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Purpose: Majority of gynecologic oncologists perform low para-aortic dissection, while only one in ten incorporated para-aortic dissection to the level of renal vessels. The aim of this study is to demonstrate the necessity of para-aortic lymph node dissection (LND) in the surgical management of the endometrioid type endometrial cancer (EC). Materials and Methods: Endometrioid type EC patients who were operated at the present institution were included in the study. The patients were stratified according to the modified Mayo Clinic risk criteria. According to these criteria, the authors identified each patient as low risk or high risk for extra-uterine disease spread on final pathology reports. Low risk criteria for nodal disease were identified as grade 1 or 2 endometrioid type disease, equal or less than 1/2 myometrial invasion (MI), and greatest tumor diameter equal or less than 2 cm. Results: Three hundred eighty-six patients were operated with the diagnosis of endometrioid type EC. Two hundred forty-seven patients had high risk factors for extra-uterine disease; thus, complete surgical staging was performed to this group. The remaining 139 patients had low risk criteria. The median follow-up time was 35 months (minimum two months, maximum 97 months). Twenty-six patients (10.5%) died of disease during the follow-up period. Two hundred fifteen patients (87%) had negative nodes, while remaining 32 (12.6%) patients had pelvic and/or para-aortic LN metastasis. Thirteen patients (40.6%) had only pelvic LN involvement (Stage 3C1), 19 patients (59.4%) had either pelvic and/or para-aortic LN involvement (Stage 3C2), and six patients (18.6%) had isolated para-aortic LN involvement. Conclusion: The present authors advocate the value of para-aortic LND in surgical management of EC, and retroperitoneal LND should not be limited to pelvic nodes, a systematic para-aortic dissection up to left renal vein should be performed for the patients with at least one risk factor for nodal disease. [ABSTRACT FROM AUTHOR]

Purpose of investigation: The present study aims to investigate the incidence, clinicopathological features, and experience of treatment outcomes of patients with endometrial adenocarcinoma (EC) at ≤ 40 years of age in a gynecologic oncology reference center in Ankara, Turkey. Materials and Methods: This retrospective study included 577 patients with EC, diagnosed and treated between 2007 and 2013. Results: The incidence of EC ≤ 40 years of age was 5.1% (n: 30). The mean age at diagnosis was 35.5 (range: 27-40). Most of the patients with EC were overweight or obese. However, 23% had normal body mass index (BMI). Infertility was seen as a risk factor in 38.4%. The mean duration of postoperative follow-up was 38.3 months with rates of disease persistence and recurrence 14.2% and 28.5%, respectively. Conclusion: The disease is diagnosed usually in its early stage and has a good prognosis. Appropriately selected patients with fertility desire have the opportunity to conceive with conservative management. [ABSTRACT FROM AUTHOR]

Purpose of the study: The study was conducted to determine whether preoperative serum levels of cancer antigen (CA) 125, CA15-3, CA19-9, carcinoembryonic antigen (CEA), and alpha-fetoprotein (AFP) are associated clinicopathologically with poor prognostic parameters and adjuvant treatment requirements in women with pure endometrioid endometrial cancer (EEC). Materials and Methods: The authors performed a retrospective review of EEC cases that were treated between January 2008 and January 2011. The association between preoperative tumor markers and prognostic parameters, recurrence risk, and adjuvant treatment requirements were investigated. Following univariate analyses, receiver-operating characteristic (ROC) curves were constructed for each marker to assess their capacity to predict prognostic parameters and need for adjuvant treatment. Results: A total of 166 EEC cases were identified. Mean CA125, CA15-3, and CAI 9-9 levels were higher in cases that required adjuvant treatment (p < 0.05). CA125 had significant power for prediction of extrauterine disease, tumor size > two cm, lymphovascular space invasion (LVSI), deep myometrial invasion, cervical involvement, adnexal involvement, positive cytology, lymph node metastasis, and adjuvant treatment requirement. CAI5-3 was a significant marker for adjuvant treatment prediction. CAI 9-9 could predict deep myometrial invasion, cervical involvement, and adjuvant treatment requirement. However, CEA and AFP did not have adequate capacity to predict any of the poor prognostic parameters and adjuvant treatment requirements. Conclusions: C A125 is currently one of the most important preoperative markers for identifying EEC cases that exhibit postoperatively poor prognostic pathologic findings and a consequent need for adjuvant treatment. CA 15-3 and CAI 9-9 were also significant markers with limited capacity in detecting prognostic parameters. [ABSTRACT FROM AUTHOR]

Objective: The present study aims to review cases of extremely rare primary ovarian tumors and thus, to evaluate the distribution of rare primary ovarian pathologies. Various aspects of the presentation, diagnosis, and treatment of these tumors are discussed. Materials and Methods: A retrospective review of women with final pathology of rare primary ovarian tumors, which were managed at the Gynecologic Oncology Department of Zekai Tahir Burak Women's Health Education and Research Hospital, from 1995 to 2010 was undertaken. Results: Among the 2,210 women treated during the study period, extremely rare ovarian tumors accounted for 1.62% (36/2210) of all cases. Conclusion: It is important to be aware of these rare entities in the pathological diagnosis of ovarian tumors. Intraoperative frozen examination should be performed because rare benign conditions that mimic malignancy may not require radical surgery. The rarity of these tumors renders basic scientific advances more challenging. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to determine whether it was necessary to add omentectomy and appendectomy to the surgical staging of endometrioid endometrial cancer. Materials and Methods: Records were reviewed from June 2005 to June 2009 for endometrioid endometrial cancer patients who underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic and para-aortic lymphadenectomy, infracolic omentectomy and appendectomy. Results: In total, 186 patients were included in the analysis. Disease was limited to uterus in 93% of patients and 87% of patients had Stage 1 disease. There was only one omental metastasis and no appendix metastasis in all stages. Conclusion: Routine omentectomy and appendectomy are unnecessary in surgical staging of endometrioid endometrial cancer unless there is suspicion of gross metastases during intraoperative examination. [ABSTRACT FROM AUTHOR]

The article presents a study that aims to examine the preoperative value of cancer antigen (CA) 125 in the diagnosis of leiomyoma and uterine sarcoma in Turkish female in Turkey. The assessment of CA 125 values in the uterine sarcoma group revealed that those with carcinosarcoma had higher mean values in CA 125. The study concluded that the preoperative serum CA 125 level have no predictivity and no connection between staging and CA 125 in uterine sarcomas.

The article presents a case study of a 47-year-old woman with abnormal vaginal bleeding and abdominal discomfort. Clinical diagnosis required a pelvic ultrasonography which revealed a 4cm solid ovarian mass while a laparoscopy indicated a smooth-surfaced adnexal mass with solid and cystic portions. Pathologic and immunohistochemical testing revealed a primary ovarian carcinoid which came from a mature cystic teratoma.

The article presents a case study of a 52-year-old menopausal woman who was referred to oncology department due to complaint of vaginal bleeding. She was founded with necrotic, exophytic mass in vagina which originates from the vaginal wall. Biopsy shows squamous cell carcinoma (SCC) of the vagina. She has undergone the vaginal rectus abdominis myocutaneous (V-RAM) flap reconstruction after the vaginectomy and hysterectomy. It discusses the vaginal reconstruction after resection procedure.