Esra Kuşçu

Timing and survival benefits of cytoreduction in patients with recurrent leiomyosarcoma

Leiomyosarcoma is characterized by its aggressive behavior, poor prognosis, resistance to chemotherapeutic drugs, and high recurrence rate. This study aimed to identify prognostic factors affecting the effectiveness of cytoreductive surgery (CRS) on overall survival (OS) in patients with recurrent leiomyosarcoma (LMS). A retrospective analysis was conducted at Başkent University Ankara Hospital from 2007 to 2016, involving 59 patients with uterine LMS who underwent surgery. We assessed demographic and clinical variables, disease recurrence intervals, and treatment outcomes. The median age of the patients was 50.0 (23-78) years, and the median follow-up time was 25.0 (2-87) months. Median disease-free survival (DFS) and OS were 15.0 and 37.0 months, respectively. Disease recurrence occurred in 44 patients (74.6%). After recurrence, 34 (77.3%) patients underwent CRS and chemotherapy (CT), while 10 (22.7%) patients received only CT. The median OS was 19.0 months for patients who underwent CRS and received CT and 15.0 months for those who received only CT (p = 0.132). Notably, OS was significantly longer for patients whose recurrence occurred after 6 months compared to those with early recurrence (19 versus 8 months, p = 0.049). CRS provided a modest survival benefit for patients with recurrent LMS, although statistical significance was not achieved. The results of this study indicate that the timing of recurrence plays a crucial role in survival.

Oncologic and obstetric outcomes of early‐stage epithelial ovarian cancer patients who underwent fertility‐sparing surgery: A retrospective study

AbstractObjectiveThis study aimed to assess the long‐term oncologic and obstetric outcomes of women with epithelial ovarian cancer who underwent fertility‐sparing surgery.MethodsA total of 68 patients observed between March 2007 and July 2021 were included in this retrospective study. Unilateral salpingo‐oophorectomy and uterine preservation with staging surgery were the main procedures for fertility‐sparing surgery. Disease‐free, overall survival, and obstetric outcomes were measured as primary outcomes.ResultsThe median age of the patients was 30.5 years. The median follow‐up time was 60.5 months. Disease recurrence occurred in 15 (22.1%) of the patients. Five‐year disease‐free survival and overall survival (OS) percentages were 75.6% and 83.3%, respectively, for all stages. The FIGO (International Federation of Gynecology & Obstetrics) stage was the only significant factor that affected OS (P = 0.001). Twenty‐three patients tried to conceive, and 15 (65.2%) patients became pregnant. Twelve (80%) pregnancies reached term and resulted in 15 live births. Chemotherapy administration and surgical intervention (cystectomy or unilateral salpingo‐oophorectomy) showed no difference in pregnancy results (P = 0.806 and P = 0.066, respectively).ConclusionFertility preservation is safe for invasive epithelial ovarian cancer at early stages for women in the reproductive era. Disease recurrence and OS results are similar to standard treatment at early stages with decent obstetric outcomes.