Cem Yagmur Ozdemir

Ultrasonography, macroscopy, and frozen section: whıch is better for predicting deep myometrial invasıon in endometrial cancer?

The aim of this study was to compare the power of preoperative transvaginal ultrasonography, intraoperative macroscopic examination, and frozen section for predicting deep myometrial invasion in endometrial cancer. This is a retrospective review involving 68 patients who underwent surgical staging for endometrial cancer from 2014 to 2017. Patients with grade 3 endometrial cancer and non-endometrioid tumors were excluded. The findings related to preoperative transvaginal ultrasonography, intraoperative macroscopic examination, and frozen section were compared with definitive histopathological diagnosis. The mean age, gravidity, and body mass index of the patients were 58.1±8.9 years (range: 30-80 years), 3.2±2.1 (range: 0-9), and 33.5±6.6 kg/m2 (range: 20-52 kg/m2), respectively. Only 11 (16.2%) patients were in the premenopausal period, while 57 (83.8%) were in the postmenopausal period. Grade 1 endometrial cancer was found in 29 patients (42.6%) and grade 2 tumors were specified in 39 patients (57.4%). Stage IA disease was found in 45 (66.2%) patients, while stage IB disease was observed in 23 (33.8%) patients. The 5-year survival rate was 91.2%. The sensitivity of preoperative transvaginal ultrasonography, intraoperative macroscopic examination, and frozen section were 56, 34, and 52%, respectively, for predicting deep myometrial invasion. In contrast, the specificity of preoperative ultrasonography, intraoperative macroscopic examination, and frozen section were 86, 100, and 100%, respectively. Transvaginal ultrasonography and intraoperative frozen section were found to have similar sensitivity and specificity for predicting deep myometrial invasion. Preoperative transvaginal ultrasonography appears as an efficient approach for predicting endometrial cancers with deep myometrial invasion.

Effect of hemoglobin, albumin, lymphocyte, and platelet score on prognosis in intermediate‐risk endometrial cancer according to molecular‐based classification

AbstractObjectiveThe aim of this study is to compare the relationship between molecular classification and HALP score in endometrial cancer (EC).MethodsPatients who were operated with the diagnosis of EC 2014 and 2024 were included in our study. 150 patients were included in the study. We divided the patients into three groups in terms of molecular classification; group 1 was the patients with POLE mutation, group 2 was the patients with MMRd and NSMP (intermediate prognosis), and group 3 was the patients with p53 mutation. Group 2 participants were divided into two groups, a low HALP score group and a high HALP score group, according to the HALP score cut‐off value.ResultsUsing the value with the highest Youden's index (0.306) as a basis, it was demonstrated that the HALP score with a cut‐off value of 33.735 has a sensitivity of 61.86% and a specificity of 68.75% in intermediate‐risk EC. The 5‐year overall survival (OS) was found to be 75.4% in intermediate‐risk EC patients with low HALP scores and 91.5% in intermediate‐risk EC patients with high HALP scores (p = 0.008). The 5‐year progression‐free survival (PFS) was found to be 86% in intermediate‐risk EC patients with low HALP scores and 94.4% in intermediate‐risk EC patients with high HALP scores (p = 0.089). MMR deficiency and NSMP have been considered intermediate‐risk groups for endometrial cancer and are a heterogeneous group. Although the use of the HALP score to reduce this heterogeneity is successful in predicting OS, it is not sufficient for PFS.

Clinical Outcomes and Risk Implications of HPV 31 Infection: A 10‐Year Retrospective Cohort Study

ABSTRACT Objective To describe the long‐term clinical outcomes of women diagnosed with human papillomavirus type 31 (HPV 31) infection and to assess its potential implications for genotype‐specific cervical cancer risk stratification in a real‐world screening setting. Methods This retrospective cohort study analyzed 106,450 women screened for cervical cancer at the Afyonkarahisar Cancer Early Diagnosis, Screening, and Education Center (KETEM) between 2015 and 2025. Among 3313 HPV‐positive women, 147 cases with confirmed HPV 31 infection and complete follow‐up data were included. Clinical outcomes, cytology results, and histopathological findings were compared across three groups: isolated HPV 31, HPV 31 co‐infected with HPV 16/18, and HPV 31 co‐infected with other high‐risk genotypes. Results Biopsies were performed in 66 women (44.9%) due to abnormal cytology or HPV 16/18 co‐infection. CIN2+ lesions were detected in 15 patients (22.7% of those biopsied; 10.2% of the entire cohort). The CIN2+ detection rate was 6.0% in isolated HPV 31 infections and 44.4% in women co‐infected with HPV 16/18 ( p  = 0.0006). Notably, 13.9% of cytology‐negative women were diagnosed with CIN2+ on histopathology. Two invasive cancers occurred in women with isolated HPV 31 infection and negative cytology at baseline. Conclusion HPV 31 infection demonstrated measurable oncogenic potential, particularly in cytology‐negative women and those with HPV 16/18 co‐infection. While isolated HPV 31 positivity alone may not warrant immediate colposcopy, these findings support the need for genotype‐specific risk stratification in cervical cancer screening. Further multicenter and prospective studies are required to confirm these results.