uterine clear cell carcinoma (UCCC), and to determine the role of adjuvant therapy. METHODS A multicenter, retrospective department database review was performed to identify patients with UCCC who underwent surgical treatment between 1997 and 2016 at 8 Gynecologic Oncology Centers. Demographic, clinicopathological, and survival data were collected. RESULTS A total of 232 women with UCCC were identified. Of these, 53 (22.8%) had surgically-staged non-invasive UCCC. Twelve patients (22.6%) were upstaged at surgical assessment, including a 5.6% rate of lymphatic dissemination (3/53). Of those, 1 had stage IIIA, 1 had stage IIIC1, 1 had stage IIIC2, and 9 had stage IVB disease. Of the 9 women with stage IVB disease, 5 had isolated omental involvement indicating omentum as the most common metastatic site. UCCC limited only to the endometrium with no extra-uterine disease was confirmed in 41 women (73.3%) after surgical staging. Of those, 13 women (32%) were observed without adjuvant treatment whereas 28 patients (68%) underwent adjuvant therapy. The 5-year disease-free survival rates for patients with and without adjuvant treatment were 100.0% vs. 74.1%, respectively (p=0.060). CONCLUSION Extra-uterine disease may occur in the absence of myometrial invasion (MMI), therefore comprehensive surgical staging including omentectomy should be the standard of care for women with UCCC regardless of the depth of MMI. Larger cohorts are needed in order to clarify the necessity of adjuvant treatment for women with UCCC truly confined to the endometrium.
Collapse
Affiliation(s)
- Mustafa Erkan Sarı
- Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey.
| | - Mehmet Mutlu Meydanlı
- Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Osman Türkmen
- Department of Gynecologic Oncology, Etlik Zubeyde Hanım Women's Health Teaching and Research Hospital, Ankara, Turkey
| | - Günsü Kimyon Cömert
- Department of Gynecologic Oncology, Etlik Zubeyde Hanım Women's Health Teaching and Research Hospital, Ankara, Turkey
| | - Ahmet Taner Turan
- Department of Gynecologic Oncology, Etlik Zubeyde Hanım Women's Health Teaching and Research Hospital, Ankara, Turkey
| | - Alper Karalök
- Department of Gynecologic Oncology, Etlik Zubeyde Hanım Women's Health Teaching and Research Hospital, Ankara, Turkey
| | - Hanifi Şahin
- Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Ali Haberal
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Eda Kocaman
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Özgür Akbayır
- Department of Gynecologic Oncology, Kanuni Sultan Suleyman Teaching and Research Hospital, Istanbul, Turkey
| | - Baki Erdem
- Department of Gynecologic Oncology, Kanuni Sultan Suleyman Teaching and Research Hospital, Istanbul, Turkey
| | - Ceyhun Numanoğlu
- Department of Gynecologic Oncology, Kanuni Sultan Suleyman Teaching and Research Hospital, Istanbul, Turkey
| | - Kemal Güngördük
- Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Muzaffer Sancı
- Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Mehmet Gökçü
- Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Nejat Özgül
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mehmet Coşkun Salman
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Gökhan Boyraz
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Kunter Yüce
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Tayfun Güngör
- Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Salih Taşkın
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Duygun Altın
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Uğur Fırat Ortaç
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Hülya Aydın Ayık
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Tayup Şimşek
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Macit Arvas
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ali Ayhan
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Baskent University, Ankara, Turkey
| |
Collapse
|
6
|
Topfedaisi Ozkan N, Meydanlı MM, Sarı ME, Demirkiran F, Kahramanoglu I, Bese T, Arvas M, Şahin H, Haberal A, Celik H, Coban G, Oge T, Yalcin OT, Akbayır Ö, Erdem B, Numanoğlu C, Özgül N, Boyraz G, Salman MC, Yüce K, Dede M, Yenen MC, Taşkın S, Altın D, Ortaç UF, Aydın Ayık H, Şimşek T, Güngör T, Güngördük K, Sancı M, Ayhan A. Factors associated with survival after relapse in patients with low-risk endometrial cancer treated with surgery alone. J Gynecol Oncol 2017; 28:e65. [PMID: 28657226 PMCID: PMC5540724 DOI: 10.3802/jgo.2017.28.e65] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 05/11/2017] [Accepted: 05/18/2017] [Indexed: 11/30/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Nazli Topfedaisi Ozkan
- Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Mehmet Mutlu Meydanlı
- Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Mustafa Erkan Sarı
- Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey.
| | - Fuat Demirkiran
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ilker Kahramanoglu
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Tugan Bese
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Macit Arvas
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Hanifi Şahin
- Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Ali Haberal
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Husnu Celik
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Gonca Coban
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Tufan Oge
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Osmangazi University, Eskisehir, Turkey
| | - Omer Tarik Yalcin
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Osmangazi University, Eskisehir, Turkey
| | - Özgür Akbayır
- Department of Gynecologic Oncology, Kanuni Sultan Suleyman Teaching and Research Hospital, Istanbul, Turkey
| | - Baki Erdem
- Department of Gynecologic Oncology, Kanuni Sultan Suleyman Teaching and Research Hospital, Istanbul, Turkey
| | - Ceyhun Numanoğlu
- Department of Gynecologic Oncology, Kanuni Sultan Suleyman Teaching and Research Hospital, Istanbul, Turkey
| | - Nejat Özgül
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Gökhan Boyraz
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mehmet Coşkun Salman
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Kunter Yüce
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Murat Dede
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Gulhane Training and Researh Hospital, Ankara, Turkey
| | - Mufit Cemal Yenen
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Gulhane Training and Researh Hospital, Ankara, Turkey
| | - Salih Taşkın
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, School of Medicine, Ankara University, Ankara, Turkey
| | - Duygu Altın
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, School of Medicine, Ankara University, Ankara, Turkey
| | - Uğur Fırat Ortaç
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, School of Medicine, Ankara University, Ankara, Turkey
| | - Hülya Aydın Ayık
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Tayup Şimşek
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Tayfun Güngör
- Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Kemal Güngördük
- Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Faculty of Medicine, University of Health Sciences, Izmir, Turkey
| | - Muzaffer Sancı
- Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Faculty of Medicine, University of Health Sciences, Izmir, Turkey
| | - Ali Ayhan
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Baskent University, Ankara, Turkey
| |
Collapse
|
7
|
Boyraz G, Başaran D, Salman MC, Özgül N, Yüce K. Stage IIIC transitional cell carcinoma and serous carcinoma of the ovary have similar outcomes when treated with platinum-based chemotherapy. J Turk Ger Gynecol Assoc 2017; 18:33-37. [PMID: 28506948 PMCID: PMC5450208 DOI: 10.4274/jtgga.2016.0190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: Previous studies reported better outcomes for transitional cell carcinoma (TCC) of the ovary when compared with more common histologic types such as serous epithelial ovarian cancers (EOCs). The aim of this study was to compare the survival outcomes of platinum- based chemotherapy in patients with stage IIIC TCCs and serous EOCs. Material and Methods: Clinicopathologic features and survival data of patients with FIGO stage IIIC TCC and serous EOC who had undergone primary surgery followed by six cycles of intravenous platinum/taxane between 2007 and 2015 were retrieved from the database of Hacettepe University Hospital. Results: We identified 14 (10.9%) TCCs and 114 (89.1%) serous EOCs. The median follow-up duration was 28 months (range, 3-101 months). Univariate analysis revealed that the TCCs and serous EOCs had similar progression-free survival (PFS) and overall survival (OS). Patients with residual disease less than 1 cm had longer OS than patients with residual disease greater than 1 cm (75.0 vs. 45.0 months, p=0.012). Cox regression analysis of all potential prognostic factors showed that the only independent prognostic factor significantly associated with OS was residual disease less than 1 cm [hazard ratio=0.38; 95% confidence interval: (0.19-0.77); p=0.007]. Conclusion: Surgically treated advanced stage TCCs did not have a significantly better prognosis after platinum/taxane-based chemotherapy when compared with serous EOCs. Residual tumor volume after primary surgery was the only independent predictor of OS in patients with EOC. Our results demonstrate the significance of achieving optimal cytoreduction in all histologic subtypes of EOC.
Collapse
Affiliation(s)
- Gökhan Boyraz
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Derman Başaran
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mehmet Coşkun Salman
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Nejat Özgül
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Kunter Yüce
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| |
Collapse
|
8
|
Tüney İ, Altay A, Ergünay K, Önder SÇ, Usubütün A, Salman MC, Bozdayi G, Karabulut E, Badur OS, Yüce K, Pinar A. HPV types and E6/E7 mRNA expression in cervical samples from Turkish women with abnormal cytology in Ankara, Turkey. Turk J Med Sci 2017; 47:194-200. [PMID: 28263489 DOI: 10.3906/sag-1508-155] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 06/05/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND/AIM Human papillomaviruses have been established as a risk factor for invasive carcinoma of the uterine cervix. HPV E6/E7 oncogene expression has recently emerged as a promising biomarker to determine the risk for progression to high-grade cervical lesions. The aim of this study was to evaluate HPV mRNA and DNA detection in samples with abnormal cytology. MATERIALS AND METHODS Cervical specimens were obtained at the Department of Obstetrics and Gynecology via cervical brushes during January-October 2011. Liquid-based cytology slides were evaluated according to the 2001 Bethesda System. Cytology specimens from a total of 81 women with abnormal cytology were included. Real-time PCR and NASBA assays were performed to detect HPV DNA and E6/E7 mRNA, respectively. RESULTS HPV DNA was identified in 73 samples (90.1%). HPV E6/E7 mRNA expression was observed in 45 samples (55.6%). A statistically significant difference was observed among cytological diagnosis groups. In 25 patients, a biopsy was performed during the follow-up. HPV DNA was detected in all of these patients. HPV E6/E7 expression was present only in CIN I-III diagnosed patients. CONCLUSION The E6/E7 mRNA test is a robust indicator of cytological atypia and correlates better with progressive lesions than DNA assays.
Collapse
Affiliation(s)
- İpek Tüney
- Department of Medical Microbiology, Virology Unit, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Aylin Altay
- Department of Medical Microbiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Koray Ergünay
- Department of Medical Microbiology, Virology Unit, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Sevgen Çelik Önder
- Department of Pathology, Cytology Unit, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Alp Usubütün
- Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mehmet Coşkun Salman
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Gülendam Bozdayi
- Department of Medical Microbiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Erdem Karabulut
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Osman Selim Badur
- Department of Medical Microbiology, Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Kunter Yüce
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ahmet Pinar
- Department of Medical Microbiology, Virology Unit, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| |
Collapse
|
9
|
Boyraz G, Başaran D, Salman MC, Özgül N, Yüce K. Does Preoperative Diagnosis of Endometrial Hyperplasia Necessitate Intraoperative Frozen Section Consultation? Balkan Med J 2016; 33:657-661. [PMID: 27994920 DOI: 10.5152/balkanmedj.2016.151232] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 04/25/2016] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND In women with endometrial hyperplasia, there is a risk for co-existent endometrial cancer when patients are subjected to immediate surgical treatment. AIMS The aim of this study was to investigate the frequency of endometrial cancer and the accuracy of frozen section analysis at the time of hysterectomy among patients with endometrial hyperplasia, to reveal whether or not a preoperative diagnosis of endometrial hyperplasia necessitates frozen section consultation. STUDY DESIGN Retrospective cross-sectional study. METHODS A department database review was performed to identify patients who were subjected to hysterectomy with a preoperative diagnosis of endometrial hyperplasia, during the period from 2007 to 2014. RESULTS The study group included 189 cases. The final pathological examination revealed endometrial cancer in 16 women (8.4%). The risk of cancer in patients with endometrial hyperplasia was 1 of 125 (0.8%) in simple hyperplasia without atypia, 1 of 21 (4.8%) in complex hyperplasia without atypia and 14 of 43 (32.5%) in atypical hyperplasia. Of women with cancer, 2 of 16 (12.5%) had high-risk features. Frozen section analysis was requested in 46 cases. Frozen sections helped to identify six out of 11 cases of endometrial cancer (54.5%). The sensitivity, specificity and positive and negative predictive values of frozen section analysis for the detection of endometrial cancer among women with endometrial hyperplasia were 54.4%, 97.2%, 85.7% and 87.5%, respectively. CONCLUSION Although a significant proportion of patients with atypical endometrial hyperplasia are diagnosed with endometrial cancer following hysterectomy, most of these cases have low-risk features and do not require surgical staging. Additionally, intraoperative frozen section analysis if not helpful for diagnosing concurrent endometrial cancer in patients with endometrial hyperplasia. Therefore, it seems that patients with endometrial hyperplasia can be operated upon in settings with no available method for obtaining frozen sections intraoperatively.
Collapse
Affiliation(s)
- Gokhan Boyraz
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Derman Başaran
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Mehmet C Salman
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Nejat Özgül
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Kunter Yüce
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey
| |
Collapse
|
10
|
Salman MC, Başaran D, Usubütün A, Özgül N, Yüce K. The Role of Frozen-Section in the Surgical Management of Patients with Endometrial Intraepithelial Neoplasia. Turk Patoloji Derg 2015; 31:181-7. [PMID: 26456964 DOI: 10.5146/tjpath.2015.01328] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Patients with endometrial intraepithelial neoplasia may have concurrent endometrial cancer if managed surgically or develop cancer in time if managed conservatively. Therefore, intraoperative assessment of the uterus may be helpful if a surgical approach is decided on. Our study aimed to investigate the role of frozen-section examination in patients with endometrial intraepithelial neoplasia. MATERIAL AND METHOD Patients with endometrial intraepithelial neoplasia who were subjected to hysterectomy with intraoperative frozen-section assessment were included. Main outcome measures were the rates of concurrent endometrial cancer and concurrent high-risk endometrial cancer as well as the efficacy of frozen-section in the detection of concurrent invasive disease and in the designation of low-risk and high-risk features. RESULTS The study group consisted of seventy-three patients. Permanent pathology revealed endometrial adenocarcinoma in 19.2% whereas only one patient (1.4%) had high-risk disease necessitating surgical staging. Frozen-section diagnoses were consistent with final pathology in 93.2% of patients in terms of the presence or absence of co-existent carcinoma. When frozen-section reports were further evaluated in terms of the presence or absence of high-risk endometrial carcinoma, consistency with the final pathology was seen in 98.6% of patients. CONCLUSION Co-existent endometrial cancer is not uncommon in endometrial intraepithelial neoplasia. Intraoperative frozen-section evaluation should therefore be considered whenever possible. Frozen-section is effective in the detection of coexistent invasive disease and in the designation of low-risk features. Although coexistent high-risk cancer is extremely rare, frozen-section assessment is not successful in determining high-risk features. Therefore, a re-staging surgery may be required on rare occasions.
Collapse
Affiliation(s)
- Mehmet Coşkun Salman
- Department of Obstetrics and Gynaecology, Hacettepe University Faculty of Medicine, ANKARA, TURKEY
| | | | | | | | | |
Collapse
|
11
|
Dursun P, Ayhan A, Mutlu L, Çağlar M, Haberal A, Güngör T, Özat M, Özgü E, Onan A, Taşkiran C, Güner H, Yetımalar H, Kasap B, Yüce K, Salman MC, Sayal B, Doğan S, Harma M, Harma M, Basaran M, Aydoğmuş H, Ergün Y, Şehıralı S, Gültekın E, Köse S, Yildirim Y, Yenen M, Dede M, Alanbay I, Karaca R, Metındır J, Keskın L, Üstüner I, Avşar F, Yüksel H, Kirdar S. HPV types in Turkey: multicenter hospital based evaluation of 6388 patients in Turkish gynecologic oncology group centers. Turk Patoloji Derg 2014; 29:210-6. [PMID: 24022311 DOI: 10.5146/tjpath.2013.01188] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To evaluate the prevalence of HPV DNA and cervical cytological abnormalities, to compare cervical cytology results and HPV DNA and to define HPV types distribution in a large series of Turkish women who have undergone HPV analysis in hospitals that are members of the Turkish Gynecological Oncology Group. MATERIAL AND METHOD Between 2006 and 2010, a total of 6388 patients' data was retrospectively evaluated at 12 healthcare centers in Turkey. Demographic characteristics, cervical cytology results, HPV status and types were compared. RESULTS The mean age of the patients was 38.9±10.2. Overall, 25% of the women were found to be HPV positive. Presence of HPV-DNA among patients with abnormal and normal cytology was 52% and 27%, respectively. There was significant difference with respect to decades of life and HPV positivity (p < 0.05). HPV was positive in (within the HPV (+) patients) 37%, 9%, 27%, 20%, 22%, and 41% of the ASCUS, ASC-H, LSIL HSIL, glandular cell abnormalities, and SCC cases respectively The most common HPV types in our study were as follows; HPV 16 (32%), HPV 6 (17%), HPV 11 (9%), HPV 18 (8%), HPV 31 (6%), HPV 51 (5%), HPV 33 (3%). CONCLUSION In this hospital based retrospective analysis, HPV genotypes in Turkish women with normal and abnormal cytology are similar to those reported from western countries. Further population based prospective multicenter studies are necessary to determine non-hospital based HPV prevalence in Turkish women.
Collapse
Affiliation(s)
- Polat Dursun
- Department of Obstetrics and Gynecology, Başkent University, Faculty of Medicine, ANKARA, TURKEY
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Aktas D, Gultekin M, Kabacam S, Alikasifoglu M, Turan A, Tulunay G, Kose M, Ortac F, Yüce K, Tunçbilek E, Ayhan A. Identification of point mutations and large rearrangements in the BRCA1 gene in 667 Turkish unselected ovarian cancer patients. Gynecol Oncol 2010; 119:131-5. [DOI: 10.1016/j.ygyno.2010.05.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2010] [Revised: 05/10/2010] [Accepted: 05/17/2010] [Indexed: 11/26/2022]
|
13
|
Caglayan A, Giray B, Hıncal F, Katlan D, Sayal B, Salman M, Tuncer Z, Yüce K. Assessment of superoxide dismutases in tissue and blood samples of primary epithelial ovarian cancer patients. Toxicol Lett 2010. [DOI: 10.1016/j.toxlet.2010.03.603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
14
|
Abstract
Bone metastasis is frequently seen in different solid tissue malignancies. However, it is a very rare entity in endometrial cancers and most of the previous reports were localized to a single bone. To the best of our knowledge, this is the first report of a case with disseminated bone metastasis from endometrial clear cell carcinoma. A 69-year-old, multiparous woman presented with the complaint of postmenopausal bleeding. Diagnostic workup revealed endometrial clear cell carcinoma. After comprehensive surgical staging, the patient was found to be at FIGO stage IIIC. Three weeks after the operation, an intractable back pain developed. Direct graphics of the lumbosacral region were suspicious of metastasis, and further evaluation of the patient revealed metastasis in multiple bones including calvarium, thoracolumbal vertebrae, pelvic bones, costae, collum of the right femur, and trochanter major of the left femur. Bone metastasis in endometrial clear cell carcinoma may be seen at initial presentation and may involve multiple bones. Whole-body scanning with scintigraphic evaluation is a reasonable approach to evaluate the extension of the bone involvement. Further studies are needed to elucidate the true incidence and management of bone metastasis in endometrial clear cell carcinoma.
Collapse
Affiliation(s)
- P Dursun
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
| | | | | | | |
Collapse
|
15
|
Dursun P, Ersoz S, Gultekin M, Aksan G, Yüce K, Ayhan A. Disseminated peritoneal tuberculosis mimicking advanced-stage endodermal sinus tumor: a case report. Int J Gynecol Cancer 2006; 16 Suppl 1:303-7. [PMID: 16515609 DOI: 10.1111/j.1525-1438.2006.00205.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
It is well known that peritoneal tuberculosis may mimic advanced-stage epithelial ovarian carcinoma because of similar clinical, radiologic, and laboratory findings. However, disseminated peritoneal tuberculosis mimicking advanced-stage endodermal sinus tumor (ESS) has not been reported previously. An 18-year-old nulliparous woman came with the complaint of pelvic pain and weight loss. Imaging studies demonstrated that she had multiple peritoneal implants and left adnexial mass. Also, laboratory studies showed elevated CA125 and alpha fetoprotein levels suggesting an initial diagnosis of ESS. However, intraoperative frozen section examination showed caseous necrosis, and she was diagnosed as having disseminated peritoneal tuberculosis. Two months after the initial exploration, the patient required liver transplantation because of hepatic failure due to widespread hepatic involvement of the tuberculosis. Concomitant peritoneal and hepatic involvement of tuberculosis may cause false elevation of multiple tumor markers of gynecological cancers and may lead to misdiagnosis and mismanagement of patients. Elevation of these markers should be carefully investigated especially in premenopausal women. To our knowledge, this is the first reported case of peritoneal tuberculosis misdiagnosed as endodermal sinus tumor.
Collapse
Affiliation(s)
- P Dursun
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
| | | | | | | | | | | |
Collapse
|
16
|
Abstract
Leiomyoma is the most common benign solid pelvic tumor seen in women. It is most commonly located in the uterus and gastrointestinal tract, but it can originate wherever smooth muscle cells exist. Although it has been reported in various atypical localizations, they are extremely rare in the retroperitoneum. Also, preoperative diagnosis is often difficult in retroperitoneal tumors. Imaging studies may demonstrate the retroperitoneal tumors; however, exact diagnosis cannot be established by imaging methods alone. Here, we report a case with retroperitoneal leiomyomatosis diagnosed by preoperative ultrasonography-guided fine-needle biopsy.
Collapse
Affiliation(s)
- P Dursun
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University Ankara, Turkey.
| | | | | | | | | |
Collapse
|
17
|
Abstract
INTRODUCTION Transvaginal bowel evisceration following either vaginal or abdominal gynecologic operations is a very rare complication. Furthermore, vaginal cuff rupture with the prolapse of the small bowel through the vagina during sexual intercourse after abdominal hysterectomy in a premenopausal woman is even more rare. However, regardless of the etiology, transvaginal evisceration requires prompt recognition and surgical intervention. CASE REPORT Here, we report a premenopausal woman who developed transvaginal bowel evisceration during the first postoperative intercourse.
Collapse
Affiliation(s)
- Kunter Yüce
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | | | | |
Collapse
|
18
|
Ayhan A, Al RA, Baykal C, Demirtas E, Ayhan A, Yüce K. The influence of splenic metastases on survival in FIGO stage IIIC epithelial ovarian cancer. Int J Gynecol Cancer 2004; 14:51-6. [PMID: 14764029 DOI: 10.1111/j.1048-891x.2004.014940.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
The purposes of this study were to compare the survival of ovarian cancer patients with splenic metastasis to patients without it and to evaluate the complications of the procedure. A retrospective study was performed on 34 patients with ovarian cancer who underwent splenectomy for initial cytoreduction at gynecologic oncology unit of Hacettepe University Hospitals between 1989 and 2001. All patients had FIGO stage IIIC disease and were left with <1 cm residual tumor after surgery. Eighteen patients (52.9%) had splenic metastasis. Patients with splenic metastasis tended poorer survival. Median survivals were 28.9 and 41.3 months for patients with splenic disease and for patients without it, respectively (P > 0.05). Univariate analysis revealed that performance status and histologic type influenced survival. Histologic type and performance status were identified as independent risk factors by multivariate analysis. Postoperative complications were developed in ten (29.4%) patients and three of these (8.8%) died in 1 month after operation. None of the complications was attributed directly to the splenectomy procedure. Complete surgical cytoreduction confers a survival benefit whether the parenchyma was involved or not. The splenectomy should be considered with its acceptable morbidity in selected patients who have a chance to achieve optimal debulking.
Collapse
Affiliation(s)
- A Ayhan
- Department of Obstetrics and Gynecology, Hacettepe University Hospitals, Ankara, Turkey
| | | | | | | | | | | |
Collapse
|
19
|
Baykal C, Demirtaş E, Al A, Ayhan A, Yüce K, Tulunay G, Köse MF, Ayhan A. Comparison of hepatocyte growth factor levels of epithelial ovarian cancer cyst fluids with benign ovarian cysts. Int J Gynecol Cancer 2004; 14:152-6. [PMID: 14764044 DOI: 10.1111/j.1048-891x.2004.14046.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Hepatocyte growth factor (HGF) is known to take role in oncogenesis and tumoral behavior of the tumors of the organs that contain mesenchymal and epithelial cells together. This study aims to compare HGF levels in cyst fluids of epithelial ovarian cancer and benign ovarian cysts and look for the role of HGF in ovarian carcinogenesis. Twenty-four consecutive patients with ovarian cancer and 34 with benign cysts of ovary were recruited prospectively at Gynecologic Oncology Departments of SSK Ankara Maternity Hospital and Hacettepe University School of Medicine between 2001 and 2002. Cyst fluids were collected during primary staging in cancer patients and during laparatomy for benign patients. HGF levels were measured by enzyme-linked immunosorbent assay method. Median HGF levels of the benign ovarian cysts and epithelial ovarian tumoral fluids were found as 3822 pg/ml (85-15,253 pgr/ml) and 12,962 pgr/ml (4136-16,025 pgr/ml), respectively. Malign cyst fluids have higher HGF levels when compared with benign ovarian cysts (P < 0.01). This finding suggests that HGF may take a paracrine role in oncogenic differentiation and tumoral development of epithelial ovarian cancers. Mechanisms that take role in HGF secretion and the answers of the neighboring epithelial cells to HGF during tumoral development need to be investigated.
Collapse
Affiliation(s)
- C Baykal
- SSK Ankara Maternity and Women's Health Teaching Hospital, Department of Gynecologic Oncology, Ankara, Turkey.
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Ayhan A, Al RA, Baykal C, Demirtas E, Ayhan A, Yüce K. Prognostic factors in FIGO stage IB cervical cancer without lymph node metastasis and the role of adjuvant radiotherapy after radical hysterectomy. Int J Gynecol Cancer 2004; 14:286-92. [PMID: 15086728 DOI: 10.1111/j.1048-891x.2004.014212.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the clinical and pathologic prognostic variables for disease free survival, overall survival and the role of adjuvant radiotherapy in FIGO stage IB cervical carcinoma without lymph node metastasis. METHODS A retrospective review was performed of 393 patients with lymph node negative stage IB cervical cancer treated by type 3 hysterectomy and pelvic lymphadenectomy at the Hacettepe University Hospitals between 1980 and 1997. RESULTS The disease free survival and overall survival were 87.6 and 91.0%, respectively. In univariate analysis, tumor size, depth of invasion, vaginal involvement, lympho-vascular space involvement (LVSI) and adjuvant radiotherapy were found significant in disease free survival. Overall survival was affected by tumor size, LVSI, vaginal involvement and adjuvant radiotherapy. Tumor size, LVSI and vaginal involvement were found as independent prognostic factors for overall and disease free survival in multivariate analysis. Disease free survival, recurrence rate and site did not differ between patients underwent radical surgery and radical surgery plus radiotherapy. CONCLUSION Tumor size, LVSI and vaginal involvement were independent prognostic factors in lymph node negative FIGO stage IB cervical cancer. Adjuvant radiotherapy in stage IB cervical cancer patients with negative nodes provides no survival advantage or better local tumoral control.
Collapse
Affiliation(s)
- A Ayhan
- Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, Hacettepe University School of Medicine, Hacettepe University Hospitals, 06100 Sihhiye, Ankara, Turkey.
| | | | | | | | | | | |
Collapse
|
21
|
Abstract
OBJECTIVES The objective of this study was to compare clinical and pathologic variables and prognosis of FIGO stage IB adenocarcinoma and squamous cell carcinoma of uterine cervix. METHODS A retrospective review was performed of 521 patients with stage IB squamous cell carcinoma and adenocarcinoma of cervix who treated primarily by type 3 hysterectomy and pelvic and/or para-aortic lymphadenectomy at Hacettepe University Hospitals between 1980 and 1997. RESULTS Age, tumor size, grade, depth of invasion, lymph node metastasis, parametrial, vaginal, and lymphvascular space involvement (LVSI) were not different between two cell types except number of the lymph nodes involved. Metastasis to three or more lymph nodes was significantly higher in adenocarcinoma. Overall and disease-free survival were 87.7%, 84.0% versus 86.4%, 83.1% for squamous cell carcinoma and adenocarcinoma, respectively (P > 0.05). The rate and site of recurrence were not different between two cell types. Multivariate analysis of disease-free and overall survival revealed independent prognostic factors as tumor size, LVSI, number of involved lymph node, and vaginal involvement. CONCLUSION Prognosis of FIGO stage IB cervical cancer patients who were treated by primarily radical surgery was found to be same for those with adenocarcinoma and squamous cell carcinoma.
Collapse
Affiliation(s)
- A Ayhan
- Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, Hacettepe University School of Medicine, Hacettepe University Hospitals, 06100 Sihhye, Ankara, Turkey.
| | | | | | | | | | | |
Collapse
|
22
|
Yüce K, Baykal C, Yüksel H, Apikoğlu M, Akkaya A. Ovarian pregnancy with intrauterine device in situ. Arch Gynecol Obstet 2004; 271:168-71. [PMID: 14722714 DOI: 10.1007/s00404-003-0589-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2003] [Accepted: 10/21/2003] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Since some reports have already suggested a higher rate of ovarian pregnancies in women using intrauterine device and some have not, an additional case report may be of interest for the literature purposes. CASE REPORT In this case report we present an ovarian pregnancy in a patient with an intrauterine device in situ.
Collapse
Affiliation(s)
- Kunter Yüce
- Department of Obstetrics and Gynaecology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | | | | | | | | |
Collapse
|
23
|
Baykal C, Ayhan A, Al A, Yüce K, Ayhan A. No relationship is indicated between FHIT expression and clinicopathologic prognostic parameters in early stage cervical carcinoma. Int J Gynecol Cancer 2003; 13:192-6. [PMID: 12657123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
In this study we investigated FHIT (Fragile Histidine Triad) protein alterations in cervical carcinomas to assess the relation of this gene with cervical cancer. Eighty-eight patients with surgically treated FIGO (International Federation of Gynecology and Obstetrics) stage IB carcinomas of the cervix were included in this study. Clinicopathologic prognostic factors were compared with FHIT expression status. Disease-free and overall survival was evaluated according to prognostic factors and FHIT expression. The FHIT gene was found to be depressed in 53% (47/88) of the tumors. None of the clinicopathologic prognostic parameters showed a correlation with FHIT expression. Univariate survival analysis with the Kaplan-Meier method showed that only the age of the patient is significantly correlated with disease-free survival. Interestingly, when the same analysis was done for 5-year overall survival; diameter of the primary tumor, depth of invasion, occurrence of lymph node involvement, and number of metastatic lymph nodes were found to be statistically significant. Furthermore, multivariate analysis with Cox regression revealed that lymph node involvement was the only independent variable for 5-year overall survival. In the present study there was no statistical correlation between FHIT expression and clinicopathologic prognostic factors or survival figures of the patients. These findings may be explained with the carcinogenic role of FHIT in tumoral progression but not in the tumoral development that takes place after the carcinogenetic period.
Collapse
Affiliation(s)
- C Baykal
- SSK Ankara Maternity Hospital Gynecologic Oncology Clinic, Turkey.
| | | | | | | | | |
Collapse
|
24
|
Abstract
OBJECTIVE The purpose of this study is to evaluate the significance of the c-Met/hepatocyte growth factor receptor expression in invasive cervical carcinoma. METHODS Ninety-Four patients with FIGO stage 1B disease, treated primarily with surgery, were studied immunohistochemically. Of the cases, 67 were squamous carcinoma and 27 were nonsquamous (10 were adenocarcinoma, 15 were adenosquamous carcinoma, and 2 were indifferentiated carcinoma). Immunohistochemically stained c-Met slides of primary malignancies were evaluated blindly of clinical outcome and other histopathological factors. RESULTS Overexpression of c-Met was found in 56 of 94 specimens. Primary tumors which show recurrences were found to be c-Met overexpressors. Univariate survival analysis (Kaplan-Meier) showed that c-Met overexpression is significantly correlated with disease-free survival. Moreover the diameter of the primary tumor, deep cervical stromal invasion, presence of metastatic lymph node, number of metastatic lymph nodes and c-Met overexpression were significantly correlated with overall 5-year survival. Furthermore multivariant analysis with Cox regression showed that the presence of metastatic lymph node and immunopositivity for c-Met are significantly correlated with overall survival, while c-Met overexpression was found to be an independent variable for disease-free survival. CONCLUSION These results reveal that c-Met oncogene overexpression is an important parameter for disease progression, recurrence, and survival in early-stage invasive uterine cervix carcinomas.
Collapse
Affiliation(s)
- Cem Baykal
- Department Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey.
| | | | | | | | | |
Collapse
|
25
|
Dursun P, Basaran M, Yüce K. CA-125 elevation in malignant and nonmalignant conditions. EUR J GYNAECOL ONCOL 2003; 24:584; author reply 585. [PMID: 14658612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
|
26
|
Yüce K, Tuncer ZS, Oncüloğlu C, Ayhan A, Baltali E, Güier N. Reproductive tract pathology in asymptomatic women treated with tamoxifen. EUR J GYNAECOL ONCOL 2002; 22:466-8. [PMID: 11874085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
PURPOSE To determine the long-term effects of tamoxifen on the female reproductive tract in patients with breast cancer. METHODS Forty-nine patients with breast cancer receiving tamoxifen longer than two years were analyzed. All the patients underwent pelvic examination, pap smear, transvaginal ultrasonography, serum CA 125 and dilatation and curettage. RESULTS There were 16 patients with genital system pathology. Three of them had atypical Pap smears, one with cervical carcinoma and the other two with chronic cervicitis. Two significant ovarian pathologies were found. These were ovarian fibroma, and unilateral dermoid cyst. There were three patients with endometrial hyperplasia without atypia. Uterine myoma was encountered in seven of the cases. Only one patient had elevated CA 125 levels despite normal genital examination findings. CONCLUSION Since no significant genital pathology attributable to tamoxifen therapy could be detected, the follow-up for gynecologic pathologies in breast cancer patients receiving tamoxifen therapy may be individualized.
Collapse
Affiliation(s)
- K Yüce
- Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey
| | | | | | | | | | | |
Collapse
|
27
|
Abstract
OBJECTIVE Gene-environment interactions have been the focus of a number of recent studies of the occurrence of human cancers, and an association between the risk and the CYP1A1*3 polymorphism has been noticed for several cancers. Previous studies suggest that estrogens are involved in the etiology of ovarian cancer. The cytochrome P450 1A1 (CYP1A1) gene polymorphism may play role in the development of epithelial ovarian neoplasm by detoxification of polycyclic hydrocarbons and other compounds and the concentration of estrogens and their metabolites. Therefore, we assessed the association of CYP1A1 gene polymorphism in patients with epithelial ovarian neoplasm in the Turkish populations through a case-control study. METHODS Using an allele-specific polymerase chain reaction (PCR)-based method, CYP1A1*3 polymorphism, in exon 7 of the gene, was analyzed in 117 epithelial ovarian neoplasm patients and 202 control subjects. RESULTS The CYP1A1 Ile/Val genotype significantly increased the risk for patients with epithelial ovarian neoplasm (OR 5.7, 95% CI 3.34-9.76). Furthermore, there were statistical differences in the distribution of CYP1A1 Val/Val genotype among all patients (OR 5.85, 95% CI 2.40-14.25). In other words, the presence of the Val allele significantly increased the risk of epithelial ovarian neoplasm. Among benign tumors, the frequency of Ile/Val and Val/Val genotypes was found to be statistically significant with an ORs of 6.01 and 4.38 (95% CI 2.61-13.84 and 1.04-18.38, respectively). In the benign serous ovarian tumors, patients with Ile/Val and Val/Val revealed a 7.2- and 10.5-fold higher risk of having ovarian carcinoma (95% CI 2.22-23.40 and 2.16-51.19), respectively. In the benign mucinous ovarian carcinoma patients, the frequency of Ile/Val was found to be statistically significant with an OR of 5.15 (95% CI 1.75-15.16). However, no patient with Val/Val genotype was observed in this group and no statistical distribution was performed. Among borderline tumors, CYP1A1 Ile/Val genotype significantly increased the risk for patients (OR 5.15, 95% CI 1.75-15.16). However, only one patient was observed with the Val/Val allele and the frequency of this genotype was not found to be statistically different with an OR of 2.50 (95% CI 0.27-22.64). Among ovarian cancer patients, there were statistically differences in the distribution of CYP1A1 Ile/Val and Val/Val genotypes (OR 5.73, 95% CI 3.04-10.76; and OR 7.42, 95% CI 2.80-19.66), suggesting that patients carrying these genotypes were at increased risk for ovarian carcinoma. In serous carcinoma, patients with CYP1A1 Ile/Val and Val/Val revealed a 6.5- and 10-fold higher risk of having ovarian cancer (OR 7.09, 95% CI 3.30-15.22; and OR 8.77, 95% CI 2.83-27.14). In mucinous carcinoma, patients with CYP1A1 Ile/Val and Val/Val also revealed a 5.4 and 10.5 times higher risk of having ovarian cancer. There were no statistical significance in the distribution of Val allele among endometroid-type cancer patients. CONCLUSIONS Our data, although based on a small number of subjects, suggest that variant alleles of CYP1A1 gene in ovarian epithelial cells, directly or through other components, may contribute to initiation of ovarian carcinogenesis.
Collapse
Affiliation(s)
- Dilek Aktas
- Department of Genetics, Hacettepe University Medical School, 06100, Sihhiye, Ankara, Turkey.
| | | | | | | | | | | |
Collapse
|
28
|
Yüce K, Baykal C, Genç C, Al A, Ayhan A. Diagnostic and prognostic value of serum and peritoneal fluid lactate dehydrogenase in epithelial ovarian cancer. EUR J GYNAECOL ONCOL 2002; 22:228-32. [PMID: 11501779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the peritoneal fluid and serum lactate dehydrogenase (LDH) levels in patients with ovarian masses. MATERIALS & METHODS Peritoneal fluid and serum lactate dehydrogenase (LDH) levels were measured in 27 patients with epithelial ovarian carcinoma and 38 with benign ovarian tumors. Serum and peritoneal fluid LDH levels were also compared with the levels of CA-125. RESULTS Both of the marker levels in ovarian cancer patients were significantly higher than those in patients with benign ovarian tumors. Serous and undifferantiated carcinomas presented higher marker levels than endometrioid and mucinous carcinomas. High grade, advanced stage and positive cytology were associated with higher serum and peritoneal fluid LDH levels; there was an inefficient correlation between them but, when these two markers were used together with CA-125, sensitivity of CA-125 increased to 70%. CONCLUSIONS In conclusion, serum LDH can be used to discriminate adnexal mass origin and peritoneal fluid LDH may have prognostic value because of the strict relationship with advanced stage, poor histologic type, higher grade and positive abdominal cytology. Peritoneal LDH is found to be a reliable biochemical marker related to prognosis in ovarian carcinoma patients.
Collapse
Affiliation(s)
- K Yüce
- Department of Obstetrics and Gynecology, Hacettepe University, School of Medicine, Ankara, Turkey
| | | | | | | | | |
Collapse
|
29
|
Baykal C, Erkek E, Tutar E, Yüce K, Ayhan A. Cutaneous fixed drug eruption to paclitaxel; a case report. EUR J GYNAECOL ONCOL 2000; 21:190-1. [PMID: 10843484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
The aim of this report was to investigate an adverse effect of paclitaxel. Cutaneous fixed drug eruption against paclitaxel--which is rarely seen--is explained. A 70-year-old caucasian woman experienced three operations for ovarian carcinoma and finally a paclitaxel-based chemotherapy regimen was initiated as adjuvant chemotherapy. Following the administration of the first dose of paclitaxel, the patient had a cutaneous reaction that was clinically consistent with "fixed drug eruption". Lesions regressed with a topical steroid dressing. Histopathological examination of the lesion confirmed clinical diagnosis. It is interesting that such a reaction could occur despite the use of premedication with systemic corticosteroid antihistaminic prophylaxis yet heal rapidly with topical corticosteroid therapy. Thus we recommend careful observation for cutaneous side-effects in patients who receive paclitaxel or other taxanes, even with premedication prophylaxis.
Collapse
Affiliation(s)
- C Baykal
- Hacettepe University, Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
| | | | | | | | | |
Collapse
|
30
|
Abstract
We describe a case of fetal rhabdomyosarcoma detected during the third trimester of pregnancy by prenatal sonography. At 33 weeks' gestation, sonography performed because of suspected polyhydramnios showed a solid mass of 120 x 54 mm arising from the anterior wall of the fetal thoracic cage. Another mass within the left maxillary area which originated from the left orbital floor was also detected. In the abdomen, there were multiple round masses in and around the liver. As the previous scan at 28 weeks had appeared normal, the multiple masses which became visible and enlarged rapidly in different locations led us to believe that there was fetal cancer. The most likely diagnosis was rhabdomyosarcoma (which was later confirmed), because it is the most prevalent soft-tissue tumor in children and may develop within or outside muscle anywhere in the body and at any age. Two other reported cases which were detected by prenatal ultrasound examination are also discussed.
Collapse
Affiliation(s)
- L S Onderoğlu
- Department of Obstetrics and Gynecology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | | | | |
Collapse
|
31
|
Ayhan A, Tuncer ZS, Doğan L, Yüce K, Küçükali T. Skinning vulvectomy for the treatment of vulvar intraepithelial neoplasia 2-3: a study of 21 cases. EUR J GYNAECOL ONCOL 1998; 19:508-10. [PMID: 9863927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Twenty-one cases of patients with vulvar intraepithelial neoplasia (VIN) 2-3 were reviewed. The mean age at diagnosis was 45.4 years. All of the patients presented with vulvar pruritus. Five of the patients had hypertension, two had coronary heart disease and two had diabetes mellitus as complicating medical illnesses. None of the patients had history or evidence of vaginal intraepithelial neoplasia (VAIN) or cervical intraepithelial neoplasia (CIN), and only one patient had invasive cervical cancer at diagnosis. Provided the histology confirmed VIN, the patients were subjected to a skinning vulvectomy procedure. Of the patients, 15 (71.4%) had VIN 2, and the remaining 6 (28.6%) had VIN 3 at preoperative evaluation. Histologic analysis of skinning vulvectomy specimens revealed no evidence of neoplasia in three patients (14.2%). Multifocality was observed in only three patients (14.2%). The areas involved were the perineum in four patients, labia in 15 and clitoris in two patients. Associated vulvar pathologies were condyloma acuminata in one, squamous vulvar hyperplasia in three and lichen sclerosus with squamous hyperplasia in one patient. The complications of the procedure included febrile morbidity in three patients and minor wound break-down in one patient. None of the patients in this series experienced recurrence. Skinning vulvectomy seems to have a high success rate in treatment of VIN 2-3 with minimal postoperative complications and satisfactory cosmetic results. However, observation of only three patients with multifocal lesions as well as no patient with invasive cancer adds credence to an ablative procedure after appropriate evaluation under colposcopy.
Collapse
Affiliation(s)
- A Ayhan
- Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey
| | | | | | | | | |
Collapse
|
32
|
Yüce K, Yücel A, Tanir M, Ayhan A, Ayhan A. Massive bilateral ovarian edema: report of 2 cases. EUR J GYNAECOL ONCOL 1998; 19:305-7. [PMID: 9641238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF INVESTIGATION Diagnostic and therapeutic approaches in two cases of bilateral massive ovarian edema were evaluated. METHODS Two cases were retrospectively evaluated with the help of the medical reports. RESULTS Both patients presented with left lower abdominal quadrant pain. Cystic pelvic masses were detected during abdomino-pelvic examination and confirmed with transabdominal ultrasonography. There were no abnormal laboratory results. Explorative laparotomy was performed with the diagnosis of torsion or rupture of ovarian tumor. Bilateral wedge resection with subsequent frozen section was performed. The final pathology was reported as bilateral massive ovarian edema. CONCLUSION A diagnostic bilateral wedge resection with subsequent frozen section is essential in the management and confirmation of the diagnosis. As the vast majority of the cases are young, a conservative surgical management is mandatory to preserve ovarian function.
Collapse
Affiliation(s)
- K Yüce
- Division of Gynecologic Oncology, Faculty of Medicine, University of Hacettepe, Ankara, Turkey
| | | | | | | | | |
Collapse
|
33
|
Ayhan A, Tuncer ZS, Tanir M, Yüce K, Ayhan A. Uterine sarcoma: the Hacettepe hospital experience of 88 consecutive patients. EUR J GYNAECOL ONCOL 1997; 18:146-8. [PMID: 9105869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The treatment modalities of 88 consecutive patients with uterine sarcomas were reviewed retrospectively in the hope of offering a more rational therapy especially in early stage disease. Of the patients, 47 had Leiomyosarcoma (LMS) (53.4%), 28 had Malignant Mixed Mesodermal Tumor (MMMT) (31.8%) and 8 had Endometrial Stromal Sarcoma (ESS) (9.0%). The patients with uterine sarcoma constituted 7.8% of all patients with uterine malignancies during the study period (88/1124). The mean age of this series at diagnosis was 49.2 years. This figure was 45.1, 53.2 and 35.3 for LMS, MMMT and ESS, respectively. The surgical procedure employed was total abdominal hysterectomy and bilateral salpingoophorectomy (TAH + BSO) in 53 (58.9%) patients and 35 patients underwent TAH + BSO and pelvic and paraaortic lymphadenectomy. The overall incidence of lymph node metastases was 28.5% (4/14) for MMMT and 5.8% (1/17) for LMS cases, respectively. The overall 3-year survival rate of this series was 29.5% (23/88). This figure was found to be 59.4% (22/37) for stage I disease and 27.2 (3/11) for stage II disease; The stage I patients with and without adjuvant therapy had similar survival rates. This study confirms that due to the existence of a substantial risk of lymph node metastasis, a complete surgical staging is necessary in the management of uterine sarcomas particularly of MMMT type. Another deserving finding is the failure to detect any therapeutic effect of adjuvant therapy in stage I patients.
Collapse
Affiliation(s)
- A Ayhan
- Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey
| | | | | | | | | |
Collapse
|
34
|
Ayhan A, Tuncer ZS, Köseoğlu F, Yüce K, Küçükali T. Microinvasive carcinoma of the cervix: an analysis of 31 patients. EUR J GYNAECOL ONCOL 1997; 18:127-9. [PMID: 9105862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A retrospective analysis of 31 patients subjected to radical surgery and lyphadenectomy for microinvasive cervical cancer was carried out. The mean age of the patients at diagnosis was 51.4 years. Twenty-nine of the patients had depth of invasion of 3 mm or less whereas 5 of them had lymphovascular space invasion. Thus, 24 patients had microinvasive cervical cancer according to the SGO (Society of Gynecologic Oncology) criteria. While nine patients had minimal stromal invasion (< 1 mm) at diagnosis, the remaining 22 patients fulfilled the criteria of FIGO IA2 disease. Most of the patients had grade I disease. With worsening of differentiation lymphovascular space involvement increases from approximately 11% (2/18) to 50% (1/2). None of the patients had lymph node involvement. All patients are living with no evidence of disease with a mean survival of 39 months. Current FIGO criteria for microinvasive carcinoma permits us to define a subset of patients that can safely be subjected to a more conservative approach.
Collapse
Affiliation(s)
- A Ayhan
- Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey
| | | | | | | | | |
Collapse
|
35
|
Yünten N, Alper H, Zileli M, Yüce K. Tuberculous radiculomyelitis as a complication of spondilodiscitis: MR demonstration. J Neuroradiol 1996; 23:241-4. [PMID: 9107110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We present the MRI features and follow-up results in a case of acute tuberculous (TB) radiculomyelitis adjacent to spondilodiscitis in the thoracic spine. Medullary involvement by tuberculosis originating by different mechanisms have been demonstrated in the recent literature. However, this rare complication accompanying TB spondilodiscitis has not been reported.
Collapse
Affiliation(s)
- N Yünten
- Department of Radiology, Ege University, School of Medicine, Bornova, Izmir, Turkey
| | | | | | | |
Collapse
|
36
|
Affiliation(s)
- T Kanra
- Hacettepe University Faculty of Medicine, Department of Pediatrics, Ankara, Turkey
| | | | | |
Collapse
|
37
|
Ayhan A, Tuncer ZS, Tuncer R, Yüce K, Küçükali T. Tumor status of lymph nodes in early endometrial cancer in relation to lymph node size. Eur J Obstet Gynecol Reprod Biol 1995; 60:61-3. [PMID: 7635233 DOI: 10.1016/0028-2243(95)02072-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A retrospective analysis of 36 patients with metastatic nodes out of 209 consecutively managed patients with a clinically stage I endometrial cancer was carried out. Of the 1023 lymph nodes removed, 154 nodes were found to be metastatic. The mean number of the involved nodes was 4.27 (range: 1-29). Of the 154 positive nodes, 3 had nodal diameters < or = 3 mm (1.9%), 84 had diameters of 4-10 mm (54.6%), 60 had diameters of 11-20 mm (39.0%) and 7 had diameters more than 20 mm (4.5%). With increasing lymph node size, the frequency of tumoral involvement varies from 1.0% in nodes < or = 3 mm to 63.6% in nodes bigger than 20 mm. In terms of patients, nine of them were found to have a single metastatic node ranging from 6 mm to 10 mm in diameter. In the remaining 27 patients with multiple metastatic nodes, the biggest nodes encountered were 6-10 mm in 4 (14.8%), 11-20 mm in 17 (62.9%) and more than 20 mm in 6 (22.2%) patients. Since mere sampling of the lymphatic tissue directed particularly to the enlarged nodes may not show the true incidence of positive nodes, a complete lymphadenectomy is advocated in order to obviate an understaging problem.
Collapse
Affiliation(s)
- A Ayhan
- Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey
| | | | | | | | | |
Collapse
|
38
|
Ayhan A, Tuncer ZS, Tuncer R, Yüce K, Küçükali T. Risk factors for recurrence in clinically early endometrial carcinoma: an analysis of 183 consecutive cases. Eur J Obstet Gynecol Reprod Biol 1994; 57:167-70. [PMID: 7713290 DOI: 10.1016/0028-2243(94)90294-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This study includes 183 patients with clinical stage I endometrial carcinoma. All patients had standard surgical staging procedure including peritoneal cytology, total abdominal hysterectomy, bilateral pelvic and paraaortic lymphadenectomy. The factors analysed for recurrence were age, menopausal state, cell type, grade, mitotic activity, myometrial invasion, lymphovascular space invasion, cervical involvement, microscopic vaginal metastases, adnexal metastases, peritoneal cytology, concomitant endometrial hyperplasia and pelvic and paraaortic node metastases. The overall recurrence rate was 14.2% (26/183). Of the 26 patients with recurrence, 11 had local and 13 had distant metastases. In the remaining two patients (7.7%), both local and pelvic metastases were observed. Of the factors analysed, age, grade, mitotic activity, myometrial invasion, lymphovascular space invasion, microscopic vaginal metastases, adnexal involvement and pelvic and paraaortic nodal metastases were found to be significant predictors of recurrence. After multivariate analysis, advanced age (RR = 1.05), marked mitotic activity (RR = 3.11), pelvic and/or paraaortic nodal metastases (RR = 6.37) were chosen as the most important determinants of recurrence. In terms of surgical pathological stages, recurrence risk reaches up to 45.4% for stage IIIC disease. Using surgical pathological parameters, it is possible to predict recurrence but because of high rate of distant failures it still seems hard to improve survival of this group. Detection of a substantial risk of recurrence even in stage IA/B grade 1 group warrants adjuvant therapy in all patients after primary surgery.
Collapse
Affiliation(s)
- A Ayhan
- Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey
| | | | | | | | | |
Collapse
|
39
|
Yüce K. Retention mesh: an alternative to retention sutures. Eur J Surg 1994; 160:641-2. [PMID: 7858050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- K Yüce
- Department of Surgery, Dörtyol State Hospital, Hatay, Turkey
| |
Collapse
|
40
|
Abstract
A retrospective analysis of 136 patients with ovarian carcinoma subjected to appendectomy as a part of surgical procedure was carried out to assess the importance of appendectomy in patients with ovarian cancer. Of the 136 patients studied, 94 had epithelial and 38 had non-epithelial type of primary ovarian carcinoma. In the remaining 4 patients, the primary operation was performed with an intraoperative diagnosis of ovarian carcinoma but the final pathological examination revealed appendiceal carcinoma metastatic to ovaries. The overall appendiceal involvement in the study group with primary ovarian cancer was found to be 32.5% (43/132). This figure was 15.7% and 39.3% for non-epithelial and epithelial tumors, respectively. Involvement of the appendix ranged from 8.8% for patients with stage I disease to 46.0% for patients with stage III-IV disease. Four of the appendices found to be inflamed during the surgical explorations were later reported as acute appendicitis. The frequent occurrence of metastatic disease in the appendix in patients with ovarian cancer suggests routine appendectomy is appropriate for staging early cases and for contributing to maximal cytoreduction in advanced cases.
Collapse
Affiliation(s)
- A Ayhan
- Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey
| | | | | | | | | |
Collapse
|
41
|
Ayhan A, Tuncer R, Tuncer Z, Yüce K, Küçükali T. Correlation between clinical and histopathologic risk factors and lymph node metastases in early endometrial cancer (a multivariate analysis of 183 cases). Int J Gynecol Cancer 1994; 4:306-309. [PMID: 11578422 DOI: 10.1046/j.1525-1438.1994.04050306.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This study includes 183 patients with clinical stage I endometrial cancer subjected to peritoneal cytology, total abdominal hysterectomy, bilateral salpingo-oophorectomy, bilateral pelvic and para-aortic lymphadenectomy and omental biopsy during a 12-year period in a single institution. The factors analyzed were age, menopausal state, cell type, grade, mitotic activity, myometrial invasion, lymphovascular space invasion, cervical involvement, microscopic vaginal metastases, adnexal metastases, peritoneal cytology, presence of concomitant endometrial hyperplasia and lymph node status. The overall incidences of pelvic and para-aortic lymph node metastases were found to be 15.3% (28/183) and 9.3% (17/183), respectively. In five of 17 patients (29.4%) with para-aortic nodal metastases, pelvic nodes were free of tumor. The most significant prognostic factors for positive pelvic and/or para-aortic nodes were found to be the depth of myometrial invasion, grade of tumor and age.
Collapse
Affiliation(s)
- A. Ayhan
- Department of Obstetrics and Gynecology and Pathology, Division of Gynecologic Oncology, Hacettepe University School of Medicine, Ankara, Turkey
| | | | | | | | | |
Collapse
|
42
|
Abstract
This study reports results of 52 patients with Bartholin abscesses or cysts who were managed by silver nitrate stick insertion into the cyst or abscess cavity for 48 hours. All patients showed complete healing within 15 days. However, 2 (3.8%) had recurrences within the first 2 months; 1 of these patients was treated with excision and the other by repetition of the same method with no further complaints. Silver nitrate application for Bartholin cysts or abscesses was found to be an effective, simple, inexpensive and the least anaesthetic requiring procedure, which can easily be carried out in the outpatient setting.
Collapse
Affiliation(s)
- K Yüce
- Hacettepe University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
| | | | | | | |
Collapse
|
43
|
Ayhan A, Altintaş A, Tuncer ZS, Küçükali T, Yüce K. Prognostic value of mitotic activity, eosinophilic and inflammatory reaction in stage I cancer of the uterine cervix. Eur J Surg Oncol 1992; 18:264-6. [PMID: 1607039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This study includes 110 patients treated surgically for stage I squamous cell carcinoma of the cervix. The prognostic significances of mitotic activity, stromal inflammatory and eosinophilic reactions were studied. The 5-year survival rate varied from 75.0% to 93.3% and pelvic lymph node metastases (PLNM) varied from 23.0% to 31.2% according to degree of these variables. None of these pathological parameters was found to be a significant predictor of pelvic lymph node metastases and 5-year survival.
Collapse
Affiliation(s)
- A Ayhan
- Department of Obstetrics and Gynecology, Hacettepe University, School of Medicine, Ankara, Turkey
| | | | | | | | | |
Collapse
|
44
|
Dereli D, Ertem E, Serter D, Yüce K. Evaluation of a direct fluorescent antibody test for detection of Chlamydia trachomatis in endocervical specimens. Brief report. APMIS 1991; 99:961-4. [PMID: 1930969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A total of 160 endocervical specimens collected from 72 symptomatic and 82 asymptomatic women attending a gynecology outpatient clinic were investigated for genital Chlamydia trachomatis infection by the use of tissue culture and DFA test. The infection rate was 42% for symptomatic and 23% for asymptomatic patient groups. The sensitivity rates of the DFA test in the symptomatic and asymptomatic groups were 84% and 75%, while the specificity rates were 89% and 95%, respectively. The DFA test had an overall sensitivity of 80% and specificity of 93%. There was 90% agreement between the two techniques. Therefore, DFA is recommended as an alternative to tissue culture where laboratory facilities are limited and genital chlamydial infections are highly prevalent.
Collapse
Affiliation(s)
- D Dereli
- Ege University Medical Faculty, Clinical Bacteriology and Infectious Diseases Department, Bornova-Izmir, Turkey
| | | | | | | |
Collapse
|
45
|
Ayhan A, Yüce K, Bilgin T, Yüce A, Koray Z, Duyar O, Erdem G. Relation between the birthweight and cord, maternal serum and amniotic fluid growth hormone levels. Int J Gynaecol Obstet 1991; 35:305-9. [PMID: 1682176 DOI: 10.1016/0020-7292(91)90662-o] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Maternal and cord serum and amniotic fluid growth hormone (GH) levels were measured in 55 term pregnancies in order to evaluate the role of GH in prenatal fetal somatic growth. The study group consisted of patients who had small, large, and average for gestational age infants. The difference in mean maternal and cord serum and amniotic fluid GH levels between the three weight groups were found to be insignificant. It is concluded that GH does not influence fetal somatic growth.
Collapse
Affiliation(s)
- A Ayhan
- Department of Obstetrics and Gynecology, School of Medicine, Hacettepe University, Ankara, Turkey
| | | | | | | | | | | | | |
Collapse
|
46
|
Ertem E, Dereli D, Serter D, Yüce K. Screening for Chlamydia trachomatis in a Turkish population. Genitourin Med 1991; 67:354-5. [PMID: 1916803 PMCID: PMC1194721 DOI: 10.1136/sti.67.4.354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
|
47
|
Abstract
The outcome of 64 pregnancies in 40 women who conceived after cardiac valve replacement were reviewed. Fetal wastage was 53.2% (25/47) in coumarin administered pregnancies, 36.4% (4/11) using heparin and 16.7% (1/6) without anticoagulants. Two fetal malformations were noted in coumarin administered pregnancies. There were two maternal deaths. Maternal morbidity due to antenatal bleeding, atrial fibrillation, thromboembolic episodes and cardiac failure were found to be 20.0% (8/40), 17.5% (7/40), 10.0% (4/40) and 10.0% (4/40), respectively.
Collapse
Affiliation(s)
- A Ayhan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | | | | | | | | | | |
Collapse
|
48
|
|
49
|
Ayhan A, Urman B, Yarali H, Yüce K, Ayhan A. Predictors of recurrent disease after negative second-look laparotomy for epithelial ovarian cancer. J Surg Oncol 1990; 44:119-21. [PMID: 2355741 DOI: 10.1002/jso.2930440212] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Twenty-four patients with epithelial ovarian cancer who had negative second-look laparotomy (SLL) were assessed in regard to recurrent disease. Four patients showed recurrence 11-36 months after negative SLL. All four patients had advanced stage and grade III tumors, with two having residual tumors greater than 1 cm in diameter after initial laparotomy. We believe that patients with advanced stage and high-grade tumors should receive some kind of treatment after negative SLL.
Collapse
Affiliation(s)
- A Ayhan
- Department of Obstetrics and Gynecology, University of Hacettepe Faculty of Medicine, Ankara, Turkey
| | | | | | | | | |
Collapse
|
50
|
Ayhan A, Ergeneli MH, Yüce K, Yapar EG, Kişnişçi AH. Pregnancy after chemotherapy for gestational trophoblastic disease. J Reprod Med 1990; 35:522-4. [PMID: 2161928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Forty-nine women who had received chemotherapy for gestational trophoblastic disease subsequently became pregnant a total of 65 times. Of these 65 pregnancies, 42 (64.7%) terminated in term births, 4 (6.1%) in premature births, 1 (1.5%) in stillbirth, 8 (2.3%) in spontaneous abortion and 7 (10.8%) in elective abortion, while 3 patients (4.6%) had repeat molar pregnancies. No congenital malformations or obstetric complications were observed. Treatment of gestational trophoblastic disease with chemotherapy is compatible with the preservation of fertility and is not associated with any increase in congenital fetal malformations.
Collapse
Affiliation(s)
- A Ayhan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | | | | | | | | |
Collapse
|