MEHMET ÜNSAL

Survival of patients with 2014 FIGO stage IIIC high-grade serous ovarian cancer who treated with platin-based adjuvant chemotherapy

Epithelial ovarian cancer is the second most prevalent type of gynecological cancer. We aimed to investigate prognostic factors related to survival in patient with 2014 FIGO stage IIIC high-grade serous ovarian cancer (HGSOC). Two hundred fifty eight patients were evaluated retrospectively. The absence of a visible tumor was determined as maximum cytoreduction, and a residual tumor size of 1 cm or less was determined as optimal cytoreduction. Patients who underwent cytoreduction followed by a combination of platinum and taxane adjuvant chemotherapy were included. Exclusion criteria for the study were patients taking neoadjuvant chemotherapy and those with suboptimal surgery. Optimal cytoreduction was performed in 107 and maximal cytoreduction was performed in 151 patients. The five-year PFS rate was 27% and the five-year DSS rate was 76%. While high ascites volume and optimal cytoreduction were identified as independent prognostic factors for disease failure, only optimal cytoreduction was an independent prognostic factor for survival. The maximal cytoreduction is improves PFS and DSS in patients with 2014 FIGO stage IIIC HGSOC as our study results. Therefore, maximum surgical effort and radical cytoreductive procedures should be performed.

Neoadjuvant chemotherapy in patients with stage IVB uterine serous carcinoma: a Turkish multicentric study

The aim of this study was to evaluate the prognostic factors for and determine the effect of neoadjuvant chemotherapy (NACT) on oncologic outcome in stage IVB pure serous endometrial carcinoma patients who received taxane and platinum. Forty-two patients with 2009 International Federation of Gynecology and Obstetrics (FIGO) stage IVB uterine serous carcinoma were enrolled from six gynecologic oncology centers and a study group was created. The study group had a 2-year disease-free survival (DFS) of 32% and 2-year disease-specific survival (DSS) of 73%. On univariate analysis; lymphadenectomy (not performed vs. performed), paraaortic lymph node metastasis (positive vs. negative) and number of metastatic lymph node count (≤5 vs. >5) were found to have statistical significance for DFS (

Surgery for patients with endometrioid-type endometrial cancer: is lymphadenectomy above the inferior mesenteric artery necessary?

The primary objective of this study was to identify the risk of metastasis to lymph nodes above the inferior mesenteric artery (IMA) in endometrioid-type endometrial cancer (EC) and the factors that influence metastasis. The study included patients who had been operated on for endometrioid-type EC in three gynecological oncology centers between 2007 and 2023. The supramesenteric lymph node (SM-LN) is the region between the left renal vein and the IMA, whereas the inframesenteric lymph node (IM-LN) is the region between the IMA and the aortic bifurcation, as determined by the level of the IMA. The study sample comprised 412 patients. The median number of lymph nodes excised per patient was 58. The median count was 37 for pelvic lymph nodes, 21 for para-aortic lymph nodes, 8 for IM-LN, and 13 for SM-LN. In the univariate analysis, the factors that were found to be statistically significant in determining SM-LN metastasis included tumor size, depth of myometrial invasion, uterine serosal invasion, lymphovascular space invasion (LVSI), cervical invasion, peritoneal cytology, adnexal metastasis, omental metastasis, non-nodal extrauterine metastasis, pelvic lymph node metastasis, and IM-LN metastasis. In the multivariate analysis, SM-LN metastasis was independently associated with tumor size, LVSI, pelvic lymph node metastasis, and IM-LN metastasis. In conclusion, in cases of intermediate-high risk EC, it is important to know that the disease spreads to SM-LN in 7.3% of patients. The efficacy of postoperative adjuvant treatment may be inadequate due to a lack of information regarding the SM-LN region.