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Akgor U, Ozgul N, Ayhan A. Response to: Author's reply to: Effect of adjuvant treatment on survival in 2023 FIGO stage IIC endometrial cancer. J Gynecol Oncol 2024:35.e92. [PMID: 38616118 DOI: 10.3802/jgo.2024.35.e92] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 04/08/2024] [Indexed: 04/16/2024] Open
Affiliation(s)
- Utku Akgor
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
| | - Nejat Ozgul
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ali Ayhan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Baskent University, Ankara, Turkey
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Akgor U. Effect of adjuvant treatment on survival in 2023 FIGO stage IIC endometrial cancer. J Gynecol Oncol 2024:35.e89. [PMID: 38606829 DOI: 10.3802/jgo.2024.35.e89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 03/25/2024] [Indexed: 04/13/2024] Open
Affiliation(s)
- Utku Akgor
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
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Abstract
Millions of women have given preference to the use of combined oral contraceptives (COCs) since its introduction in the 1960s. Both oestrogens and progestogens can regulate proliferation and it is plausible these effects may contribute to carcinogenesis. We aimed to review the accumulated knowledge to date to appreciate the modifying effects combined oral contraceptives may have on carcinogenesis. Our methodology involved a review of the current published literature, paying attention to studies published in the last 20 years. It has been noted that the overall cancer odds do not change with the use of COCs. Increased risk for breast cancer with COC use is not consistently backed in the literature; the results range from no increase in risk to a 20%–30% elevation in risk, and the risk seems to be temporary, limited to recent or current regular COC use. Also, diagnosed breast cancer cases seem to be clinically advanced in ever-users compared to never-users. Data show that the ongoing and prolonged use of COCs may provide diminished risk for endometrial, colorectal and ovarian cancers. Although studies do not clearly support increased risk with COC use in high-risk groups, such as women with family history of cancer or BRCA carriers, local and international guidelines are available for clinical decision-making. For cervical cancer, COCs seem to enhance the risk with more than 5 years of use, and in many studies, this enhanced risk diminishes after discontinuation and restores to those of never-users within 10 years. The relationship between COC use and liver malignancy risk assessments has provided conflicting findings. Some studies have suggested that hormonal contraceptives may increase the risk of not only hepatocellular carcinoma but also intrahepatic cholangiocarcinoma. Combined oral contraceptives are safe and effective and the effects are reversible. Patients who pursue family planning should be warned of possible carcinogenic outcomes, but it should also be explained that—in addition to sexual health advantages—preferring COCs may also decrease the risks of endometrial, colorectal and ovarian cancers.
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Affiliation(s)
- Mustafa Kamani
- Department of Obstetrics and Gynaecology, Hacettepe University Faculty of Medicine, Ankara 06230, Turkey
| | - Utku Akgor
- Department of Obstetrics and Gynaecology, Hacettepe University Faculty of Medicine, Ankara 06230, Turkey
| | - Murat Gültekin
- Department of Obstetrics and Gynaecology, Hacettepe University Faculty of Medicine, Ankara 06230, Turkey
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Akgor U, Ayhan A, Shushkevich A, Ozdal B, Angelou K, Akbayır O, Kaidarova D, Ulrikh E, Stepanyan A, Ortac F, Aliyev S, Ozgul N, Taranenka S, Haberal A, Salman C, Seyhan A, Selcuk I, Haidopoulos D, Akıllı H, Bolatbekova R, Alaverdyan A, Taskin S, Murshudova S, Batur M, Berlev I, Gultekin M. OPEC study: An international multicenter study of ovarian preservation in endometrial cancers. Int J Gynaecol Obstet 2022; 159:550-556. [PMID: 35323994 DOI: 10.1002/ijgo.14190] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 02/17/2022] [Accepted: 03/16/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To evaluate the feasibility and oncological safety of ovarian preservation in early stage endometrial adenocarcinoma (EC) patients aged 40 and below. METHODS A total of 11 institutions from eight countries participated in the study. 169 of 5898 patients aged ≤40 years were eligible for the study. Patients with EC treated between March 2007 and January 2019 were retrospectively assessed. RESULTS The median duration of follow-up after EC diagnosis was 59 months (4-187). Among 169 participants, ovarian preservation surgery (OPS) was performed in 54 (31.9%), and BSO was performed in 115 (68.1%) patients. Although patients younger than 30 years of age were more likely to have OPS than patients aged 30 to 40 years (20.4% vs. 9.6%, P = 0.021), there was no significant difference by the mean age. There were no other relevant baseline differences between OPS and BSO groups. The Kaplan-Meier analysis revealed no difference in either the overall survival (P = 0.955) or recurrence-free survival (P = 0.068) among patients who underwent OPS, and BSO. CONCLUSION OPS appears to be safe without having any adverse impact on survival in women aged ≤40 years with FIGO Stage I EC.
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Affiliation(s)
- Utku Akgor
- Department of Gynecologic Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ali Ayhan
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Alexander Shushkevich
- Department of Gynecologic Oncology, N.N. Alexandrov Cancer Center of Belarus, Minsk, Belarus
| | - Bulent Ozdal
- Department of Gynecologic Oncology, Ankara, Turkey
| | - Kyveli Angelou
- Gynecologic Oncology Unit, 1st Department of Obstetrics and Gynecology, Alexandra Hospital, University of Athens, Athens, Greece
| | - Ozgur Akbayır
- Department of Gynecologic Oncology, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
| | - Dilyara Kaidarova
- Oncogynecology Center, Kazakh Institute of Oncology and Radiology, Almaty, Kazakhstan
| | - Elena Ulrikh
- North-Western State Medical University, N.N. Petrov Research Institute of Oncology, Saint-Petersburg, Russian Federation
| | - Artem Stepanyan
- Department of Gynecologic Oncology, NAIRI Medical Center, Yerevan, Armenia
| | - Fırat Ortac
- Division of Gynaecologic Oncology, Department of Obstetrics and Gynaecology, School of Medicine, Ankara University, Ankara, Turkey
| | | | - Nejat Ozgul
- Department of Gynecologic Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Siarhei Taranenka
- Department of Gynecologic Oncology, N.N. Alexandrov Cancer Center of Belarus, Minsk, Belarus
| | - Ali Haberal
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Coskun Salman
- Department of Gynecologic Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Alper Seyhan
- Department of Gynecologic Oncology, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
| | - Ilker Selcuk
- Department of Gynecologic Oncology, Ankara, Turkey
| | - Dimitrios Haidopoulos
- Gynecologic Oncology Unit, 1st Department of Obstetrics and Gynecology, Alexandra Hospital, University of Athens, Athens, Greece
| | - Huseyin Akıllı
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Raikhan Bolatbekova
- Oncogynecology Center, Kazakh Institute of Oncology and Radiology, Almaty, Kazakhstan
| | - Areg Alaverdyan
- Department of Gynecologic Oncology, NAIRI Medical Center, Yerevan, Armenia
| | - Salih Taskin
- Division of Gynaecologic Oncology, Department of Obstetrics and Gynaecology, School of Medicine, Ankara University, Ankara, Turkey
| | | | - Meltem Batur
- Department of Gynecologic Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Igor Berlev
- North-Western State Medical University, N.N. Petrov Research Institute of Oncology, Saint-Petersburg, Russian Federation
| | - Murat Gultekin
- Department of Gynecologic Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Donmez HG, Akgor U, Onder S, Tanacan A, Kuru O, Ozgul N, Usubutun A, Hufbauer M, Akgül B, Beksac MS. Impact of Human Papillomavirus on Wnt/Beta-Catenin Signaling in Morphological Inconspicuous Cervicovaginal Cells. Acta Cytol 2022; 66:409-419. [PMID: 35306501 DOI: 10.1159/000522635] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 02/12/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aim of this study was to identify early changes in the Wnt/beta-catenin signaling pathway in high-risk human papillomavirus (HPV) infected cervicovaginal cells and to correlate these changes with cell proliferation, apoptosis, and autophagic processes. METHODS We evaluated 91 cervicovaginal smears of women with (n = 41) and without (n = 50) HPV-DNA. Smears were stained against beta-catenin, c-myc, secreted frizzled-related protein 4 (sFRP4), cleaved caspase-3, and the autophagy markers Beclin-1 and light chain 3B. In addition, sFRP-1, -2, -3, -4, -5 mRNA levels were determined by quantitative reverse transcription-PCR in primary keratinocytes and FaDu cells expressing HPV16-E6, -E7, or -E6E7. RESULTS Our data indicated that the Wnt/beta-catenin signaling is activated in HPV (+) cervicovaginal cells that can already be detected in cells with no obvious changes in cellular morphology (HPV [+]/cyto [-]). These cells also had significantly higher sFRP4 levels when compared to HPV-negative samples. In primary keratinocytes, sFRP4 was found to be absent and sFRP1 and sFRP2 to be repressed in the presence of HPV16-E6 and E7. Interestingly, sFRP4 is expressed in FaDu cells and can be upregulated in the presence of E6E7. Curiously, SFRP4 expression correlated with an increase in the level of autophagic markers in HPV (+)/cyto (-) smears. CONCLUSION In conclusion, the activation of the Wnt/beta-catenin signaling pathway and upregulation of sFRP4, paralleled by an activation of the autophagic pathway may represent predisposing cellular factors early after HPV infection which need to be further determined in larger study.
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Affiliation(s)
- Hanife Guler Donmez
- Department of Biology, Faculty of Science, Hacettepe University, Ankara, Turkey
- Institute of Virology, University of Cologne, Medical Faculty and University Hospital Cologne, Cologne, Germany
| | - Utku Akgor
- Division of Gynecological Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Sevgen Onder
- Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Atakan Tanacan
- Division of Perinatology, Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Oguzhan Kuru
- Division of Gynecological Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
- Department of Obstetrics and Gynecology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Nejat Ozgul
- Division of Gynecological Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Alp Usubutun
- Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Martin Hufbauer
- Institute of Virology, University of Cologne, Medical Faculty and University Hospital Cologne, Cologne, Germany
| | - Baki Akgül
- Institute of Virology, University of Cologne, Medical Faculty and University Hospital Cologne, Cologne, Germany
| | - Mehmet Sinan Beksac
- Division of Perinatology, Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Kucukyıldız I, Karaca M, Akgor U, Turkyılmaz M, Keskinkılıc B, Kara F, Ozgul N, Gultekin M. Endocervical polyps in high risk human papillomavirus infections. Ginekol Pol 2022; 93:7-10. [PMID: 35072226 DOI: 10.5603/gp.a2021.0207] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/14/2021] [Accepted: 09/18/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Human papillomavirus (HPV) positive patients with and without endocervical polyps is compared with respect to HPV genotypes and presence of pre-invasive diseases. To our knowledge, this is the first and largest report in the literature examining the endocervical polyps in HPV positive cases. MATERIAL AND METHODS Clinicopathological data for the first one million screening patients (n = 1060 992) from around the entire country during 2015 and 2016 were targeted for this research. Colposcopy, colposcopic surgical diagnostic procedures and final pathology results of 3499 patients with high-risk (HR) HPV-positive were obtained from reference colposcopy centers. Patients with endocervical polyps (n = 243 [6.9 %]) were accepted as experimental arm while patients without any endocervical polyp (n = 3256 [93.1%]) were regarded as the control group. Age, HPV genotype, Pap smear abnormality, and final pathological results were compared between two groups using Student's t-test and cross-tabulation chi-square test. RESULTS The incidence of endocervical polyp was found to be 6.9 % in HR HPV-positive women. The most common HPV genotypes observed in both groups were HPV 16 or 18. Abnormal cytology reports (≥ ASC-US) were not significantly different between both groups. However, with respect to final pathological diagnosis, patients with endocervical polyp had significantly lower numbers of pre-invasive diseases (31.3% vs 44.2%; p < 0.10). CONCLUSIONS Endocervical polyps may be more common in patients with HR HPV infections. HPV 18 is observed significantly more, in the HR HPV positive endocervical polyp group. Patients with endocervical polyps do not have increased risk for preinvasive cervical diseases.
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Affiliation(s)
- Irem Kucukyıldız
- Cumhuriyet Unıversity School of Medicine, Merkez, Cumhuriyet Üniversitesi, Sivas, Turkey, Turkey.
| | - Mujdegul Karaca
- Cumhuriyet Unıversity School of Medicine, Merkez, Cumhuriyet Üniversitesi, Sivas, Turkey, Turkey
| | - Utku Akgor
- Cumhuriyet Unıversity School of Medicine, Merkez, Cumhuriyet Üniversitesi, Sivas, Turkey, Turkey
| | - Murat Turkyılmaz
- Cumhuriyet Unıversity School of Medicine, Merkez, Cumhuriyet Üniversitesi, Sivas, Turkey, Turkey
| | - Bekir Keskinkılıc
- Cumhuriyet Unıversity School of Medicine, Merkez, Cumhuriyet Üniversitesi, Sivas, Turkey, Turkey
| | - Fatih Kara
- Cumhuriyet Unıversity School of Medicine, Merkez, Cumhuriyet Üniversitesi, Sivas, Turkey, Turkey
| | - Nejat Ozgul
- Cumhuriyet Unıversity School of Medicine, Merkez, Cumhuriyet Üniversitesi, Sivas, Turkey, Turkey
| | - Murat Gultekin
- Cumhuriyet Unıversity School of Medicine, Merkez, Cumhuriyet Üniversitesi, Sivas, Turkey, Turkey
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Kuru O, Cakır I, Akgor U, Sen S, Gorgulu G, Ozdemir HE, Basok BI, Akpınar G, Gokcu M. Serum markers for the early diagnosis of intestinal anastomotic leak after gyne-oncological operations. Int J Clin Pract 2021; 75:e14609. [PMID: 34231277 DOI: 10.1111/ijcp.14609] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 07/02/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To analyse the serum markers for the early diagnosis of intestinal anastomotic leak (AL) after the gyne-oncological operations. METHODS Between September 2017 and March 2021, patients with an intestinal anastomosis performed during the gyne-oncological surgeries were identified from a tertiary centre in Turkey. As the local guideline of the clinic, all these patients were followed by measuring serum samples including procalcitonin (PCT) and C-reactive protein (CRP) on postoperative day (POD) 1 through the day of discharge or the day of re-operation for AL. RESULTS 12.5% (5/40) of the patients suffered an AL and 4 of them were re-operated. The mean albumin values on POD 3-4 and the mean platelet values on POD 1 were lower in the AL group (P < .05). Although it was not statistically significant (P > .05), median PCT values (ng/mL) on POD 8-10 were higher in the AL group compared with no leak group. The best cut-off point for PCT on POD 9 was determined to be 0.11 ng/mL (AUC: 0.917, Sensitivity = 100.0%, specificity = 66.7%, positive predictive value = 66.7%, negative predictive value = 100.0%). CONCLUSION Serum PCT and CRP concentrations were not found to be helpful for the early diagnosis of AL in patients operated for gyne-oncological malignancies. Low levels of albumin and platelets in the first days after the operation may be clue for a possible AL.
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Affiliation(s)
- Oguzhan Kuru
- Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Ilker Cakır
- Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Utku Akgor
- Department of Gynecologic Oncology, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Serhat Sen
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Izmir Katip Celebi University, Izmir, Turkey
| | - Goksen Gorgulu
- Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Hasan Emre Ozdemir
- Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Banu Isbilen Basok
- Department of Clinical Biochemistry, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Goksever Akpınar
- Department of General Surgery, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Mehmet Gokcu
- Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey
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Ozgul N, Akgor U, Salman M
, Kuru O, Gultekın M. Lymph node dissection in intermediate and high-intermediate risk endometrial cancer. EUR J GYNAECOL ONCOL 2021. [DOI: 10.31083/j.ejgo4206167] [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: 11/06/2022]
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Yüksel D, Ayhan S, Korkmaz V, Çakır C, Kılıç Ç, Akgor U, Özgül N, Kılıç F, Ersak B, Esen S, Kuru O, Uncu D, Gökcü M, Özdal B, Gültekin M, Salman MC, Boran N, Toptaş T, Üreyen I, Taşcı T, Kimyon Cömert G, Türkmen O, Moraloğlu Tekin Ö, Engin Üstün Y, Turan T. Retrospective Analysis of Pure Ovarian Immature Teratoma in Patients Aged 15-39 Years: A Turkish Multicenter Study. J Adolesc Young Adult Oncol 2020; 10:697-702. [PMID: 33296263 DOI: 10.1089/jayao.2020.0155] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
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.
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Affiliation(s)
- Dilek Yüksel
- Division of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey
| | - Sevgi Ayhan
- Division of Gynecologic Oncology, Ankara City Hospital, Ankara, Turkey
| | - Vakkas Korkmaz
- Division of Gynecologic Oncology, Ankara City Hospital, Ankara, Turkey
| | - Caner Çakır
- Division of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey
| | - Çiğdem Kılıç
- Division of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey
| | - Utku Akgor
- Division of Gynecologic Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Nejat Özgül
- Division of Gynecologic Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Fatih Kılıç
- Division of Gynecologic Oncology, Ankara City Hospital, Ankara, Turkey
| | - Burak Ersak
- Division of Gynecologic Oncology, Ankara City Hospital, Ankara, Turkey
| | - Selin Esen
- Division of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Oğuzhan Kuru
- Division of Gynecologic Oncology, University of Health Sciences Tepecik Education and Research Hospital, İzmir, Turkey
| | - Doğan Uncu
- Division of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Mehmet Gökcü
- Division of Gynecologic Oncology, University of Health Sciences Tepecik Education and Research Hospital, İzmir, Turkey
| | - Bülent Özdal
- Division of Gynecologic Oncology, Ankara City Hospital, Ankara, Turkey
| | - Murat Gültekin
- Division of Gynecologic Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mehmet Coşkun Salman
- Division of Gynecologic Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Nurettin Boran
- Division of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey
| | - Tayfun Toptaş
- Antalya Education and Research Hospital Faculty of Medicine, University of Health Sciences, Antalya, Turkey
| | - Işın Üreyen
- Antalya Education and Research Hospital Faculty of Medicine, University of Health Sciences, Antalya, Turkey
| | - Tolga Taşcı
- Division of Gynecologic Oncology, Faculty of Medicine Bahçeşehir University, Istanbul, Turkey
| | - Günsu Kimyon Cömert
- Division of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey
| | - Osman Türkmen
- Division of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey
| | | | - Yaprak Engin Üstün
- Division of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey
| | - Taner Turan
- Division of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey
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Erturk A, Kuru O, Akgor U, Boyraz G, Cakir C, Turan T, Ozgul N, Salman C, Yuce K. Cytoreductive surgery including distal pancreatectomy with splenectomy in advanced stage ovarian cancer: Two centers analysis. Taiwan J Obstet Gynecol 2020; 59:862-864. [PMID: 33218402 DOI: 10.1016/j.tjog.2020.09.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2020] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Complex procedures such as distal pancreatectomy and splenectomy (DPS) may be required for R0 resection in patients with ovarian cancer (OC). These procedures can increase survival and cause serious morbidity. We aimed to present our experience in this field. MATERIALS AND METHODS Thirteen patients who underwent DPS for OC between January 2004 and July 2018 in two centers (Hacettepe University Hospital, Etlik Hospital) were evaluated. Statistical analysis was performed using SPSS. RESULTS The mean operative time was 310 min (220-570 min). None of the patients required transfusion. No perioperative mortality was observed. The mean postoperative hospital stay was 12 days (ranging from 8 to 33 days). The number of patients with early postoperative complications was four (30.7%). One of these patients was complicated by intestinal perforation, one with pancreatic fistula, one with pneumonia and the other with atelectasis. Other complications were observed conservatively. Ten patients underwent 6 cycles of platinum-based chemotherapy postoperatively. The median value of the postoperative chemotherapy period was 20 days (range 11-47 days). The median follow-up period was 46 months (2-144 months). Ten patients had recurrence. Eleven patients died of disease. Two patients are stil alive. Disease-free (DFS) and overall (OS) survival were 16 and 63 months, respectively. CONCLUSION DPS for cytoreductive surgery is a procedure that increases morbidity, but most of the complications can be treated conservatively. Considering the increase in survival, it is considered to be a valuable procedure in upper abdominal disease.
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Affiliation(s)
- Anil Erturk
- Hacettepe University, Department of Gynecology and Obstetrics, Ankara, Turkey.
| | - Oguzhan Kuru
- Hacettepe University, Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Ankara, Turkey
| | - Utku Akgor
- Hacettepe University, Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Ankara, Turkey
| | - Gokhan Boyraz
- Hacettepe University, Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Ankara, Turkey
| | - Caner Cakir
- Etlik Training and Research Hospital, Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Ankara, Turkey
| | - Taner Turan
- Etlik Training and Research Hospital, Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Ankara, Turkey
| | - Nejat Ozgul
- Hacettepe University, Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Ankara, Turkey
| | - Coskun Salman
- Hacettepe University, Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Ankara, Turkey
| | - Kunter Yuce
- Hacettepe University, Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Ankara, Turkey
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Gultekin M, Ak S, Ayhan A, Strojna A, Pletnev A, Fagotti A, Perrone AM, Erzeneoglu BE, Temiz BE, Lemley B, Soyak B, Hughes C, Cibula D, Haidopoulos D, Brennan D, Cola E, van der Steen-Banasik E, Urkmez E, Akilli H, Zapardiel I, Tóth I, Sehouli J, Zalewski K, Bahremand K, Chiva L, Mirza MR, Papageorgiou M, Zoltan N, Adámková P, Morice P, Garrido-Mallach S, Akgor U, Theodoulidis V, Arik Z, Steffensen KD, Fotopoulou C. Perspectives, fears and expectations of patients with gynaecological cancers during the COVID-19 pandemic: A Pan-European study of the European Network of Gynaecological Cancer Advocacy Groups (ENGAGe). Cancer Med 2020; 10:208-219. [PMID: 33205595 PMCID: PMC7753798 DOI: 10.1002/cam4.3605] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [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: 09/21/2020] [Revised: 10/14/2020] [Accepted: 10/23/2020] [Indexed: 11/10/2022] Open
Abstract
Background The impact of the COVID‐19 pandemic on European gynaecological cancer patients under active treatment or follow‐up has not been documented. We sought to capture the patient perceptions of the COVID‐19 implications and the worldwide imposed treatment modifications. Methods A patient survey was conducted in 16 European countries, using a new COVID‐19‐related questionnaire, developed by ENGAGe and the Hospital Anxiety & Depression Scale questionnaire (HADS). The survey was promoted by national patient advocacy groups and charitable organisations. Findings We collected 1388 forms; 592 online and 796 hard‐copy (May, 2020). We excluded 137 due to missing data. Median patients’ age was 55 years (range: 18–89), 54.7% had ovarian cancer and 15.5% were preoperative. Even though 73.2% of patients named cancer as a risk factor for COVID‐19, only 17.5% were more afraid of COVID‐19 than their cancer condition, with advanced age (>70 years) as the only significant risk factor for that. Overall, 71% were concerned about cancer progression if their treatment/follow‐up was cancelled/postponed. Most patients (64%) had their care continued as planned, but 72.3% (n = 892) said that they received no information around overall COVID‐19 infection rates of patients and staff, testing or measures taken in their treating hospital. Mean HADS Anxiety and Depression Scores were 8.8 (range: 5.3–12) and 8.1 (range: 3.8–13.4), respectively. Multivariate analysis identified high HADS‐depression scores, having experienced modifications of care due to the pandemic and concern about not being able to visit their doctor as independent predictors of patients’ anxiety. Interpretation Gynaecological cancer patients expressed significant anxiety about progression of their disease due to modifications of care related to the COVID‐19 pandemic and wished to pursue their treatment as planned despite the associated risks. Healthcare professionals should take this into consideration when making decisions that impact patients care in times of crisis and to develop initiatives to improve patients’ communication and education.
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Affiliation(s)
- Murat Gultekin
- Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynaecological Oncology, Hacettepe University, Ankara, Turkey.,European Society of Gynaecological Oncoloy (ESGO, European Network of Gynaecological Cancers Advocacy Groups (ENGAGe) Executive Group, Prague, Czech Republic
| | - Sertac Ak
- Stress Assesment and Research Center (STAR, Hacettepe University, Ankara, Turkey.,Faculty of Medicine, Department of Psychiatry, Hacettepe University, Ankara, Turkey
| | - Ali Ayhan
- Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynaecological Oncology, Baskent University, Ankara, Turkey
| | - Aleksandra Strojna
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Andrei Pletnev
- Department of Gynecologic Oncology, N.N. Alexandrov National Cancer Center of Belarus, Minsk, Belarus
| | - Anna Fagotti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | | | - B Emre Erzeneoglu
- Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynaecological Oncology, Hacettepe University, Ankara, Turkey
| | - B Esat Temiz
- Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynaecological Oncology, Hacettepe University, Ankara, Turkey
| | - Birthe Lemley
- European Society of Gynaecological Oncoloy (ESGO, European Network of Gynaecological Cancers Advocacy Groups (ENGAGe) Executive Group, Prague, Czech Republic.,KIU - Patient Organisation for Women with Gynaecological Cancer, Copenhagen, Denmark
| | - Burcu Soyak
- Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynaecological Oncology, Hacettepe University, Ankara, Turkey
| | - Cathy Hughes
- Ovacome - Ovarian Cancer Support Charity, London, UK.,Department of Gynecology, Imperial College London, NHS Trust London, London, UK
| | - David Cibula
- Department of Obstetrics and Gynecology, Gynecologic Oncology Center, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Dimitrios Haidopoulos
- Department of Obstetrics and Gynecology, Alexandra Hospital, University of Athens, Athens, Greece
| | - Donal Brennan
- Department of Gynaecological Oncology, University College Dublin (UCD) School of Medicine, Catherine McAuley Research Centre, Mater University Hospital, Dublin, Ireland
| | - Edoardo Cola
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | | | - Esra Urkmez
- European Society of Gynaecological Oncoloy (ESGO, European Network of Gynaecological Cancers Advocacy Groups (ENGAGe) Executive Group, Prague, Czech Republic.,Dance With Cancer Society, Ankara, Turkey
| | - Huseyin Akilli
- Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynaecological Oncology, Baskent University, Ankara, Turkey
| | - Ignacio Zapardiel
- Gynecologic Oncology Unit, La Paz University Hospital-IdiPAZ, Madrid, Spain
| | - Icó Tóth
- European Society of Gynaecological Oncoloy (ESGO, European Network of Gynaecological Cancers Advocacy Groups (ENGAGe) Executive Group, Prague, Czech Republic.,Mallow Flower Foundation, Budapest, Hungary
| | - Jalid Sehouli
- Department of Gynecology with Center for Oncological Surgery, Charité-University Hospital, Berlin, Germany
| | - Kamil Zalewski
- European Society of Gynaecological Oncoloy (ESGO, European Network of Gynaecological Cancers Advocacy Groups (ENGAGe) Executive Group, Prague, Czech Republic.,Department of Gynecological Oncology, Hollycross Cancer Center, Kielce, Poland.,Department of Molecular and Translational Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.,Department of Gynaecological Oncology, Barts Health NHS Trust, London, UK
| | - Kiarash Bahremand
- Department of Gynaecology, National Institute of Oncology, Budapest, Hungary
| | - Luis Chiva
- Clinica Universidad de Navarra, Madrid, Spain
| | - Mansoor Raza Mirza
- Department of Oncology, The Finsen Centre, Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark
| | - Maria Papageorgiou
- European Society of Gynaecological Oncoloy (ESGO, European Network of Gynaecological Cancers Advocacy Groups (ENGAGe) Executive Group, Prague, Czech Republic.,K.E.F.I. Cancer Society, Athens, Greece
| | - Novak Zoltan
- Department of Gynaecology, National Institute of Oncology, Budapest, Hungary
| | - Petra Adámková
- European Society of Gynaecological Oncoloy (ESGO, European Network of Gynaecological Cancers Advocacy Groups (ENGAGe) Executive Group, Prague, Czech Republic.,Onko Unie Cancer Society, Prague, Czech Republic
| | - Philippe Morice
- Department of Surgery, Institute Gustave Roussy, Villejuif, France
| | | | - Utku Akgor
- Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynaecological Oncology, Hacettepe University, Ankara, Turkey
| | - Vasilis Theodoulidis
- Department of Obstetrics and Gynecology, Alexandra Hospital, University of Athens, Athens, Greece
| | - Zafer Arik
- Faculty of Medicine, Department of Medical Oncology, Hacettepe University, Ankara, Turkey
| | - Karina D Steffensen
- European Society of Gynaecological Oncoloy (ESGO, European Network of Gynaecological Cancers Advocacy Groups (ENGAGe) Executive Group, Prague, Czech Republic.,Department of Oncology, Lillebaelt Hospital-University Hospital of Southern Denmark, Vejle, Denmark.,Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.,Center for Shared Decision Making, Lillebaelt Hospital-University Hospital of Southern Denmark, Vejle, Denmark
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12
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Akgor U, Kuru O, Sakinci M, Boyraz G, Sen S, Cakır I, Turan T, Gokcu M, Gultekin M, Sayhan S, Salman C, Ozgul N. Neuroendocrine carcinoma of the endometrium: A very rare gynecologic malignancy. J Gynecol Obstet Hum Reprod 2020; 50:101897. [PMID: 32827837 DOI: 10.1016/j.jogoh.2020.101897] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 06/03/2020] [Revised: 08/16/2020] [Accepted: 08/17/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To investigate the clinicopathologic characteristics, prognostic factors, outcome, and treatment of the neuroendocrine carcinoma (NEC) of the endometrium. MATERIALS AND METHODS We retrospectively reviewed the clinicopathologic and survival data of 10 patients who underwent surgery for NEC. The patients were collected between 1999 and 2017 from four referral centers in Turkey. RESULTS The median age of patients was 67 years (range: 34-75 years). The NEC of endometrium consist of 9 cases with small cell carcinoma (SC) NEC (two with mixed histotypes), and one with a large cell (LC) NEC. According to FIGO 2009 criteria, 70 % (7/10) of patients had advanced stage (III and IV) disease. All patients except one underwent surgical staging, eight patients received platinum-based chemotherapy (CTX) and of 6 those were additionally treated with radiotherapy (RT). Four patients died of disease ranging from 2 to 10 months and six were alive 12-72 months with no evidence of disease. In addition, 4 SC NEC cases raised in polypoid features had no evidence of disease from 24 to 72 months. DISCUSSION NEC of the endometrium is a rare disease with poor prognosis, which frequently diagnosed in advanced stages. The main treatment modality was the administration of platinum-based CTX as an adjuvant to surgery or surgery and RT. Our result suggests that the polypoid feature of the tumor might be one of the best predictors for the prognosis of SC NEC.
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Affiliation(s)
- Utku Akgor
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
| | - Oguzhan Kuru
- Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Mehmet Sakinci
- Department of Obstetrics and Gynecology, Akdeniz University, Faculty of Medicine, Antalya, Turkey
| | - Gokhan Boyraz
- Division of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey
| | - Serhat Sen
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Izmir Katip Celebi University, Izmir, Turkey
| | - Ilker Cakır
- Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Taner Turan
- Division of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey
| | - Mehmet Gokcu
- Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Murat Gultekin
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Sevil Sayhan
- Department of Pathology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Coskun Salman
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Nejat Ozgul
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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13
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Akgor U, Kuru O, Soyak B, Gunes AC, Uyanık E, Gultekin M, Ozgul N, Salman C. Adnexal masses in patients with colorectal cancer. J Gynecol Obstet Hum Reprod 2020; 50:101898. [PMID: 32827838 DOI: 10.1016/j.jogoh.2020.101898] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 07/25/2020] [Accepted: 08/17/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate the clinicopathological features and outcomes of patients undergone surgery for benign and metastatic adnexal masses during the surveillance of colorectal cancer (CRC). METHODS A single institute retrospective study involving 90 patients diagnosed with CRC that undergone surgery at Hacettepe University Hospital between 2000-2018. Clinicopathological and survival data was obtained from hospital records. RESULTS Elevated blood levels of CEA (HR, 1.23; 95 % CI: 1.03-1.24; p = 0.01), adnexal masses larger than 5 cm (HR, 3.296; 95 % CI: 1.527-7.076; p = 0.002), bilaterality of adnexal mass (HR, 2.200; 95 % CI: 2.464-11.969; p = 0.001) and high PCI score (HR, 0.150; 95 % CI: 0.044-0.479; p = 0.01) were found to be significantly associated with ovarian metastasis. There was a significant difference in overall survival (OS), with respect to complete and incomplete resection in adnexal surgery of ovarian metastasis (46.6 vs. 29.6 months; p = 0.004). The median survival time was 32.8 months for patients with ≤ 24 months interval time to adnexal metastasis surgery, and 48.5 months for patients with >24 months interval time to adnexal metastasis surgery (p = 0.001). CONCLUSION This study showed that numerous clinicopathological variables such as bilaterality and size of adnexal mass, serum blood levels of CEA and PCI score may have a significant impact on the prediction and management of ovarian masses diagnosed during CRC surveillance. Complete resection and interval time to adnexal surgery is significantly associated with OS.
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Affiliation(s)
- Utku Akgor
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
| | - Oguzhan Kuru
- Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Burcu Soyak
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ali Can Gunes
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Esra Uyanık
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Murat Gultekin
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Nejat Ozgul
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Coskun Salman
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Donmez HG, Sahal G, Akgor U, Cagan M, Ozgul N, Beksac MS. The relationship between the presence of HPV infection and biofilm formation in cervicovaginal smears. Infection 2020; 48:735-740. [PMID: 32623704 DOI: 10.1007/s15010-020-01478-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 04/13/2020] [Accepted: 06/30/2020] [Indexed: 01/21/2023]
Abstract
PURPOSE To demonstrate and understand the association of HPV infection and biofilm formation. METHODS The study consisted of cervicovaginal samples of 72 women who were evaluated at the colposcopy unit. Papanicolaou staining was used for cytological examination while "Crystal Violet Binding" assay was performed to detect biofilm formation. RESULTS HPV-DNA was positive in 55.5% (n = 40) of the patients. The biofilm formation rate was statistically significantly higher in the HPV-positive women (45%) compared to HPV-negative women (21.9%) (P < 0.05). There was a statistically significant relationship between the presence of single HPV and "high-risk HPV" types and biofilm formation (P < 0.05). Biofilm formation was found in 80% of women with abnormal smear demonstrating atypical epithelial cells (P < 0.05). CONCLUSION Biofilm formation is more frequent at the cervicovaginal microbiota of patients with HPV infection. This finding is especially important in cases with atypical epithelial cells at their cervicovaginal smears.
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Affiliation(s)
- Hanife Guler Donmez
- Department of Biology, Faculty of Science, Hacettepe University, Beytepe, 06800, Ankara, Turkey.
| | - Gulcan Sahal
- Department of Biology, Faculty of Science, Hacettepe University, Beytepe, 06800, Ankara, Turkey
| | - Utku Akgor
- Department of Gynecology and Obstetrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Murat Cagan
- Department of Gynecology and Obstetrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Nejat Ozgul
- Department of Gynecology and Obstetrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mehmet Sinan Beksac
- Department of Gynecology and Obstetrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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15
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Kaplanoglu M, Karateke A, Un B, Akgor U, Baloğlu A. Complications and outcomes of repeat cesarean section in adolescent women. Int J Clin Exp Med 2014; 7:5621-5628. [PMID: 25664081 PMCID: PMC4307528] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 11/25/2014] [Indexed: 06/04/2023]
Abstract
AIM The evaluation of the effect of repeat cesarean sections in adolescent pregnancies on the morbidity, obstetric and perinatal results. MATERIALS AND METHODS We reviewed the patient file and hospital records of patients who underwent at least one cesarean section among adolescent age group pregnant women who gave birth at our clinic between January 2010 and May 2013. The patients were divided into two groups as the patients who underwent the second cesarean section (116 patients) and those who underwent the third cesarean section (36 patients). The demographic data, maternal data and obstetric and perinatal results of the patients were evaluated. RESULTS A significant difference was present between the patients in the evaluation of the total number of examinations during pregnancy (P = 0.001), total maternal weight gain during pregnancy (P = 0.006), and the first examination gestational age (P = 0.006) and all values were less favorable in the third cesarean group. The gestational week at birth (P < 0.001), birth weight (P < 0.001), and APGAR score (P < 0.001) in the group with the third cesarean section were statistically significantly lower than the second cesarean section. The third cesarean cesarean was found to cause a significant risk increase for placenta accreta risk in adolescent pregnancies (P = 0.042). CONCLUSION The increasing number of cesarean sections in the adolescent group is seen to be a significant risk factor for low gestational week of birth, low birth weight and related morbidities. The most important reason for the increased morbidity with increasing cesarean sections in the adolescent age has been defined as placenta accreta.
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Affiliation(s)
- Mustafa Kaplanoglu
- Department of Obstetric and Gynecology, Adiyaman University School of MedicineAdiyaman, Turkey
| | - Atilla Karateke
- Department of Obstetric and Gynecology, Hatay Goverment HospitalAntakya, Turkey
| | - Burak Un
- Department of Obstetric and Gynecology, Duzici Goverment HospitalAntakya, Turkey
| | - Utku Akgor
- Department of Obstetric and Gynecology, Andırın Goverment HospitalKahramanmaras, Turkey
| | - Ali Baloğlu
- Department of Obstetric and Gynecology, Private Çınarlı Hospitalİzmir, Turkey
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