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Multicenter Analysis of Gestational Trophoblastic Neoplasia in Turkey
Ozalp, Sabit Sinan,Telli, Elcin,Oge, Tufan,Tulunay, Gokhan,Boran, Nurettin,Turan, Taner,Yenen, Mufit,Kurdoglu, Zehra,Ozler, Ali,Yuce, Kunter,Ulker, Volkan,Arvas, Macit,Demirkiran, Fuat,Bese, Tugan,Tok Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.8
Background: To evaluate the incidence, diagnosis and management of GTN among 28 centers in Turkey. Materials and Methods: A retrospective study was designed to include GTN patients attending 28 centers in the 10-year period between January 2003 and May 2013. Demographical characteristics of the patients, histopathological diagnosis, the International Federation of Gynecology and Obstetrics (FIGO) anatomical and prognostic scores, use of single-agent and multi-agent chemotherapy, surgical interventions and prognosis were evaluated. Results: From 2003-2013, there were 1,173,235 deliveries and 456 GTN cases at the 28 centers. The incidence was calculated to be 0.38 per 1,000 deliveries. According to the evaluated data of 364 patients, the median age at diagnosis was 31 years (range, 15-59 years). A histopathological diagnosis was present for 45.1% of the patients, and invasive mole, choriocarcinoma and PSTTs were diagnosed in 22.3% (n=81), 18.1% (n=66) and 4.7% (n=17) of the patients, respectively. Regarding final prognosis, 352 (96.7%) of the patients had remission, and 7 (1.9%) had persistence, whereas the disease was mortal for 5 (1.4%) of the patients. Conclusions: Because of the differences between countries, it is important to provide national registration systems and special clinics for the accurate diagnosis and treatment of GTN.
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Adjuvant Treatment Modalities, Prognostic Predictors and Outcomes of Uterine Carcinosarcomas
Kemal Gungorduk,Aykut Ozdemir,Ibrahim E. Ertas,Mehmet Gokcu,Elcin Telli,Tufan Oge,Ahmet Sahbaz,Sevil Sayhan,Muzaffer Sanci,Mehmet Harma,Sinan Ozalp 대한암학회 2015 Cancer Research and Treatment Vol.47 No.2
Purpose The purpose of this study is to evaluate the clinicopathological characteristics, treatment,and prognosis of uterine carcinosarcoma (UC). Materials and MethodsA retrospective review of three cancer registry databases in Turkey was conducted foridentification of patients diagnosed with UC between January 1, 1996, and December 31,2012. We collected clinicopathological data in order to evaluate factors important in disease-free survival (DFS) and overall survival (OS). ResultsA total of 66 patients with UC with a median age of 65.0 years were included in the analysis. The median survival time of all patients was 37.5 months and the 5-year OS rate was 59.1%. In early stage patients (I-II) who received adjuvant chemotherapy (CT) with radiation therapy(RT), the median DFS and OS was 44 months and 55 months, respectively, compared to34.5 months and 36 months, respectively, in patients who received adjuvant RT or CT alone(hazard ratio [HR], 1.4; 95% confidence interval [CI], 0.7 to 3.1 for DFS; p=0.23 and HR,2.2; 95% CI, 0.9 to 5.3 for OS; p=0.03). In advanced stage patients (III-IV), the median DFSand OS of patients receiving adjuvant RT with CT was 25 months and 38 months, respectively,compared to 23.5 months and 24.5 months, respectively, in patients receivingadjuvant RT or CT alone (HR, 3.1; 95% CI, 0.6 to 16.0 for DFS; p=0.03); (HR, 3.3; 95% CI,0.7 to 15.0 for OS; p=0.01). In multivariate analysis, advanced International Federation ofGynecology and Obstetrics (FIGO) stage and suboptimal surgery showed significant associationwith poor OS. ConclusionIn patients with early or advanced stage UC, adjuvant CT with RT is associated with improvedDFS and OS, as compared to CT or RT alone.
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Kemal Gungorduk,Ibrahim E. Ertas,Aykut Ozdemir,Emrah Akkaya,Elcin Telli,Salih Taskin,Mehmet Gokcu,Ahmet Baris Guzel,Tufan Oge,Levent Akman,Tayfun Toptas,Ulas Solmaz,Askın Dogan,Mustafa Cosan Terek,Muz 대한암학회 2015 Cancer Research and Treatment Vol.47 No.3
Purpose The purpose of this study is to evaluate the prognostic role of preoperative neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) and the need for para-aortic lymphadectomy in patients with primary fallopian tube carcinoma (PFTC). Materials and Methods Ninety-one patients with a diagnosis of PFTC were identified through the gynecologic oncology service database of six academic centers. Clinicopathological, surgical, and complete blood count data were collected. Results In univariate analysis, advanced stage, suboptimal surgery, and NLR > 2.7 were significant prognostic factors for progression-free survival, whereas in multivariate analysis, only advanced stage and suboptimal surgery were significant. In addition, in univariate analysis, cancer antigen 125 ! 35 U/mL, ascites, advanced stage, suboptimal surgery, NLR > 2.7, PLR > 233.3, platelet count ! 400,000 cells/mm3, staging type, and histological subtype were significant prognostic factors for overall survival (OS); however, in multivariate analysis, only advanced stage, suboptimal surgery, NLR > 2.7, and staging type were significant. Inclusion of pelvic and para-aortic lymphadenectomy in surgery showed significant association with longer OS, with a mean and median OS of 42.0 months and 35.5 months (range, 22 to 78 months), respectively, vs. 33.5 months and 27.5 months (range, 14 to 76 months), respectively, for patients who underwent surgery without para-aortic lymphadenectomy (hazard ratio, 3.1; 95% confidence interval, 1.4 to 5.7; p=0.002). Conclusion NLR (in both univariate and multivariate analysis) and PLR (only in univariate analysis) were prognostic factors in PFTC. NLR and PLR are inexpensive and easy tests to perform. In addition, patients with PFTC who underwent bilateral pelvic and para-aortic lymphadenectomy had longer OS.
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Nazli Topfedaisi Ozkan,Mehmet Mutlu Meydanlı,Mustafa Erkan Sarı,Fuat Demirkiran,Ilker Kahramanoglu,TUGAN BESE,Macit Arvas,Hanifi Şahin,Ali Haberal,Husnu Celik,Gonca Coban,Tufan Oge,Omer Tarik Yalcin,Ö 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.5
Objective: To determine factors influencing overall survival following recurrence (OSFR) inwomen with low-risk endometrial cancer (EC) treated with surgery alone. Methods: A multicenter, retrospective department database review was performed to identifypatients 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 beingdiagnosed and treated for low-risk EC. For the entire study cohort, the median time torecurrence (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 observed32 (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 locoregionalwhereas 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 highintermediaterisk (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) weresignificant predictors. Conclusion: Low-risk EC patients recurring earlier than 36 months and those carrying HIRcriteria seem more likely to succumb to their tumors after recurrence.
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