Osman Türkmen

Sağlık Bilimleri Üniversitesi

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Taner Turan

Sağlık Bilimleri Üniversitesi

Günsu Kimyon Cömert

Sağlık Bilimleri Üniversitesi

Alper Karalök

Sağlık Bilimleri Üniversitesi

Derman Başaran

Hacettepe University

Fatih Kılıç

Ankara Mevki Asker Hastanesi

IÜ

Işın Üreyen

Sağlık Bilimleri Üniversitesi

Tolga Taşçı

Bahçeşehir University

Gökhan Tulunay

TOBB University of Economics and Technology

ÇK

Çiğdem Kılıç

Zübeyde Hanim Maternity Hospital

CÇ

Caner Çakır

Zübeyde Hanim Maternity Hospital

Cooperative Institutions

Sağlık Bilimleri Üniversitesi

137

Zübeyde Hanim Maternity Hospital

Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi

Memorial Ankara Hospital

University of Health Science

University of Health Sciences

Ministry of Health

Bilkent University

Gynecologic Oncology Group

Ankara Bilkent City Hospital

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Retrospective Analysis of Pure Ovarian Immature Teratoma in Patients Aged 15–39 Years: A Turkish Multicenter Study

Journal of Adolescent and Young Adult Oncology (2020)

Dilek Yüksel Sevgi Ayhan Vakkaş Korkmaz Caner Çakır Çiğdem Kılıç

Purpose: To evaluate the clinicopathological characteristics and surgical outcomes in patients with pure ovarian immature teratomas (POITs). Materials and Methods: In this multicenter study, a retrospective review was made of the databases of six Gynecology Oncology Departments in Turkey to identify patients with POITs who had undergone surgery between 1993 and 2019. Results: Evaluation was made of 48 patients with a median age at diagnosis of 22.5 years (range, 15-37 years). In 40 (83%) patients, stage I was determined and in eight patients, an advanced stage (IIIB, IIIC, and IVB) was determined. Tumors were found to be grade I in 17 (35.4%) cases, grade II in 12 (25%), and grade III in 19 (39.6%). Fertility-sparing surgery was applied to 42 (87.5%) patients and radical surgery to 6 (12.5%). The median follow-up was 60 months (range, 3-246 months). Recurrence was seen in seven patients, all with grade III tumors. In the final pathological examination of recurrent tumors, mature teratoma was reported in five patients, and immature teratoma in one patient. Salvage surgery was not performed in one patient as the tumor was unresectable and so a regimen of bleomycin, etoposide, and cisplatin (BEP) was administered. Conclusion: POITs are rare tumors seen at a young age, and benign or malignant relapse can be seen in these tumors. In this cohort, the malignant recurrence rate was 4.1%, and the benign recurrence rate was 10.4%. All the recurrences were in grade III tumors. Benign recurrences can be treated with surgery alone and the malignant group should be treated with surgery followed by chemotherapy.

Immature teratoma

Regimen

Radical surgery

10.1089/jayao.2020.0155

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Citations (3)

NNMT overexpression is an adverse prognostic factor in uterine leiomyosarcoma

TURKISH JOURNAL OF MEDICAL SCIENCES (2024)

Osman Türkmen Kamil Hakan Müftüoğlu Nazmiye Dinçer Zeliha Esin Çelik Serra Akar

Uterine leiomyosarcomas (uLMS) are extremely rare high-grade tumors with a poor prognosis. Their etiopathogenesis remains largely unknown. The uterus is the most frequent site for LMS. uLMS and uterine leiomyoma (uLM) must frequently be differentiated in patients with a uterine mass. Nicotinamide N-methyltransferase (NNMT), a cytoplasmic protein, is involved in the progression and spread of a variety of cancer types. The expression of NNMT in a mesenchymal malignancy was not examined previously. This study represents the first investigation into NNMT expression in uLMS, uLM and benign uterine myometrium and correlates NNMT overexpression with worse prognosis in uLMS.

10.55730/1300-0144.5852

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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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Preoperatif Nötrofil/Lenfosit, Lenfosit/Monosit ve Trombosit/Lenfosit Oranlarının Seröz Over Kanseri Sağ Kalımındaki Yeri

Balıkesir Medical Journal (2021)

Serap DURMUŞOĞLU ERBEN Fatih Kılıç Mehmet Ünsal Okan Aytekın Günsu Kimyon Cömert

Amaç: Seröz tip over kanserinde preoperatif sistemik inflamatuar belirteçlerin prognozu predikte etmedeki etkinliğini değerlendirmek ve sağ kalım ile ilişkilerini tanımlamak amaçlandı.Gereç ve Yöntemler: Çalışma grubu seröz tip over kanseri nedeniyle tedavisi yapılan 86 hastadan oluşturuldu. Hastalara ait veriler retrospektif olarak tarandı. Preoperatif inflamatuar belirteçler olarak nötrofil/lenfosit oranı (NLO), lenfosit/monosit oranı (LMO) ve trombosit/lenfosit oranları (TLO) kullanıldı. Hastalar NLO, LMO ve TLO değerlerine göre yüksek veya düşük riskli olarak gruplandırıldı. Grupları kategorize etmede sınır değer olarak ortanca değerler kullanıldı. Klinik, cerrahi ve patolojik değişkenlerle birlikte NLO, LMO, TLO değerlerinin hastalıksız sağ kalım (HSK) ve genel sağ kalım (GSK) üzerindeki etkisi incelendi.Bulgular: Hastaların ortanca yaşları 58.03 (aralık; 25-80) yıldı. Evre 12 hastada evre I-II ve 74 hastada evre III-IV’tü. Ortanca takip süresi 29.45 aydı (aralık; 1-63) ve bu süre içerisinde 21 (%24,4) hastada rekürrens geliştiği ve 15 (%17,4) hastanın hastalıktan dolayı öldüğü tespit edildi. Tüm çalışma grubunda ortalama HSK süresi 46.32±3,00 ay ve GSK süresi 51.30±2.43 aydı. HSK için; omentum metastazı, dalak metastazı, diyafragma metastazı, kolon metastazı, cerrahi sonuç ve adjuvant tedavi başarısı, GSK için; omentum metastazı, hastanın adjuvant tedavi alıp almaması ve adjuvan tedavi başarısı anlamlıydı (p<0.05). NLO-LMO-TLO ile GSK ve HSK verileri arasında istatistiksel olarak anlamlı bir ilişki saptanmadı (p>0.05).Sonuç: Seröz tip over kanserinde, preoperatif inflamatuar belirteçlerin hastalıksız sağ kalımı ve genel sağ kalımı öngörmede yönlendirici olmadığı tespit edilmiştir.

10.33716/bmedj.871929

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Citations (2)

Takayasu’s Arteritis and Tuberculosis: a Case Report

Clinical Rheumatology (2000)

Ali Düzova Osman Türkmen Alev Çınar S. Çekirge U Saatçi

Arteritis

Abdominal aorta

Takayasu's arteritis

Etiology

10.1007/s100670070013

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Citations (22)

Independent predictors of survival in endometrium cancer: platelet-to-lymphocyte ratio and platelet/neutrophil/monocyte-to-lymphocyte ratio

Journal of the Turkish-German Gynecological Association (2018)

Günsu Kimyon Cömert Osman Türkmen İrem Kar Selcan Sınacı Seval Yılmaz Ergani

To evaluate the association between ratios of inflammatory markers and survival in endometrium cancer (EC).Four hundred ninety-seven patients with epithelial EC were included. The evaluated ratios were neutrophil (N)/lymphocyte (L), neutrophil count divided by the lymphocyte count; platelet (P)/lymphocyte, platelets divided by the lymphocyte count; lymphocyte/monocyte (M), lymphocytes divided by the monocyte count; NM/L, neutrophil plus monocyte divided by the lymphocyte count; PNM/L, the sum total counts of platelets, neutrophils and monocytes divided by the lymphocyte count.The median follow-up time was 24 months (1-129). Recurrence and exitus occurred in 34 (7%) and 18 (3.7%) patients, respectively. Metastasis in pelvic or para-aortic lymph nodes were significantly related only with low L/M. None of the inflammatory ratios were associated with disease-free survival. In multi-variant analysis, only high P/L (>168) and high PNM/L (>171) were related with a statistically significant hazard ratio for death of 2.91 (p=0.024) and 2.93 (p=0.023), respectively.The P/L and PNM/L were in relation with worse overall survival and also independent prognostic factors for OS.

Monocyte

Absolute neutrophil count

10.4274/jtgga.2017.0112

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Citations (13)

Cytoreductive surgery in advanced stage malignant ovarian germ cell tumors

Journal of Gynecology Obstetrics and Human Reproduction (2019)

Alper Karalök Günsu Kimyon Cömert Çiğdem Kılıç Osman Türkmen Fatih Kılıç

Debulking

10.1016/j.jogoh.2019.06.006

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Citations (5)

The criterion value of fetal cerebral lateral ventricular atrium width for diagnosis of ventriculomegaly

Clinical and Experimental Obstetrics & Gynecology (2014)

Gökhan Göynümer Murat Yayla Resul Arısoy Osman Türkmen

Aim: To determine the distribution of cerebral lateral ventricular atrium width (LVAW) as established according to gestational weeks, and calculate the criterion value of LVAW that differentiates normal fetuses from abnormal fetuses. Materials and Methods: A total of 832 patients meeting the study's criteria were included in the control group. An additional 43 fetuses with LVAW > ten mm formed the case group. Results: The criterion value of LVAW was 9.7 mm. It did not change significantly throughout gestation. In the case group, 23 fetuses were terminated for fetal abnormalities, two fetuses died in utero, and 18 infants were born alive. Most of the abnormal development coincided with LVAW values greater than 12 mm. Conclusion: The authors suggest 9.7 mm as the criterion value, based on receiver operating characteristic (ROC) curve analysis. When the LVAW is between 9.8 and 12 mm without other fetal abnormalities, it may be regarded as a variation of the normal.

Ventriculomegaly

Cerebral ventricle

Atrium (architecture)

10.12891/ceog16442014

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Citations (10)

Revaluating survival effects of FIGO 1988 stage IIIA criteria for endometrial cancer

Journal of the Turkish-German Gynecological Association (2017)

Osman Türkmen Alper Karalök Derman Başaran Günsu Kimyon Cömert Gizem Kul

Objective: This study aimed to define factors that affected survival in the International Federation of Gynecology and Obstetrics (FIGO) 1988 stage IIIA endometrial cancer (EC). Material and Methods:The study included patients with EC who underwent surgery between 1992 and 2013.Patients with adnexal metastases, uterine serosal involvement or positive peritoneal cytology (stage IIIA disease according to the former 1988 FIGO staging system) were selected for further analysis.Clinical and pathologic factors associated with progression-free survival (PFS) were evaluated using univariate and multivariate statistical tests. Results:Seventy-seven patients with stage IIIA disease according to the 1988 FIGO staging system were included.The median follow-up was 37 months (range, 1-175 months) and recurrence was detected in 19 patients.Univariate analysis revealed that the presence of uterine serosal invasion and advanced histologic grade (grade 1-2 vs. grade 3) were associated with diminished PFS (p=0.001,p=0.047).The presence of adnexal involvement and positive peritoneal cytology had no statistically significant influence on PFS (p=0.643 and p=0.795, respectively). Conclusion:In patients with stage IIIA EC according to the FIGO 1988 staging system, only uterine serosal involvement was related with adverse oncologic outcomes, not adnexal involvement or presence of positive cytology.(

Univariate analysis

10.4274/jtgga.2017.0033

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Citations (2)

Clinical and pathological features of isolated pulmonary and liver recurrences in endometrial cancer.

Medical Science and Discovery (2016)

Derman Başaran Işın Üreyen Alper Karalök Osman Türkmen Günsu Kimyon Cömert

Objective: To present the clinicopathological features of endometrial cancer (EC) patients with isolated liver or lung metastases and to compare the survival differences after diagnosis of recurrent disease. Material and Methods: The clinical and histopathological data of the patients who were treated with a diagnosis of epithelial EC between January 1993 and May 1993 at Etlik Zubeyde Hanim Teaching and Research Hospital were retrospectively reviewed. Patients with isolated recurrence in liver (ILR) or lung (IPR) were included in the analysis. Results: The clinical data of 162 patients with recurrent EC were available. Of these, 21 had IPR and 9 had ILR. Patients with ILR presented with more advanced stage, and omental and adnexal involvement was more common compared to patients with IPR. On the other hand, patients with IPR had higher grade disease. Fifty-seven percent of patients with IPR had grade 3 compared to 11% of grade 3 disease in ILR (p=0.02). The median time to recurrence (TTR) was 18 months (range 1-54) in the whole study population. While the median TTR of patients with IPR was 19 months, the median TTR of patients with ILR was 16 months (p=0.204). Both study groups have similar survival. The 1-year post-recurrence survival of IPR and ILR was 66% and 56% (p=0.129), respectively. Conclusion: Although, isolated liver and lung metastases are the result of hematogenous spread in EC, clinicopathological features of these two recurrence patterns significantly differ. Clinicians should try to categorize these patients separately to better understand the prognostic outcomes.

10.36472/msd.v3i1.129

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