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Radiotherapy improves stress urinary incontinence but impairs pelvic floor function in endometrial cancer patients: a prospective cohort study

Abstract Purpose Investigating the impact of radiotherapy on urinary incontinence and pelvic floor dysfunction in endometrial cancer patients. Method A comparative study was conducted between endometrial cancer patients who underwent radiotherapy and those who did not receive adjuvant therapy. Patients were assessed during their first follow-up visit at third month post-radiotherapy or post-surgery. Demographic data and physical examinations were conducted, along with the administration of validated questionnaires. Turkish validated Incontinence Severity Index (ISI), Incontinence Impact Questionairre-7 (IIQ-7) and 20 ıtem Pelvic Floor Dysfunction Index (PFDI-20) were applied to the all patients. Results The study comprised 37 patients in the non-radiotherapy group and 41 patients in the radiotherapy group. Comparable demographics were observed between the two groups. Vaginal length was notably longer in the non-radiotherapy group, and the Q-tip test angle was significantly greater in this group. A higher incidence of stress urinary incontinence and higher scores on the Incontinence Severity Index were noted in the non-radiotherapy group. Conversely, the radiotherapy group exhibited significantly higher scores on the Pelvic Floor Dysfunction Index components and total score. Urogenital Distress Inventory scores were similar between the groups. Conclusion Radiotherapy showed mixed effects on pelvic floor function in endometrial cancer patients. While it potentially improved stress urinary incontinence, it was associated with unfavorable outcomes in overall pelvic floor dysfunction.

Diagnostic role of galanin in distinguishing endometrial atypical hyperplasia and carcinoma from benign endometrial conditions

Endometrial atypical hyperplasia is recognized as a precursor to endometrial cancer, which ranks as the fourth most common cancer in women and is the leading type of gynecological malignancy in high-income countries. The development and progression of endometrial cancer are strongly linked to increased body fat and insulin resistance. Peptides involved in glucose metabolism, such as leptin, chemerin, and galanin, may contribute to carcinogenesis through shared pathways. This study aims to investigate the role of galanin levels in diagnosing endometrial neoplastic disorders. This prospective case-control study included 85 patients, divided into three groups: endometrial cancer, atypical hyperplasia, and a control group. Serum galanin levels were measured using ELISA across all groups. The mean galanin levels were 472.76 ± 44.86 pg/ml in Control Group, 516.81 ± 51.15 pg/ml in EAH, and 543.15 ± 73.22 pg/ml in Cancer Group. Galanin levels were found to be significantly different among groups. (p < .001) . Galanin levels have the potential to differentiate between normal endometrium and patients with endometrial hyperplasia.

Laparoscopy without uterine manipulator vs. laparotomy in endometrial cancer: a retrospective study

SUMMARY OBJECTIVE: The objective of the study was to evaluate perioperative and oncologic outcomes of laparoscopy without the use of uterine manipulators and laparotomy in high-grade and serous endometrial cancer. METHODS: Patients with grade III endometrioid adenocarcinoma and serous carcinoma between 2018 and 2022 were included in the study. Preoperative staging with positron emission tomography/computed tomography or thoracoabdominal computed tomography and pelvic magnetic resonance imaging was performed. All patients underwent staging surgery including hysterectomy, bilateral salpingo-oophorectomy, peritoneal washing, omentectomy, and pelvic and paraaortic lymphadenectomy up to the renal vein. No uterine manipulator was used for laparoscopic hysterectomy. Age, CA 125 level, body mass index, accompanying diseases, pathologic data including stage, lymphovascular invasion, number of pelvic and paraaortic lymph nodes, and surgical data including surgical time, surgical complications, and adjuvant therapies were collected from the hospital database retrospectively. RESULTS: Notably, 89 patients were included in the study: 34 underwent laparotomy and 55 underwent laparoscopy. Surgical times were similar between the groups. The mean pelvic lymph node count in the laparotomy and laparoscopy groups was 33 and 34, respectively. The mean paraaortic lymph node counts in the laparotomy and laparoscopy groups were 23 and 22, respectively. Red blood cell transfusion, hemorrhage, urinary tract infection, postoperative fever, bladder atony, bladder injury, and chylous leakage showed no significant differences between the groups. However, ileus, intestinal injury, and evisceration were significantly higher in the laparotomy group. Hospital stay was significantly longer in the laparotomy group compared with the laparoscopy group. Overall and recurrence-free survival were similar between the groups. CONCLUSION: Laparoscopic surgery, performed without manipulators, provides comparable oncologic outcomes to open surgery in the treatment of high-grade endometrial cancer, while also offering improved perioperative results.

The role of serum inflammatory markers in determining the severity of cervical lesions

AbstractObjectiveTo evaluate the role of serum inflammatory markers in determining colposcopy indications more accurately, reducing unnecessary colposcopy requests, and preventing overtreatment.Materials and MethodsIn our study, the data of 218 patients who were followed up in our hospital's oncology outpatient clinic between April 2017 and November 2023 and who underwent colposcopy and biopsy for suspected cervical lesions due to Papanicolaou smear test abnormalities or the presence of human papillomavirus were evaluated retrospectively. The parameters of patients with and without cervical lesions were compared. Patients with cervical lesions were compared according to lesion type.ResultsNeutrophil/lymphocyte ratio and platelet/lymphocyte ratio levels were significantly higher in the cervical lesions (+) group compared with the cervical lesions (−) (p &lt; 0.001 and p &lt; 0.001, respectively). Systemic immuno‐inflammation index and systemic inflammatory response index levels were significantly higher in the cervical lesions (+) group compared with the cervical lesions (−) group (p &lt; 0.001 and p &lt; 0.001, respectively). Mean platelet volume level was significantly lower in the cervical lesions (+) group compared with the cervical lesions (−) group (p &lt; 0.001). In the group with cervical lesions, no significant relationship was found between the severity of the cervical lesions and serum inflammatory marker levels.ConclusionAccording to the results of our study, although there were significant differences between the serum inflammatory marker levels of patients with and without cervical lesions, their importance in predicting cervical lesions could not be clearly demonstrated. The importance of serum inflammatory markers should be evaluated in prospective studies with larger patient numbers and longer follow‐up periods.