Mehmet Mutlu Meydanlı

Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesi

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Ali Ayhan

Başkent University

Tayfun Güngör

Sağlık Bilimleri Üniversitesi

Kemal Güngördük

Muğla University

MÖ

Murat Öz

Sivas State Hospital

Mustafa Erkan Sarı

Ministry of Health

HŞ

Hanifi Şahin

Haliç University

İY

İbrahim Yalçın

Ondokuz Mayıs University

Hüseyin Akıllı

Başkent University

ÖA

Özgür Akbayır

Istanbul Eye Hospital

Zeliha Fırat Cüylan

Ankara Bilkent City Hospital

Cooperative Institutions

Clinica Universidad de Navarra

152

Sağlık Bilimleri Üniversitesi

145

Gynecologic Oncology Group

Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesi

Zübeyde Hanim Maternity Hospital

University of Health Science

Ministry of Health

University of Health Sciences

Başkent University

Women’s Health Care

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SUCCOR study: an international European cohort observational study comparing minimally invasive surgery versus open abdominal radical hysterectomy in patients with stage IB1 cervical cancer

International Journal of Gynecological Cancer (2020)

Luis Chiva Vanna Zanagnolo Denis Querleu Nerea Martín‐Calvo Juan Arévalo‐Serrano

Background

Minimally invasive surgery in cervical cancer has demonstrated in recent publications worse outcomes than open surgery. The primary objective of the SUCCOR study, a European, multicenter, retrospective, observational cohort study was to evaluate disease-free survival in patients with stage IB1 (FIGO 2009) cervical cancer undergoing open vs minimally invasive radical hysterectomy. As a secondary objective, we aimed to investigate the association between protective surgical maneuvers and the risk of relapse.

Methods

We obtained data from 1272 patients that underwent a radical hysterectomy by open or minimally invasive surgery for stage IB1 cervical cancer (FIGO 2009) from January 2013 to December 2014. After applying all the inclusion-exclusion criteria, we used an inverse probability weighting to construct a weighted cohort of 693 patients to compare outcomes (minimally invasive surgery vs open). The first endpoint compared disease-free survival at 4.5 years in both groups. Secondary endpoints compared overall survival among groups and the impact of the use of a uterine manipulator and protective closure of the colpotomy over the tumor in the minimally invasive surgery group.

Results

Mean age was 48.3 years (range; 23–83) while the mean BMI was 25.7 kg/m² (range; 15–49). The risk of recurrence for patients who underwent minimally invasive surgery was twice as high as that in the open surgery group (HR, 2.07; 95% CI, 1.35 to 3.15; P=0.001). Similarly, the risk of death was 2.42-times higher than in the open surgery group (HR, 2.45; 95% CI, 1.30 to 4.60, P=0.005). Patients that underwent minimally invasive surgery using a uterine manipulator had a 2.76-times higher hazard of relapse (HR, 2.76; 95% CI, 1.75 to 4.33; P<0.001) and those without the use of a uterine manipulator had similar disease-free-survival to the open surgery group (HR, 1.58; 95% CI, 0.79 to 3.15; P=0.20). Moreover, patients that underwent minimally invasive surgery with protective vaginal closure had similar rates of relapse to those who underwent open surgery (HR, 0.63; 95% CI, 0.15 to 2.59; P<0.52).

Conclusions

Minimally invasive surgery in cervical cancer increased the risk of relapse and death compared with open surgery. In this study, avoiding the uterine manipulator and using maneuvers to avoid tumor spread at the time of colpotomy in minimally invasive surgery was associated with similar outcomes to open surgery. Further prospective studies are warranted.

Open surgery

Abdominal hysterectomy

10.1136/ijgc-2020-001506

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Citations (228)

Survival associated with extent of radical hysterectomy in early-stage cervical cancer: a subanalysis of the Surveillance in Cervical CANcer (SCCAN) collaborative study

American Journal of Obstetrics and Gynecology (2023)

Nicolò Bizzarri Denis Querleu Lukáš Dostálek Luc van Lonkhuijzen Diana Giannarelli

10.1016/j.ajog.2023.06.030

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Citations (7)

PharmaNews

Oncology Research and Treatment (2017)

Kemal Güngördük İsa Aykut Özdemir Tayfun Güngör Elçin Telli Salih Taşkın

10.1159/000470891

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Oncological Outcomes of Stage II Endometrial Cancer: A Retrospective Analysis of 250 Cases

International Journal of Gynecological Cancer (2017)

Nejat Özgül Gökhan Boyraz Mehmet Coşkun Salman Murat Gültekin K. Yüce

The aim of this study was to investigate the effect of different surgical approaches, adjuvant therapy, and pathological characteristics on oncological outcomes in patients with 2009 International Federation of Gynecology and Obstetrics (FIGO) stage II endometrial cancer (EC).A multicenter, retrospective department database review was performed to identify patients with FIGO 2009 stage II EC who underwent surgical staging between 2002 and 2015 at 5 gynecologic oncology centers in Turkey.Original pathology reports of 4867 patients who underwent surgical treatment for EC were analyzed. The study group consisted of 250 FIGO stage II patients. Of these patients, 203 (81.2%) had endometrioid and 47 (18.8%) had nonendometrioid histologic subtype of EC. Whereas 199 patients (79.6%) underwent type I hysterectomy, the remaining 51 patients (20.4%) underwent radical hysterectomy. Of the 250 patients, 208 patients (83.2%) had adjuvant therapy including radiotherapy (pelvic external beam radiotherapy and/or vaginal brachytherapy [VBT]) and/or platinum-based chemotherapy. Disease recurred in 29 patients (11.6%). The 5-year disease-free survival (DFS) and overall survival (OS) for the entire cohort were 82% and 85%, respectively. Multivariate analysis showed that only adjuvant treatment (P = 0.001; hazard ratio, 4.02; 95% confidence interval, 1.72-9.36) was significantly associated with DFS. According to multivariate analysis, only age older than 60 years (P = 0.01; hazard ratio, 3.03; 95% confidence interval, 1.3-7.04) was identified as an independent risk factor for OS. However, there were no differences in OS when evaluated by grade, histology, tumor size, type of hysterectomy, or adjuvant treatment.In stage II EC, adjuvant external beam radiotherapy ± VBT were associated with increased DFS but not OS. However, the benefit of VBT alone on DFS could not be demonstrated. Only age was an independent risk factor for OS. Type of hysterectomy and histologic subtype of the tumor for patients with uterus-confined disease improved neither DFS nor OS in our study group.

10.1097/igc.0000000000001133

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Comparison Of Hematologic Parameters In Patients With Positive vs. Negative Surgical Margins After Conization

Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi (2018)

İbrahim Ertuğrul Yalçın Mustafa Erkan Sarı Hanifi Şahin Vakkaş Korkmaz Nazlı Topfedaisi Özkan

Cervical conization

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Is lower uterine segment involvement a prognostic factor in endometrial cancer?

TURKISH JOURNAL OF MEDICAL SCIENCES (2017)

Salim Erkaya Murat Öz Hasan Onur Topçu Ali Levent Şirvan Tayfun Güngör

Background/aim: The purpose of this study is to investigate the prognostic significance of lower uterine segment (LUS) involvement in endometrial cancer (EC). Materials and methods: We reviewed the patients who were operated at our institution between July 2007 and March 2015 with the diagnosis of EC. Tumors localized in the corpus and involving the LUS or localized entirely in the LUS formed Group A, while tumors in the uterine corpus without LUS involvement formed Group B. Clinicopathological characteristics and survival of the patients were compared in both groups. Results: A total of 500 patients were included in the study. There were 139 patients who had tumors involving the LUS and formed Group A, while 361 patients with endometrial tumors in the uterine corpus without LUS involvement formed Group B. We did not detect a significant difference between survival of the patients in group A and group B (78 months vs. 87 months, respectively; P > 0.05). Conclusion: We found that LUS involvement was not an independent prognostic factor for poor survival, but it is associated with other poor prognostic factors such as deep myometrial invasion, uterine serosal involvement, lymphovascular space invasion, lymph node metastasis and higher FIGO grade.

Uterine cancer

10.3906/sag-1602-137

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Citations (10)

Endometriyum Kanserinde Lenfadenektominin Yeri Nedir? En Uygun Yöntem Ne Olmalıdır?

Turkiye Klinikleri Gynecology Obstetrics - Special Topics (2021)

İbrahim Ertuğrul Yalçın Mehmet Mutlu Meydanlı

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Elevated nucleated red blood cell count: a population-based study.

Journal of reproductive medicine (2006)

Yusuf Üstün Yaprak Engin Üstün Emın Kaya Mehmet Mutlu Meydanlı Nalan Kulak

Apgar score

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Comparison Of Early-Stage High-Grade Serous Primary Fallopian Tube Cancers and Epithelial Ovarian Cancers: A Multicenter Study

Oncology Research and Treatment (2017)

Kemal Güngördük Aykut Özdemir İlker Selçuk Elçin Telli Öztürk Şahin

Introduction: We compared the disease free-survival (DFS) and overall survival (OS) rates of patients with high-grade serous primary fallopian tube cancer (HG-sPFTC) and high-grade serous epithelial ovarian cancer (HG-sEOC). Methods: 22 early-stage cancer patients (International Federation of Gynecology and Obstetrics (FIGO) stages I-II) with HG-sPFTC were retrospectively evaluated. In addition, 44 control patients diagnosed with HG-sEOC were matched to these patients with respect to tumor stage at diagnosis. All patients underwent complete surgical staging, followed by adjuvant chemotherapy. Kaplan-Meier curves were used to generate survival data. Results: The mean age of HG-sPFTC patients was 59.4 ± 6.2 years, and that of HG-sEOC patients 55.2 ± 11.0 years (p = 0.002). All patients underwent 6 cycles of platinum-based adjuvant chemotherapy. All operations were optimal. The 5-year DFSs were 77.3% for HG-sPFTC patients and 75% for HG-sEOC patients (p = 1.00).The 5-year OS rates were 81.8% in women with HG-sPFTC and 77.3% in those with HG-sEOC (p = 0.75). Conclusion: The DFS and OS rates of patients with early-stage (FIGO stages I and II) HG-sPFTC and HG-sEOC were similar. The surgical and adjuvant therapy management of these malignancies should be similar.

Fallopian tube

Fallopian tube cancer

10.1159/000458440

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Citations (2)

The Relationship between Plasma D-Dimer Level and Prognostic Factors in Cases with High-Grade Serous Ovarian Cancer

Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi (2022)

Nazlı Topfedaisi Özkan Nezaket Kadıoğlu Burcu TİMUR Mehmet Mutlu Meydanlı

Over kanseri jinekolojik kanserler arasında kansere bağlı ölümlerin önde gelen nedenidir. Kanser hastalarında özellikle ileri evrede, venöz tromboembolizm yokken bile hemostatik aktivasyona bağlı hiperkoagülasyon ve artmış fibrinoliz sıklıkla gözlenir. Bu çalışma ile yüksek dereceli seröz karsinom olgularında operasyon öncesi ölçülen plazma d-dimer düzeyinin klinik önemi ve prognostik değerini incelemeyi amaçladık. Retrosptektif olarak yapılan çalışmamızda Dr. Zekai Tahir Burak Eğitim ve Araştırma Hastanesi Jinekolojik Onkoloji Kliniği’nde 2013-2017 tarihleri arasında primer yüksek dereceli seröz over kanseri (HGSK) tanısı alan ve operasyondan önceki 15 gün içinde D-dimer testi yapılan 142 hasta dahil edildi. Tanı anındaki yaş, tedavi öncesi plazma D-dimer düzeyi, asit varlığı, rezidüel tümör, CA125 seviyesi, FIGO evresi ve demografik bilgileri karşılaştırıldı. Ortalama yaşları 55.25 ±10.84 olan hastaların 52’ sinde (%36,6) normal, 90’ ında(%63,4) D-dimer seviyeleri yüksek olarak saptandı. D-dimer düzeyi yüksek olan ve olmayan olgularda 60 yaş sınır alındığında anlamlı farklılık saptanmazken, D-dimer düzeyi yüksek olan olgularda FIGO evresi (III-IV) daha yüksek olup (p

D-dimer

10.37989/gumussagbil.1049371

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