Samet Topuz - Academia.edu (original) (raw)

Papers by Samet Topuz

Research paper thumbnail of Hyperthyroidism in molar pregnancy: Rapid preoperative preparation by plasmapheresis and complete improvement after evacuation

Transfusion and Apheresis Science, Feb 1, 2007

Human chorionic gonadotropin bears structural homology to pituitary thyrotropin. The extremely el... more Human chorionic gonadotropin bears structural homology to pituitary thyrotropin. The extremely elevated levels of human chorionic gonadotropin in patients with molar pregnancy or other trophoblastic diseases can lead to hyperthyroidism. We describe a patient with molar pregnancy who had secondary hyperthyroidism prepared rapidly by plasmapheresis for surgery. The clinical picture improved dramatically after the first plasmapheresis. Three subsequent plasmapheresis provided a 75.1% decrease in serum free T3 concentrations and 63.9% free T4 concentrations and recovery after evacuation. This is the first use of plasmapheresis in rapid preparation of a patient who had secondary hyperthyroidism due to molar pregnancy.

Research paper thumbnail of Geriatrik Yaş Grubunda Jinekolojik Kanserler

Research paper thumbnail of 000180 THE Expression of KI-67, P53, Estrogen and Progesterone Receptors Affecting Survival in Uterine Leiomyosarcomas. A Clinicopathologic Study

International Journal of Gynecologic Cancer, 2005

Research paper thumbnail of Optimal Cytoreduction is an Independent Prognostic Factor in Ovarian Carcinosarcoma: A Turkish Gynecologic Oncology Group Study

Journal of Oncological Sciences, 2020

Un paso crucial en el desarrollo de un inmunosensor piezoeléctrico para la detección de tuberculo... more Un paso crucial en el desarrollo de un inmunosensor piezoeléctrico para la detección de tuberculosis (TB), es la selección y obtención de los inmunoreactivos empleados en el inmunoensayo y la estrategia para la biofuncionalización del transductor. Diversos estudios han reportado el uso del antígeno proteico 38kDa (Ag38kDa) de Mycobacterium tuberculosis (Mtb) como un

Research paper thumbnail of Prognostic Factors in Patients Undergoing Primary Cytoreductive Surgery for FIGO Stage IIIC Ovarian, Tubal or Peritoneal Cancer

Journal of Obstetrics and Gynaecology Canada, 2018

Objective: The aim of the study is to investigate factors related to overall survival in advanced... more Objective: The aim of the study is to investigate factors related to overall survival in advanced stage ovarian, tubal, or peritoneal cancer and to identify strong and weak prognostic factors. Methods: We retrospectively reviewed 190 patients who underwent primary cytoreductive surgery between 2003 and 2013. Results: Median overall survival duration was founded 58 months (95% CI 49-67). Five-year overall survival ratio was 48.5%. Presence of tumour at upper abdomen, suboptimal cytoreduction (residual >1 cm), surgery without lymphadenectomy, and presence of peritoneal ascites more than 1 L had a significantly negative effect on overall survival, but not histological grade and CA-125 level, by univariate Cox analysis. Age and presence of tumour in the upper abdomen were independent poor prognostic factors according to multivariate Cox model (HR 1.025; 95% CI 1.009-1.040 and HR 1.533; 95% CI 1.039-2.263, respectively). Conclusion: This study supports that the presence of tumour in the upper abdomen is the most important independent poor prognostic factor in patients with performed primary surgery for advanced stage ovarian, tubal, and peritoneal cancer. Upper abdominal metastasis is the most important predictive factor for optimal cytoreduction (P < 0.001, HR 6.567; 95% CI 3.059-14.096). Résumé Objectif : Le but de la présente étude était d'analyser les facteurs associés à la survie globale chez les patientes atteints d'un cancer de l'ovaire, des trompes ou du péritoine de stade avancé, et de mettre en évidence les facteurs pronostiques forts et faibles. Méthodologie : Nous avons rétrospectivement examiné le dossier de 190 patientes ayant subi leur chirurgie de réduction tumorale initiale entre 2003 et 2013.

Research paper thumbnail of The survival effect of residual disease on hysterectomy specimen among the patients previously treated by chemoradiotherapy

Zeynep Kamil Tıp Bülteni, 2018

ÖZET:Amaç: Primer kemoradyoterapi tedavisi almış ileri evre serviks kanserli hastalarda uterusa s... more ÖZET:Amaç: Primer kemoradyoterapi tedavisi almış ileri evre serviks kanserli hastalarda uterusa sınırlı rezidü tümör miktarının sağkalıma etkisini belirlemek ve bu tarz tümörlerde görüntüleme yöntemlerinin rezidü tümör saptamadaki başarısı saptamakMateryal Metod: İstanbul Universitesi İstanbul Tıp Fakültesi Jinekolojik Onkoloji Kliniğinde 2009 Nisan-2017 Mayıs ayları arasında opere edilen 31 hasta çalışmaya dahil edilmiştir. Bu hastaların klinikopatolojik özellikleri değerlendirilmiştir. Hastalar operasyon öncesi Magnetik Rezonans inceleme (MRI) ve/veya Pozitron Emisyon Tomografi (PET-BT) ile değerlendirilmiştir. Hastalar operasyon sonrası uterus materyalinde tümör miktarına göre i) rezidu tümör yok ii) rezidü tümör <10 mm iii) rezidü tümör > 10 mm olarak üç gruba ayrılmış ve hastalıksız sağkalım incelemesi yapılmıştır.Sonuçlar: Ortanca yaş 54 olarak hesaplanmıştır. MRI rezidü tümör saptamada sensitivitesi %75 spesifitesi %50 ; PET-BT sensitivitesi %54.5 spesifitesi %50 olar...

Research paper thumbnail of Ji̇nekoloji̇k Kanserler Ve Pelvi̇k Egzenterasyon Kisa Dönem Sonuçlari Tek Merkez Deneyi̇mleri̇

Zeynep Kamil Tıp Bülteni, 2018

Giriş:Pelvik egzenterasyon rekürren jinekolojik kanserlerde kür veya daha uzun sağkalım amacıyla ... more Giriş:Pelvik egzenterasyon rekürren jinekolojik kanserlerde kür veya daha uzun sağkalım amacıyla uygulanan ultraradikal bir cerrahidir. Bu çalışmanın birincil amacı kliniğimizce pelvik egzenterasyon operasyonu uygulanan hastaların klinik özelliklerini, operatif ve postoperatif komplikasyon türlerini ve sıklığını tanımlamaktır. Kısa dönem ortalama sağkalım ve hastalıksız sağkalım rakamlarını belirlemek çalışmanın ikincil amacıdır.Materyal Metod:Kliniğimizde 2013-2017 yılları arasında Pelvik egzenterasyon yöntemi ile opere edilen 14 nüks serviks, endometriyum, vagina kanserli hasta retrospektif olarak incelenmiştir.Sonuçlar:Hastaların 11 tanesi rekürren serviks kanseri 2 tanesi rekürren endometriyum kanseri 1 tanesi de rekürren vagina kanseri idi. Opere edilen hastaların ortanca yaş 52.5 olarak hesaplanmıştır. Hastaların çoğunluğu (%57) daha önce opere edilmeyen kemoradyoterapi ile tedavi edilen hastalardan oluşmakta idi. En sık uygulanan pelvik egzenterasyon tipi total pelvik egzent...

Research paper thumbnail of Surgical Treatment of Metastatic Ovarian Tumors From Extragenital Primary Sites

International Journal of Gynecologic Cancer, 2016

ObjectiveThe purpose of this study was to investigate the outcomes and prognostic factors of meta... more ObjectiveThe purpose of this study was to investigate the outcomes and prognostic factors of metastasectomy in patients with metastatic ovarian tumors from extragenital primary sites.Materials and MethodsAll patients with pathologically confirmed metastatic ovarian tumors between January 1997 and June 2015 were included in this study. A total of 131 patients were identified. The data were obtained from the patients’ medical records. Clinicopathological features were evaluated by both univariate and multivariate analyses.ResultsThe primary sites were colorectal region (53.4%), stomach (26%), and breast (13%). Preoperative serum CA 125 and CA 19-9 levels were elevated in 29.4% and 39.8% of the patients, respectively. Cytoreductive surgery was performed in 41.2% of the patients. Seventy-three (55.7%) patients had no residual disease after surgery. Sixty-six (49.6%) patients had combined metastases at the time of the surgery to sites including the liver, pancreas, lung, bone, lymph node...

Research paper thumbnail of Combination of adjuvant chemotherapy and radiotherapy is associated with improved survival at early stage type II endometrial cancer and carcinosarcoma

Australian and New Zealand Journal of Obstetrics and Gynaecology, 2016

The aim of this study was to describe the impact of postoperative adjuvant treatment modalities a... more The aim of this study was to describe the impact of postoperative adjuvant treatment modalities and identify risk factors associated with recurrence and survival rates in women diagnosed with early stage type II endometrial cancer and carcinosarcoma. Methods: In this retrospective study, patients diagnosed with early stage (stages I-II) carcinosarcoma and type II endometrial cancer were reviewed. All women underwent comprehensive surgical staging. Postoperative treatment options of chemotherapy (CT), radiotherapy (RT), observation (OBS) and chemotherapy-radiotherapy (CT-RT) combination were compared in terms of recurrence and survival outcome. Results: In CT-RT treatment arm, recurrence rate was found as 12.5% and this result is significantly lower than the other treatment approaches (P = 0.01 CT alone: 33.3%, RT alone: 26.7%, OBS: 62.5%). Three-year disease free survival(DFS) rate and overall survival (OS) rate were statistically higher for the group of women treated with combination of CT-RT (92-95%) compared to the women treated with RT alone (65-72%), treated with CT alone (67-74%) and women who received no adjuvant therapy (38-45%). The multivariate analysis revealed that carcinosarcoma histology was associated with shortened DFS and OS (P = 0.001, P = 0.002). On the other hand, being at stage Ia (P = 0.01, P = 0.04) and receiving adjuvant treatment of CT-RT combination (P = 0.005, P = 0.002) appeared to lead to increased DFS and OS rates. Conclusions: We identified that a combination treatment of chemotherapy and radiotherapy is superior compared to other postoperative adjuvant treatment approaches concerning PFS, OS and recurrence rates in stages I-II of type II endometrial cancers and uterine carcinosarcoma.

Research paper thumbnail of Factors affecting recurrence and disease-free survival in granulosa cell tumors of the ovary

European journal of gynaecological oncology, 2010

To determine risk factors for prognosis and recurrence in ovarian adult-type granulosa cell tumor... more To determine risk factors for prognosis and recurrence in ovarian adult-type granulosa cell tumor (GCT). A retrospective review of GCT cases treated at our university hospital between 1991-2006. Of 39 patients with GCT, 82% had Stage I disease. The median follow-up period was 71 months. There were 12 cases of recurrence (30.8%) and seven of them had died of disease. The pelvis and liver were the most common sites of recurrence (8 and 3 patients, respectively). Interestingly lymph node recurrence was encountered in two patients. Estimated disease-free survival for five years was 82%. Stage and presence of residual tumor were calculated to be the only associated risk factors for recurrence and prognosis (p < 0.05). Recurrences in GCT might be associated with stage and presence of residual tumor during primary surgery. Although rarely present during diagnosis, lymph node metastasis might be more common in recurrent disease.

Research paper thumbnail of Acute colonic pseudo-obstruction after hysterectomy in a patient with Friedreich ataxia

Archives of Gynecology and Obstetrics, 2013

Acute colonic pseudo-obstruction is a rare complication of gynecological surgery. Despite the com... more Acute colonic pseudo-obstruction is a rare complication of gynecological surgery. Despite the complete description of this condition, diagnosis remains difficult and is often delayed. Due to delay in diagnosis and existence of serious comorbid illnesses, morbidity and mortality approaches higher levels. Early recognition of signs and symptoms of this condition and prompt accurate management are vital to prevent serious mortality. Here, we report a case of acute colonic pseudo-obstruction after total abdominal hysterectomy in a patient with known Friedreich ataxia.

Research paper thumbnail of Groin recurrence following stage IA squamous cell carcinoma of the vulva with negative nodes on superficial inguinal lymphadenectomy

European journal of gynaecological oncology, 2010

Stage IA vulvar cancer with a depth of stromal invasion less than 1 mm is generally managed by wi... more Stage IA vulvar cancer with a depth of stromal invasion less than 1 mm is generally managed by wide local excision alone since there is less than 1% risk of lymph node involvement. A 62-year-old patient was admitted to a university hospital with a suspicious vulvar lesion. We present the first case of inguinal node and a possible contralateral pubic ramus recurrence following bilateral superficial inguinal lymphadenectomy and wide local resection for Stage 1A vulvar cancer. There is no evidence that extended radical surgery provides a better overall survival or reduces recurrence rate in Stage 1A vulvar carcinomas. Conservative vulvar resection and sentinel node dissection seem to be a rational choice. Nevertheless the disease may recur in the inguinal areas and frequently be lethal, therefore close surveillance and early attempts to treat the recurrent disease before infection and inflammation ensues should be the aim of current treatment strategies.

Research paper thumbnail of Adiponectin, Leptin and Ghrelin Levels in Obese Adolescent Girls with Polycystic Ovary Syndrome

Journal of Pediatric and Adolescent Gynecology, 2013

To evaluate the differences in adipokines, namely adiponectin, leptin, and ghrelin, in obese adol... more To evaluate the differences in adipokines, namely adiponectin, leptin, and ghrelin, in obese adolescent girls with or without polycystic ovary syndrome (PCOS). Case-control study. University hospital. 38 adolescent girls (age 15-20 years). Group I: 17 Obese adolescent girls with PCOS (BMI ≥ 30 kg/m(2)); Group II: Control group of 21 obese adolescent girls (BMI ≥ 30 kg/m(2)). Adiponectin, leptin, and ghrelin measurements. LH, LH/FSH, and cortisol levels were significantly higher in the obese PCOS girls compared to the obese controls (6.94 ± 3.28 vs 4.44 ± 1.79; 1.50 ± 0.72 vs 0.90 ± 0.36; 16.02 ± 4.28 vs 12.46 ± 5.29; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05, respectively). Adiponectin, leptin, and ghrelin levels were similar between the obese PCOS girls and the obese controls (11.13 ± 6.00 vs 15.26 ± 12.66; 23.66 ± 11.54 vs 23.11 ± 11.17; 665.69 ± 402.12 vs 650.22 ± 467.73, respectively). Adiponectin negatively correlated with BMI (r = -0.32; P = .04) and positively correlated with fasting glucose (r = 0.40; P = .01). Leptin positively correlated with BMI (r = 0.534; P = .001), estradiol (r = 0.354; P = .02), and TSH (r = 0.374; P = .02). No significant correlation was found between ghrelin and the test parameters. Among obese adolescents with PCOS, adiponectin, and leptin levels do not seem to be determined by the existence of PCOS, while ghrelin presents no significant correlation.

Research paper thumbnail of Aggressive Angiomyxoma of the Pelviperineum: Surgical Treatment through a Perineal Incision

Journal of Minimally Invasive Gynecology, 2011

Aggressive angiomyxoma is a rare benign tumor of the pelvic soft tissue in women of reproductive ... more Aggressive angiomyxoma is a rare benign tumor of the pelvic soft tissue in women of reproductive age. The tumor is locally infiltrative and tends to recur. Herein is presented a case report of aggressive angiomyxoma that was totally excised using a transperineal approach. A 35-year-old woman had an aggressive angiomyxoma of the vulva and pelvis, with swelling of the right labium majus pudendi. Three years previously, she had undergone incomplete excision of the same type of pelviperineal mass via the transabdominal route. After a complete workup, a transperineal minimally invasive approach was used to excise the 20-cm mass filling the right side of the pelvis. Histopathologic findings were consistent with a diagnosis of aggressive angiomyxoma. Although often misdiagnosed as various other benign genital disorders, angiomyxoma usually is manifested as a soft nontender mass. After a thorough examination and full radiologic workup, a small transperineal incision may be sufficient for complete removal of the tumor.

Research paper thumbnail of The expression of Ki-67, p53, estrogen and progesterone receptors affecting survival in uterine leiomyosarcomas. A clinicopathologic study

Gynecologic Oncology, 2005

Objectives. To evaluate the level of expression of estrogen receptor (ER), progesterone receptor ... more Objectives. To evaluate the level of expression of estrogen receptor (ER), progesterone receptor (PR), p53 and Ki-67 in patients with leiomyosarcoma and to investigate the effect of these and to identify the clinical parameters on prognosis.

Research paper thumbnail of Ovarian carcinosarcomas: Clinicopathological prognostic factors and evaluation of chemotherapy regimens containing platinum

Gynecologic Oncology, 2008

To evaluate the clinicopathological prognostic factors and outcome of chemotherapy in ovarian car... more To evaluate the clinicopathological prognostic factors and outcome of chemotherapy in ovarian carcinosarcomas. We reviewed the records of 26 patients treated from 1990 to 2006 at the Oncology Institute of Istanbul University. Clinical data including demographics, stage, surgery, chemotherapy, and survival were collected from patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; charts. All patients underwent initial debulking surgery. Optimal debulking was achieved in 21 (81%) patients. The most striking clinicopathological finding was the high incidence of hemorrhagic ascites (n: 6) which was observed in 60% of the patients with ascites (n: 10). The overall median survival of the patients was 26 months. Residual disease was associated with a decreased overall survival, P=0.04. Median survival (50 months vs 9.7 months, P=0.042) of the patients with early stage disease were longer than the patients with advanced stage. Twenty-two patients received platinum-based combination chemotherapy. There was a trend for increased median survival in the patients who were treated with carboplatin/paclitaxel combination (P=0.066). Although the numbers were insufficient for statistical evaluation, the patients treated with ifosfamide combinations had improved survival (36 months vs 26 months). However, when the patients treated with ifosfamide and carboplatin/paclitaxel combinations were combined, survival was statistically improved compared to the other regimens (36 months vs 9.7 months, P=0.04). Chemotherapy regimens containing doxorubicin or cyclophosphamide were not encouraging. Stage (P=0.02) and adjuvant platinum-based chemotherapy containing either paclitaxel or ifosfamide (P=0.024) remained predictive of outcome in the multivariate analysis. Hemorrhagic ascites can be used in the initial differential diagnosis of ovarian carcinosarcomas. Stage, optimal debulking and type of adjuvant therapy were statistically significant prognostic predictors of ovarian carcinosarcomas. We advise that patients with ovarian carcinosarcomas should be treated by optimal cytoreduction followed by adjuvant platinum/taxan or platinum/ifosfamide combinations.

Research paper thumbnail of Pubic symphysis diastasis: imaging and clinical features

European Journal of Radiology Extra, 2006

Symphysis pubis diastasis is an uncommon complication of delivery. Computerized tomography, pelvi... more Symphysis pubis diastasis is an uncommon complication of delivery. Computerized tomography, pelvic X-ray and perineal ultrasonography as well as clinical findings can be used in diagnosis. Conservative treatment consisting of bed rest and analgesics is helpful in most patients and functional recovery is excellent. We present a case of pubic symphysis diastasis following spontaneous vaginal delivery. Imaging findings, clinical features and management methods were discussed under the view of literature.

Research paper thumbnail of Could the Long-Term Oncological Safety of Laparoscopic Surgery in Low Risk Endometrial Cancer be also valid for the High Intermediate and High-Risk Patients? A Multi-center Turkish Gynecologic Oncology Group Study Conducted with 2745 Endometrial Cancer Cases. (TRSGO-End-001)

Could the Long-Term Oncological Safety of Laparoscopic Surgery in Low Risk Endometrial Cancer be ... more Could the Long-Term Oncological Safety of Laparoscopic Surgery in Low Risk Endometrial Cancer be also valid for the High Intermediate and High-Risk Patients? A Multi-center Turkish Gynecologic Oncology Group Study Conducted with 2745 Endometrial Cancer Cases. (TRSGO-End-001)Aim: to compare the long-term oncological outcomes of laparotomy and laparoscopic surgeries in endometrial cancer under the light of 2016 ESMO-ESGO-ESTRO risk classification system with particular focus on the high intermediate and high-risk categories.Methods: Using multicentric database between January 2005 and January 2016, disease-free and overall survivals of 2745 endometrial cancer cases were compared according to the surgery route, laparotomy vs laparoscopy. The high intermediate and high-risk patients were defined with respect to the 2016 ESMO-ESGO-ESTRO risk classification system and they were analyzed with respect to difference in survival rates.Results: Of the 2745 patients 1743 (63.5%) were operated b...

Research paper thumbnail of Clinicopathologic and survival results in serous endometrium carcinoma and subgroup analysis for mixed serous and pure serous histology

Journal of the Turkish-German Gynecological Association, 2018

Objective: To review the clinicopathologic and survival outcomes of patients with serous endometr... more Objective: To review the clinicopathologic and survival outcomes of patients with serous endometrial cancer (EC) and to investigate subgroup analysis based on pure serous and mixed serous EC subtypes. Material and Methods: Patients who underwent EC surgery between 2002 and 2014 and who were reported as serous EC were enrolled in the study. All patients were diagnosed as having serous EC or mixed serous EC with serous component higher than 10% based on the postoperative pathology report. Results: A total of 93 patients were analyzed. The median disease-free and overall survival (OS) durations were 49.6 and 32.2 months, respectively. Forty-three patients (46.2%) relapsed and 35 patients (37.6%) died. The histologic type was pure serous EC in 52 (55.9%) and mixed EC in 41 (44.9%) patients. There was no statistical difference between the pure serous and mixed serous groups in terms of age, International Federation of Gynecology and Obstetrics stage, lymphadenectomy, lymph node metastasis or adjuvant therapy combinations. Twenty-nine (55.8%) patients in the pure serous group and 14 (34.1%) in the mixed serous group hade recurrence (p=0.038). Twenty-five (48.1%) patients in the pure serous group and 10 (24.4%) in the mixed serous group died (p=0.034). In the pure serous group, the mean disease-free and OS durations were shorter than in the mixed serous group (59 vs. 81 months and 73 vs. 95 months, log-rank p=0.055 and 0.041, respectively). Histologic type was a significant prognostic factor on recurrence and OS in the univariate analysis (Hazard ratio: 2.404, 95% Confidence interval: 1.01-5.71; 2.027, respectively), but not in the multivariate analysis, which included disease stage and age of the patients. Conclusion: Compared with pure serous and mixed serous endometrium cancer groups, primary surgical treatments, clinicopathologic features and adjuvant treatments were similar, but there was a survival difference. Patients with pure serous cancer had a worse prognosis. However histology was not an independent factor for survival. (

Research paper thumbnail of Could the Long-Term Oncological Safety of Laparoscopic Surgery in Low-Risk Endometrial Cancer also Be Valid for the High–Intermediate- and High-Risk Patients? A Multi-Center Turkish Gynecologic Oncology Group Study Conducted with 2745 Endometrial Cancer Cases. (TRSGO-End-001)

Current Oncology, 2021

This study was conducted to compare the long-term oncological outcomes of laparotomy and laparosc... more This study was conducted to compare the long-term oncological outcomes of laparotomy and laparoscopic surgeries in endometrial cancer under the light of the 2016 ESMO-ESGO-ESTRO risk classification system, with particular focus on the high–intermediate- and high-risk categories. Using multicentric databases between January 2005 and January 2016, disease-free and overall survivals of 2745 endometrial cancer cases were compared according to the surgery route (laparotomy vs. laparoscopy). The high–intermediate- and high-risk patients were defined with respect to the 2016 ESMO-ESGO-ESTRO risk classification system, and they were analyzed with respect to differences in survival rates. Of the 2745 patients, 1743 (63.5%) were operated by laparotomy, and the remaining were operated with laparoscopy. The total numbers of high–intermediate- and high-risk endometrial cancer cases were 734 (45%) patients in the laparotomy group and 307 (30.7%) patients in the laparoscopy group. Disease-free and...

Research paper thumbnail of Hyperthyroidism in molar pregnancy: Rapid preoperative preparation by plasmapheresis and complete improvement after evacuation

Transfusion and Apheresis Science, Feb 1, 2007

Human chorionic gonadotropin bears structural homology to pituitary thyrotropin. The extremely el... more Human chorionic gonadotropin bears structural homology to pituitary thyrotropin. The extremely elevated levels of human chorionic gonadotropin in patients with molar pregnancy or other trophoblastic diseases can lead to hyperthyroidism. We describe a patient with molar pregnancy who had secondary hyperthyroidism prepared rapidly by plasmapheresis for surgery. The clinical picture improved dramatically after the first plasmapheresis. Three subsequent plasmapheresis provided a 75.1% decrease in serum free T3 concentrations and 63.9% free T4 concentrations and recovery after evacuation. This is the first use of plasmapheresis in rapid preparation of a patient who had secondary hyperthyroidism due to molar pregnancy.

Research paper thumbnail of Geriatrik Yaş Grubunda Jinekolojik Kanserler

Research paper thumbnail of 000180 THE Expression of KI-67, P53, Estrogen and Progesterone Receptors Affecting Survival in Uterine Leiomyosarcomas. A Clinicopathologic Study

International Journal of Gynecologic Cancer, 2005

Research paper thumbnail of Optimal Cytoreduction is an Independent Prognostic Factor in Ovarian Carcinosarcoma: A Turkish Gynecologic Oncology Group Study

Journal of Oncological Sciences, 2020

Un paso crucial en el desarrollo de un inmunosensor piezoeléctrico para la detección de tuberculo... more Un paso crucial en el desarrollo de un inmunosensor piezoeléctrico para la detección de tuberculosis (TB), es la selección y obtención de los inmunoreactivos empleados en el inmunoensayo y la estrategia para la biofuncionalización del transductor. Diversos estudios han reportado el uso del antígeno proteico 38kDa (Ag38kDa) de Mycobacterium tuberculosis (Mtb) como un

Research paper thumbnail of Prognostic Factors in Patients Undergoing Primary Cytoreductive Surgery for FIGO Stage IIIC Ovarian, Tubal or Peritoneal Cancer

Journal of Obstetrics and Gynaecology Canada, 2018

Objective: The aim of the study is to investigate factors related to overall survival in advanced... more Objective: The aim of the study is to investigate factors related to overall survival in advanced stage ovarian, tubal, or peritoneal cancer and to identify strong and weak prognostic factors. Methods: We retrospectively reviewed 190 patients who underwent primary cytoreductive surgery between 2003 and 2013. Results: Median overall survival duration was founded 58 months (95% CI 49-67). Five-year overall survival ratio was 48.5%. Presence of tumour at upper abdomen, suboptimal cytoreduction (residual >1 cm), surgery without lymphadenectomy, and presence of peritoneal ascites more than 1 L had a significantly negative effect on overall survival, but not histological grade and CA-125 level, by univariate Cox analysis. Age and presence of tumour in the upper abdomen were independent poor prognostic factors according to multivariate Cox model (HR 1.025; 95% CI 1.009-1.040 and HR 1.533; 95% CI 1.039-2.263, respectively). Conclusion: This study supports that the presence of tumour in the upper abdomen is the most important independent poor prognostic factor in patients with performed primary surgery for advanced stage ovarian, tubal, and peritoneal cancer. Upper abdominal metastasis is the most important predictive factor for optimal cytoreduction (P < 0.001, HR 6.567; 95% CI 3.059-14.096). Résumé Objectif : Le but de la présente étude était d'analyser les facteurs associés à la survie globale chez les patientes atteints d'un cancer de l'ovaire, des trompes ou du péritoine de stade avancé, et de mettre en évidence les facteurs pronostiques forts et faibles. Méthodologie : Nous avons rétrospectivement examiné le dossier de 190 patientes ayant subi leur chirurgie de réduction tumorale initiale entre 2003 et 2013.

Research paper thumbnail of The survival effect of residual disease on hysterectomy specimen among the patients previously treated by chemoradiotherapy

Zeynep Kamil Tıp Bülteni, 2018

ÖZET:Amaç: Primer kemoradyoterapi tedavisi almış ileri evre serviks kanserli hastalarda uterusa s... more ÖZET:Amaç: Primer kemoradyoterapi tedavisi almış ileri evre serviks kanserli hastalarda uterusa sınırlı rezidü tümör miktarının sağkalıma etkisini belirlemek ve bu tarz tümörlerde görüntüleme yöntemlerinin rezidü tümör saptamadaki başarısı saptamakMateryal Metod: İstanbul Universitesi İstanbul Tıp Fakültesi Jinekolojik Onkoloji Kliniğinde 2009 Nisan-2017 Mayıs ayları arasında opere edilen 31 hasta çalışmaya dahil edilmiştir. Bu hastaların klinikopatolojik özellikleri değerlendirilmiştir. Hastalar operasyon öncesi Magnetik Rezonans inceleme (MRI) ve/veya Pozitron Emisyon Tomografi (PET-BT) ile değerlendirilmiştir. Hastalar operasyon sonrası uterus materyalinde tümör miktarına göre i) rezidu tümör yok ii) rezidü tümör <10 mm iii) rezidü tümör > 10 mm olarak üç gruba ayrılmış ve hastalıksız sağkalım incelemesi yapılmıştır.Sonuçlar: Ortanca yaş 54 olarak hesaplanmıştır. MRI rezidü tümör saptamada sensitivitesi %75 spesifitesi %50 ; PET-BT sensitivitesi %54.5 spesifitesi %50 olar...

Research paper thumbnail of Ji̇nekoloji̇k Kanserler Ve Pelvi̇k Egzenterasyon Kisa Dönem Sonuçlari Tek Merkez Deneyi̇mleri̇

Zeynep Kamil Tıp Bülteni, 2018

Giriş:Pelvik egzenterasyon rekürren jinekolojik kanserlerde kür veya daha uzun sağkalım amacıyla ... more Giriş:Pelvik egzenterasyon rekürren jinekolojik kanserlerde kür veya daha uzun sağkalım amacıyla uygulanan ultraradikal bir cerrahidir. Bu çalışmanın birincil amacı kliniğimizce pelvik egzenterasyon operasyonu uygulanan hastaların klinik özelliklerini, operatif ve postoperatif komplikasyon türlerini ve sıklığını tanımlamaktır. Kısa dönem ortalama sağkalım ve hastalıksız sağkalım rakamlarını belirlemek çalışmanın ikincil amacıdır.Materyal Metod:Kliniğimizde 2013-2017 yılları arasında Pelvik egzenterasyon yöntemi ile opere edilen 14 nüks serviks, endometriyum, vagina kanserli hasta retrospektif olarak incelenmiştir.Sonuçlar:Hastaların 11 tanesi rekürren serviks kanseri 2 tanesi rekürren endometriyum kanseri 1 tanesi de rekürren vagina kanseri idi. Opere edilen hastaların ortanca yaş 52.5 olarak hesaplanmıştır. Hastaların çoğunluğu (%57) daha önce opere edilmeyen kemoradyoterapi ile tedavi edilen hastalardan oluşmakta idi. En sık uygulanan pelvik egzenterasyon tipi total pelvik egzent...

Research paper thumbnail of Surgical Treatment of Metastatic Ovarian Tumors From Extragenital Primary Sites

International Journal of Gynecologic Cancer, 2016

ObjectiveThe purpose of this study was to investigate the outcomes and prognostic factors of meta... more ObjectiveThe purpose of this study was to investigate the outcomes and prognostic factors of metastasectomy in patients with metastatic ovarian tumors from extragenital primary sites.Materials and MethodsAll patients with pathologically confirmed metastatic ovarian tumors between January 1997 and June 2015 were included in this study. A total of 131 patients were identified. The data were obtained from the patients’ medical records. Clinicopathological features were evaluated by both univariate and multivariate analyses.ResultsThe primary sites were colorectal region (53.4%), stomach (26%), and breast (13%). Preoperative serum CA 125 and CA 19-9 levels were elevated in 29.4% and 39.8% of the patients, respectively. Cytoreductive surgery was performed in 41.2% of the patients. Seventy-three (55.7%) patients had no residual disease after surgery. Sixty-six (49.6%) patients had combined metastases at the time of the surgery to sites including the liver, pancreas, lung, bone, lymph node...

Research paper thumbnail of Combination of adjuvant chemotherapy and radiotherapy is associated with improved survival at early stage type II endometrial cancer and carcinosarcoma

Australian and New Zealand Journal of Obstetrics and Gynaecology, 2016

The aim of this study was to describe the impact of postoperative adjuvant treatment modalities a... more The aim of this study was to describe the impact of postoperative adjuvant treatment modalities and identify risk factors associated with recurrence and survival rates in women diagnosed with early stage type II endometrial cancer and carcinosarcoma. Methods: In this retrospective study, patients diagnosed with early stage (stages I-II) carcinosarcoma and type II endometrial cancer were reviewed. All women underwent comprehensive surgical staging. Postoperative treatment options of chemotherapy (CT), radiotherapy (RT), observation (OBS) and chemotherapy-radiotherapy (CT-RT) combination were compared in terms of recurrence and survival outcome. Results: In CT-RT treatment arm, recurrence rate was found as 12.5% and this result is significantly lower than the other treatment approaches (P = 0.01 CT alone: 33.3%, RT alone: 26.7%, OBS: 62.5%). Three-year disease free survival(DFS) rate and overall survival (OS) rate were statistically higher for the group of women treated with combination of CT-RT (92-95%) compared to the women treated with RT alone (65-72%), treated with CT alone (67-74%) and women who received no adjuvant therapy (38-45%). The multivariate analysis revealed that carcinosarcoma histology was associated with shortened DFS and OS (P = 0.001, P = 0.002). On the other hand, being at stage Ia (P = 0.01, P = 0.04) and receiving adjuvant treatment of CT-RT combination (P = 0.005, P = 0.002) appeared to lead to increased DFS and OS rates. Conclusions: We identified that a combination treatment of chemotherapy and radiotherapy is superior compared to other postoperative adjuvant treatment approaches concerning PFS, OS and recurrence rates in stages I-II of type II endometrial cancers and uterine carcinosarcoma.

Research paper thumbnail of Factors affecting recurrence and disease-free survival in granulosa cell tumors of the ovary

European journal of gynaecological oncology, 2010

To determine risk factors for prognosis and recurrence in ovarian adult-type granulosa cell tumor... more To determine risk factors for prognosis and recurrence in ovarian adult-type granulosa cell tumor (GCT). A retrospective review of GCT cases treated at our university hospital between 1991-2006. Of 39 patients with GCT, 82% had Stage I disease. The median follow-up period was 71 months. There were 12 cases of recurrence (30.8%) and seven of them had died of disease. The pelvis and liver were the most common sites of recurrence (8 and 3 patients, respectively). Interestingly lymph node recurrence was encountered in two patients. Estimated disease-free survival for five years was 82%. Stage and presence of residual tumor were calculated to be the only associated risk factors for recurrence and prognosis (p < 0.05). Recurrences in GCT might be associated with stage and presence of residual tumor during primary surgery. Although rarely present during diagnosis, lymph node metastasis might be more common in recurrent disease.

Research paper thumbnail of Acute colonic pseudo-obstruction after hysterectomy in a patient with Friedreich ataxia

Archives of Gynecology and Obstetrics, 2013

Acute colonic pseudo-obstruction is a rare complication of gynecological surgery. Despite the com... more Acute colonic pseudo-obstruction is a rare complication of gynecological surgery. Despite the complete description of this condition, diagnosis remains difficult and is often delayed. Due to delay in diagnosis and existence of serious comorbid illnesses, morbidity and mortality approaches higher levels. Early recognition of signs and symptoms of this condition and prompt accurate management are vital to prevent serious mortality. Here, we report a case of acute colonic pseudo-obstruction after total abdominal hysterectomy in a patient with known Friedreich ataxia.

Research paper thumbnail of Groin recurrence following stage IA squamous cell carcinoma of the vulva with negative nodes on superficial inguinal lymphadenectomy

European journal of gynaecological oncology, 2010

Stage IA vulvar cancer with a depth of stromal invasion less than 1 mm is generally managed by wi... more Stage IA vulvar cancer with a depth of stromal invasion less than 1 mm is generally managed by wide local excision alone since there is less than 1% risk of lymph node involvement. A 62-year-old patient was admitted to a university hospital with a suspicious vulvar lesion. We present the first case of inguinal node and a possible contralateral pubic ramus recurrence following bilateral superficial inguinal lymphadenectomy and wide local resection for Stage 1A vulvar cancer. There is no evidence that extended radical surgery provides a better overall survival or reduces recurrence rate in Stage 1A vulvar carcinomas. Conservative vulvar resection and sentinel node dissection seem to be a rational choice. Nevertheless the disease may recur in the inguinal areas and frequently be lethal, therefore close surveillance and early attempts to treat the recurrent disease before infection and inflammation ensues should be the aim of current treatment strategies.

Research paper thumbnail of Adiponectin, Leptin and Ghrelin Levels in Obese Adolescent Girls with Polycystic Ovary Syndrome

Journal of Pediatric and Adolescent Gynecology, 2013

To evaluate the differences in adipokines, namely adiponectin, leptin, and ghrelin, in obese adol... more To evaluate the differences in adipokines, namely adiponectin, leptin, and ghrelin, in obese adolescent girls with or without polycystic ovary syndrome (PCOS). Case-control study. University hospital. 38 adolescent girls (age 15-20 years). Group I: 17 Obese adolescent girls with PCOS (BMI ≥ 30 kg/m(2)); Group II: Control group of 21 obese adolescent girls (BMI ≥ 30 kg/m(2)). Adiponectin, leptin, and ghrelin measurements. LH, LH/FSH, and cortisol levels were significantly higher in the obese PCOS girls compared to the obese controls (6.94 ± 3.28 vs 4.44 ± 1.79; 1.50 ± 0.72 vs 0.90 ± 0.36; 16.02 ± 4.28 vs 12.46 ± 5.29; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05, respectively). Adiponectin, leptin, and ghrelin levels were similar between the obese PCOS girls and the obese controls (11.13 ± 6.00 vs 15.26 ± 12.66; 23.66 ± 11.54 vs 23.11 ± 11.17; 665.69 ± 402.12 vs 650.22 ± 467.73, respectively). Adiponectin negatively correlated with BMI (r = -0.32; P = .04) and positively correlated with fasting glucose (r = 0.40; P = .01). Leptin positively correlated with BMI (r = 0.534; P = .001), estradiol (r = 0.354; P = .02), and TSH (r = 0.374; P = .02). No significant correlation was found between ghrelin and the test parameters. Among obese adolescents with PCOS, adiponectin, and leptin levels do not seem to be determined by the existence of PCOS, while ghrelin presents no significant correlation.

Research paper thumbnail of Aggressive Angiomyxoma of the Pelviperineum: Surgical Treatment through a Perineal Incision

Journal of Minimally Invasive Gynecology, 2011

Aggressive angiomyxoma is a rare benign tumor of the pelvic soft tissue in women of reproductive ... more Aggressive angiomyxoma is a rare benign tumor of the pelvic soft tissue in women of reproductive age. The tumor is locally infiltrative and tends to recur. Herein is presented a case report of aggressive angiomyxoma that was totally excised using a transperineal approach. A 35-year-old woman had an aggressive angiomyxoma of the vulva and pelvis, with swelling of the right labium majus pudendi. Three years previously, she had undergone incomplete excision of the same type of pelviperineal mass via the transabdominal route. After a complete workup, a transperineal minimally invasive approach was used to excise the 20-cm mass filling the right side of the pelvis. Histopathologic findings were consistent with a diagnosis of aggressive angiomyxoma. Although often misdiagnosed as various other benign genital disorders, angiomyxoma usually is manifested as a soft nontender mass. After a thorough examination and full radiologic workup, a small transperineal incision may be sufficient for complete removal of the tumor.

Research paper thumbnail of The expression of Ki-67, p53, estrogen and progesterone receptors affecting survival in uterine leiomyosarcomas. A clinicopathologic study

Gynecologic Oncology, 2005

Objectives. To evaluate the level of expression of estrogen receptor (ER), progesterone receptor ... more Objectives. To evaluate the level of expression of estrogen receptor (ER), progesterone receptor (PR), p53 and Ki-67 in patients with leiomyosarcoma and to investigate the effect of these and to identify the clinical parameters on prognosis.

Research paper thumbnail of Ovarian carcinosarcomas: Clinicopathological prognostic factors and evaluation of chemotherapy regimens containing platinum

Gynecologic Oncology, 2008

To evaluate the clinicopathological prognostic factors and outcome of chemotherapy in ovarian car... more To evaluate the clinicopathological prognostic factors and outcome of chemotherapy in ovarian carcinosarcomas. We reviewed the records of 26 patients treated from 1990 to 2006 at the Oncology Institute of Istanbul University. Clinical data including demographics, stage, surgery, chemotherapy, and survival were collected from patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; charts. All patients underwent initial debulking surgery. Optimal debulking was achieved in 21 (81%) patients. The most striking clinicopathological finding was the high incidence of hemorrhagic ascites (n: 6) which was observed in 60% of the patients with ascites (n: 10). The overall median survival of the patients was 26 months. Residual disease was associated with a decreased overall survival, P=0.04. Median survival (50 months vs 9.7 months, P=0.042) of the patients with early stage disease were longer than the patients with advanced stage. Twenty-two patients received platinum-based combination chemotherapy. There was a trend for increased median survival in the patients who were treated with carboplatin/paclitaxel combination (P=0.066). Although the numbers were insufficient for statistical evaluation, the patients treated with ifosfamide combinations had improved survival (36 months vs 26 months). However, when the patients treated with ifosfamide and carboplatin/paclitaxel combinations were combined, survival was statistically improved compared to the other regimens (36 months vs 9.7 months, P=0.04). Chemotherapy regimens containing doxorubicin or cyclophosphamide were not encouraging. Stage (P=0.02) and adjuvant platinum-based chemotherapy containing either paclitaxel or ifosfamide (P=0.024) remained predictive of outcome in the multivariate analysis. Hemorrhagic ascites can be used in the initial differential diagnosis of ovarian carcinosarcomas. Stage, optimal debulking and type of adjuvant therapy were statistically significant prognostic predictors of ovarian carcinosarcomas. We advise that patients with ovarian carcinosarcomas should be treated by optimal cytoreduction followed by adjuvant platinum/taxan or platinum/ifosfamide combinations.

Research paper thumbnail of Pubic symphysis diastasis: imaging and clinical features

European Journal of Radiology Extra, 2006

Symphysis pubis diastasis is an uncommon complication of delivery. Computerized tomography, pelvi... more Symphysis pubis diastasis is an uncommon complication of delivery. Computerized tomography, pelvic X-ray and perineal ultrasonography as well as clinical findings can be used in diagnosis. Conservative treatment consisting of bed rest and analgesics is helpful in most patients and functional recovery is excellent. We present a case of pubic symphysis diastasis following spontaneous vaginal delivery. Imaging findings, clinical features and management methods were discussed under the view of literature.

Research paper thumbnail of Could the Long-Term Oncological Safety of Laparoscopic Surgery in Low Risk Endometrial Cancer be also valid for the High Intermediate and High-Risk Patients? A Multi-center Turkish Gynecologic Oncology Group Study Conducted with 2745 Endometrial Cancer Cases. (TRSGO-End-001)

Could the Long-Term Oncological Safety of Laparoscopic Surgery in Low Risk Endometrial Cancer be ... more Could the Long-Term Oncological Safety of Laparoscopic Surgery in Low Risk Endometrial Cancer be also valid for the High Intermediate and High-Risk Patients? A Multi-center Turkish Gynecologic Oncology Group Study Conducted with 2745 Endometrial Cancer Cases. (TRSGO-End-001)Aim: to compare the long-term oncological outcomes of laparotomy and laparoscopic surgeries in endometrial cancer under the light of 2016 ESMO-ESGO-ESTRO risk classification system with particular focus on the high intermediate and high-risk categories.Methods: Using multicentric database between January 2005 and January 2016, disease-free and overall survivals of 2745 endometrial cancer cases were compared according to the surgery route, laparotomy vs laparoscopy. The high intermediate and high-risk patients were defined with respect to the 2016 ESMO-ESGO-ESTRO risk classification system and they were analyzed with respect to difference in survival rates.Results: Of the 2745 patients 1743 (63.5%) were operated b...

Research paper thumbnail of Clinicopathologic and survival results in serous endometrium carcinoma and subgroup analysis for mixed serous and pure serous histology

Journal of the Turkish-German Gynecological Association, 2018

Objective: To review the clinicopathologic and survival outcomes of patients with serous endometr... more Objective: To review the clinicopathologic and survival outcomes of patients with serous endometrial cancer (EC) and to investigate subgroup analysis based on pure serous and mixed serous EC subtypes. Material and Methods: Patients who underwent EC surgery between 2002 and 2014 and who were reported as serous EC were enrolled in the study. All patients were diagnosed as having serous EC or mixed serous EC with serous component higher than 10% based on the postoperative pathology report. Results: A total of 93 patients were analyzed. The median disease-free and overall survival (OS) durations were 49.6 and 32.2 months, respectively. Forty-three patients (46.2%) relapsed and 35 patients (37.6%) died. The histologic type was pure serous EC in 52 (55.9%) and mixed EC in 41 (44.9%) patients. There was no statistical difference between the pure serous and mixed serous groups in terms of age, International Federation of Gynecology and Obstetrics stage, lymphadenectomy, lymph node metastasis or adjuvant therapy combinations. Twenty-nine (55.8%) patients in the pure serous group and 14 (34.1%) in the mixed serous group hade recurrence (p=0.038). Twenty-five (48.1%) patients in the pure serous group and 10 (24.4%) in the mixed serous group died (p=0.034). In the pure serous group, the mean disease-free and OS durations were shorter than in the mixed serous group (59 vs. 81 months and 73 vs. 95 months, log-rank p=0.055 and 0.041, respectively). Histologic type was a significant prognostic factor on recurrence and OS in the univariate analysis (Hazard ratio: 2.404, 95% Confidence interval: 1.01-5.71; 2.027, respectively), but not in the multivariate analysis, which included disease stage and age of the patients. Conclusion: Compared with pure serous and mixed serous endometrium cancer groups, primary surgical treatments, clinicopathologic features and adjuvant treatments were similar, but there was a survival difference. Patients with pure serous cancer had a worse prognosis. However histology was not an independent factor for survival. (

Research paper thumbnail of Could the Long-Term Oncological Safety of Laparoscopic Surgery in Low-Risk Endometrial Cancer also Be Valid for the High–Intermediate- and High-Risk Patients? A Multi-Center Turkish Gynecologic Oncology Group Study Conducted with 2745 Endometrial Cancer Cases. (TRSGO-End-001)

Current Oncology, 2021

This study was conducted to compare the long-term oncological outcomes of laparotomy and laparosc... more This study was conducted to compare the long-term oncological outcomes of laparotomy and laparoscopic surgeries in endometrial cancer under the light of the 2016 ESMO-ESGO-ESTRO risk classification system, with particular focus on the high–intermediate- and high-risk categories. Using multicentric databases between January 2005 and January 2016, disease-free and overall survivals of 2745 endometrial cancer cases were compared according to the surgery route (laparotomy vs. laparoscopy). The high–intermediate- and high-risk patients were defined with respect to the 2016 ESMO-ESGO-ESTRO risk classification system, and they were analyzed with respect to differences in survival rates. Of the 2745 patients, 1743 (63.5%) were operated by laparotomy, and the remaining were operated with laparoscopy. The total numbers of high–intermediate- and high-risk endometrial cancer cases were 734 (45%) patients in the laparotomy group and 307 (30.7%) patients in the laparoscopy group. Disease-free and...