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Amaç: Çalışmanın amacı Kanser Erken Tanı ve Tarama Merkezlerinden Jinekolojik Onkoloji polikliniğine sevk edilen, yetersiz servikal sitolojili ve yüksek riskli insan papilloma virüsü (HPV) pozitifliği olan kadınların kolposkopik biyopsi sonuçlarının incelemektir.Gereç ve Yöntemler: Bu retrospektif çalışmada Mart 2015-Ekim 2017 tarihleri arasında kliniğimize yönlendirilen yetersiz servikal sitoloji ve yüksek riskli HPV pozitifliği olan kadınlara kolposkopi eşliğinde servikal biyopsi ve endoservikal küretaj yapıldı. Hastalar HPV tiplerine göre gruplandırıldı. Endoservikal küretaj, servikal biyopsi ve servikal konizasyon sonuçları analiz edildi.Bulgular: Yetersiz servikal sitolojisi ve yüksek riskli HPV pozitifliği olan 46 hasta 30 aylık dönemde bu çalışmaya dahil edildi. Yirmi bir hastada (% 45,7) HPV 16 ve/veya HPV 18 ve 25 hastada (% 54,3) “16 olmayan 18 olmayan” HPV yüksek risk alt tipi mevcuttu. Servikal biyopsi sonuçları 20 hastada (% 43.5) normal histopatoloji, dört hastada (% 8.7) "HPV etkisi", 17 hastada (% 37) düşük dereceli skuamöz intraepitelyal lezyon (L-SIL) ve 5 hastada (% 10.9) yüksek dereceli skuamöz intraepitelyal lezyon (H-SIL) olarak bildirildi. Endoservikal küretaj incelemesinde üç hastada H-SIL (% 6.5) ve yedi hastada L-SIL (% 15.2) tespit edildi. Yedi (% 15.2) hastaya H-SIL nedeniyle konizasyon yapıldı ve konizasyon materyelinde üç cerrahi sınırları negatif H-SIL ve dört L-SIL bildirildi.Sonuç: Yetersiz servikal sitolojisi ve yüksek riskli HPV pozitifliği olan kadınlar için HPV alt tiplerinden bağımsız olarak H-SIL riski arttığından kolposkopi yapmak çok önemli görünmektedir., Aim: We aimed to analyze the colposcopic directed biopsy results of women with unsatisfactory cervical cytology and high-risk human papilloma virus (HPV) positivity, who were referred to the Gynecologic Oncology outpatient clinic from Cancer Early Diagnosis and Screening Centers.Materials and Methods: In this retrospective study, women with high-risk HPV subtypes who applied to our clinic between March 2015 and October 2017 with an inadequate cervical cytology underwent colposcopy-directed biopsy. Patients were grouped according to HPV types. The results of endocervical curettage, cervical biopsy, and cervical conization were analyzed.Results: Forty-six patients with unsatisfactory cervical cytology and high-risk HPV were included in this study during the 30-month period. Twenty-five (54.3%) of the patients had “non-16 non-18” HPV subtypes, while 21 (45.7%) had HPV 16 and/or HPV 18. Cervical biopsy results revealed high-grade squamous intraepithelial lesion (H-SIL) in 5 (10.9%) patients, low-grade squamous intraepithelial lesion (L-SIL) in 17 (37%), “HPV effect” in 4 (8.7%) and normal histopathology in 20 (43.5%) patients. The endocervical curettage revealed three (6.5%) women with H-SIL and seven (15.2%) with L-SIL. Seven (15.2%) patients underwent conization due to H-SIL and there were three H-SIL with negative margins and four L-SIL in the final histopathology report.Conclusion: Performing colposcopy seems to be crucial for women with inadequate cervical cytology and high-risk HPV regardless of HPV subtypes as there is an increased risk of H-SIL in this patient population.

Objective: The purpose of this study is to evaluate the impact of loop electrosurgical excision procedure (LEEP) and cold-knife conization (CKC) active training model on the surgical education and confidence levels of gynecologists. Materials and Methods: The LEEP and CKC hands-on training model consists of sausage, which is 2.5 cm in diameter, as cervix; plastic cup as vagina; foam rubber as posterior and anterior fornices; and cotton plate as the leukoplakia area. In total, 34 participants performed LEEP and CKC procedures on the training model under the guidance of mentors after theoretical lessons about the transformation zone, indications, and surgical techniques of LEEP and CKC. Afterward, a web-based survey was conducted to measure the effectiveness of this surgical model, and participants graded their learning and confidence levels on the same. Results: We evaluated the educational levels of the course, which were based on the basic surgical steps of LEEP and CKC procedures, and the confidence levels of the participants with regard to the previous practice or expertise of LEEP and CKC. Importantly, participants in each group had similar learning gains irrespective of previous practice or expertise. Despite a significantly higher pre-course confidence level of participants who had previously performed LEEP (p

Amaç: Bu çalışmada konizasyon cerrahisi sonrası servikal intraepitelyal neoplazi nüksünü öngörmede preoperatif nötrofil-lenfosit oranının prediktif değerinin araştırılması amaçlanmıştır.Gereç ve Yöntem: Bu retrospektif çalışmada, servikal intraepitelyal neoplazi patolojisine bağlı konizasyon uygulanan hastalar analiz edildi. Çalışmaya konizasyon materyalinde servikal intraepitelyal neoplazi saptanıp cerrahi sınırları negatif olan ve klinik veri tabanımızda en az 12 aylık takip süresi olan hastalar dahil edildi. Hastaların demografik, klinik, patolojik verileri ve preoperatif tam kan sayımı bulguları tıbbi dosyalardan çıkarıldı.Bulgular: Toplamda mevcut olan 105 hasta iki gruba ayrıldı: rekürrens grubu (n = 30) ve kontrol grubu (n = 85). İki grup arasında servikal intraepitelyal neoplazi patoloji dereceleri açısından istatistiksel olarak anlamlı fark yoktu. Rekürrens grubunda kontrol grubuna göre endoservikal küretaj pozitif sonuç sayısı artmıştı. Nüks grubunda rekürrenssiz sağkalım ortalaması 10.5 aydı. İki grup arasında preoperatif nötrofil-lenfosit oranı ve diğer hematolojik parametreler açısından istatistiksel olarak anlamlı fark yoktu. Lojistik regresyon analizinde rekürrens tahmininde sadece endoservikal küretaj pozitifliği belirleyici idi (p = 0.002,% 95 CI 0.084-0.365). Sonuç: Preoperatif nötrofil-lenfosit oranı ve diğer inflamatuar belirteçler cerrahi sınırları temiz konizasyon olgularında nüksü öngörmede etkin bulunmamıştır. Pozitif postkonizasyon endoservikal küretaj, eksizyonel tedaviden sonra nüks ile ilişkili tek prognostik faktör olarak bulunmuştur., Objective: This study aimed to evaluate the predictive value of preoperative neutrophil-lymphocyte ratio in cervical intraepithelial neoplasia recurrence after conization surgery.Materials and Methods: In this retrospective study, patients who underwent conization due to cervical intraepithelial neoplasia were analyzed. Inclusion criteria were cervical intraepithelial neoplasia in the conization specimen with negative surgical margins and at least 12 months follow-up period at our clinical database. Demographic, clinical, pathological data, and preoperative complete blood count findings of the patients were extracted from medical files. Results: There were a total of 105 patients divided into two groups: the recurrence group (n = 30) and the control group (n =85). There were no statistically significant differences between the two groups in terms of cervical intraepithelial neoplasia pathology grades. There was statistically increased number of postconization endocervical positive results in the recurrence group. In the recurrence group, the mean of recurrence free survival was 10.5 months. There were no statistically significant differences in the preoperative neutrophil-lymphocyte ratio and in other hematologic parameters between the groups. In logistic regression analysis, only endocervical curettage positivity was predictive in estimating recurrence (p=0.002, %95 CI 0.084-0.365). Conclusion: Preoperative neutrophil-lymphocyte ratio and other inflammatory markers were not predictive of recurrence after conization in women with negative surgical margins. Positive postconization endocervical curettage was the only prognostic factor associated with recurrence after excisional therapy.

Background: Cold knife conization is a surgical procedure that allows both diagnosis and treatment of cervical lesions at the same time. It is mainly performed for indications of high-grade cervical intraepithelial neoplasia (CIN). In this study, we aimed to investigate the clinical outcome of cases without CIN in cold knife conization specimen, following a high-grade lesion (CIN2/3) in cervical biopsy. Materials and Methods: We performed a retrospective cohort study at a tertiary referral hospital between January 1 st 2008 and August 1 st 2012. Cases that underwent cold knife conization for CIN2/3 within the study period were included. Cone-negative (Group 1) and cone-positive (Group 2) cases were analyzed for various clinical parameters, and were compared in the 1-year post-conization period for histological recurrence and human papillomavirus (HPV) DNA status. Results: A total of 173 women underwent cold knife conization for CIN2/3 within the study period. Twenty-two cases (12.7%)

Serous borderline ovarian tumors (SBOT) generally occur in young women, present at early stages and are associated with an excellent prognosis. However, there are rare subtypes of SBOT which may exhibit a more aggressive course. In contrast with other types of SBOT, the micropapillary variant SBOT (SBOT-MP) tends to present at advanced stages. Herein, we present a rare case of a SBOT-MP that occurred in a 66-year-old woman, who had tumoral involvement on bilateral ovaries, sigmoid serosa and a positive peritoneal cytology. The currently recommended treatment options for these cases are also discussed.Seröz borderline over tümörleri (SBOT) genellikle genç kadınlarda ortaya çıkmakta, erken evrede tanı almakta ve çok iyi bir prognoza sahip olmaktadır. Ancak, SBOT’nin daha agresif bir seyir gösterebilen nadir alt tipleri mevcuttur. Diğer SBOT’lerin aksine, SBOT’nin mikropapiller varyantı (SBOT-MP) ileri evrelerde ortaya çıkma eğilimindedir. Bu yazıda, 66 yaşındaki postmenopozal bir kadında ortaya çıkan, bilateral overlerde ve sigmoid kolon serozasında tutuluma ve pozitif peritoneal sitolojiye sahip nadir bir SBOT-MP olgusu sunulmaktadır. Ayrıca, bu tip olgular için güncel tedavi önerileri de tartışılmaktadır.

Ozgu, Emre/0000-0002-8444-9694; Gungor, Tayfun/0000-0002-7869-9662 WOS: 000343832900049 PubMed: 25169520 Background: There are limited data in the literature related to concomitant genital or extra-genital organ pathologies in patients with borderline ovarian tumors (BOTs). The aim of this study was to evaluate our experience with 183 patients to draw attention to the accompanying organ pathologies with BOTs. Materials and Methods: One hundred eighty-three patients with BOTs, diagnosed and/or treated in our center between January of 2000 and March of 2013 were evaluated retrospectively. Data related to age, tumor histology, lesion side, disease stage, accompanying incidental ipsilateral and/or contralateral ovarian pathologies, treatment approaches, and follow-up periods were investigated. Incidental gynecologic and non-gynecologic concomitant organ pathologies were also recorded. Results: The mean age at diagnosis was 40.6 years (range: 17-78). Ninety-five patients (51%) were

Objective The aim of this study was to investigate the clinical and laboratory features of patients with the incidental diagnosis of endometrial adenocarcinoma (EC) during infertility work-up, with special attention given to treatment approaches, recurrence rate, and fertility outcome. Material and Methods The medical records of 577 patients who were diagnosed with EC and treated between 2007 and 2013 were included in the study. Out of 577 EC patients, 5.1% (n = 30) were ≤ 40 years of age. However, 10 patients had a history of infertility and had been diagnosed during evaluation for infertility. Patients' clinical and laboratory data were reviewed retrospectively. Results The mean age at diagnosis was 34.3 ± 4.5 years and the mean duration of infertility was 5.1 ± 4.7 years. Immediate staging surgery was performed on three patients. The others were treated with oral megestrol acetate and/or a levonorgestrel-containing intrauterine device (IUD) for 6 months. The mean duration of postoperative or postdiagnostic follow-up was 44.7 ± 25.9 months. The disease persistence and recurrence rates were 11.1% and 22.2%, respectively. Two patients achieved pregnancy naturally or by assisted reproductive technology (ART) trial. Conclusion The investigation of patients during infertility work-up provides an opportunity to evaluate the endometrium and its malignancies in young women, when the disease is in its early stage and symptom free. The standard surgical treatment for early-stage EC is total hysterectomy with bilateral salpingo-oophorectomy. However, conservative management of early stage EC with progestational drugs, especially in young patients who wish to preserve their fertility, is acceptable with the possibility of future pregnancies.

The present study aims to compare the clinical and reproductive outcomes of women who have undergone lymph node dissection with those who have not and to discuss the indications for retroperitoneal evaluation in the treatment of borderline ovarian tumors. The present study investigated 123 women who were finally diagnosed with borderline epithelial ovarian tumors at the study center between January 1999 and January 2009. A total of 68 patients (55.3%) were found to have a complete surgical staging procedure. The patients who underwent complete lymph node dissection were significantly younger than those who did not have lymphadenectomy. Thus, the ratio of postmenopausal women was significantly higher among those in whom retroperitoneal evaluation was performed. As expected, the intraoperative blood loss was significantly more and the hospital stay was significantly longer in patients who underwent complete lymph node dissection. Also, the non-serous borderline ovarian tumors were significantly more frequent in the latter patient group. However, overall and disease-free survival spans were found to be statistically similar for both study groups as well as the recurrence rate. Retroperitoneal evaluation can be spared in every woman with borderline ovarian tumor unless she is to undergo complete surgical staging procedure because of high recurrence risk, advanced stage disease or personal choice.