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The Papanicolaou (Pap) smear test is standard screening test that detects cervical lesions and cancers. In this multicentric study, we performed a retrospective analysis of cytologic results associated with atypical glandular cells-not otherwise specified (AGC-NOS).We retrospectively reviewed Pap smear tests resulted as "atypical glandular cells-not otherwise specified". A total of 254 women who underwent colposcopy due to a Pap smear result of AGC-NOS were included the study between 2003 and 2021. The ages, Pap smear results, HPV results if any, colposcopic biopsy results, endocervical and endometrial pathology results and management of these patients were analayzed.Two hundred fifty-four patients with AGC-NOS Pap smear result were included in the study. A total of 70 (27.6%) patients had cervical and endometrial premalignant or malignant lesions. Malignancy was observed in 17 (6.7%) patients (endometrium; n: 11 (4.3%) and cervix; n: 6 (2.4%)). Isolated premalign or malign lesions of cervix and endometrium were detected in 57 (22.4%) and 12 (4.7%) patients, respectively.Patients diagnosed with AGC-NOS should undergo a careful evaluation with all its clinicopathological features. Because the cancer of the cervix and endometrium is not rare in patients diagnosed with AGC-NOS, colposcopic examination with endocervical sampling should be a priority based on a cervicovaginal smear. Endometrial sampling is also required according to the patient's clinic, age and examination characteristics.

In this retrospective study, patients with epithelial gynaecologic cancer with pulmonary recurrence (PR) were evaluated from five national gynaecologic oncology clinics. Patients with a diagnosis of primary endometrial, ovarian/fallopian tube/peritoneal, cervical or vaginal/vulvar tumours who developed an initial PR were included in the study A total of 122 patients were included in the study. The median follow-up time after recurrence was 7.5 (range, 1-84) months. The 2-year PRS was 48% in the main cohort. The risk of death was more than seven times higher in patients who did not receive salvage chemotherapy compared with those who did (hazard ratio: 7.6, 95% CI: 3.0-18.9

Purpose: To evaluate the clinicopathological characteristics and surgical outcomes in patients with pure ovarian immature teratomas (POITs). Materials and Methods: In this multicenter study, a retrospective review was made of the databases of six Gynecology Oncology Departments in Turkey to identify patients with POITs who had undergone surgery between 1993 and 2019. Results: Evaluation was made of 48 patients with a median age at diagnosis of 22.5 years (range, 15-37 years). In 40 (83%) patients, stage I was determined and in eight patients, an advanced stage (IIIB, IIIC, and IVB) was determined. Tumors were found to be grade I in 17 (35.4%) cases, grade II in 12 (25%), and grade III in 19 (39.6%). Fertility-sparing surgery was applied to 42 (87.5%) patients and radical surgery to 6 (12.5%). The median follow-up was 60 months (range, 3-246 months). Recurrence was seen in seven patients, all with grade III tumors. In the final pathological examination of recurrent tumors, mature teratoma was reported in five patients, and immature teratoma in one patient. Salvage surgery was not performed in one patient as the tumor was unresectable and so a regimen of bleomycin, etoposide, and cisplatin (BEP) was administered. Conclusion: POITs are rare tumors seen at a young age, and benign or malignant relapse can be seen in these tumors. In this cohort, the malignant recurrence rate was 4.1%, and the benign recurrence rate was 10.4%. All the recurrences were in grade III tumors. Benign recurrences can be treated with surgery alone and the malignant group should be treated with surgery followed by chemotherapy.

We investigated the association between preoperative ratios of inflammatory markers and the prognosis in patients with invasive cervical cancer (CC). In this single-centre study, we retrospectively enrolled 163 CC patients who underwent radical hysterectomy between February 2008 and October 2018. Among the evaluated ratios, a high neutrophil-to-lymphocyte ratio (N/L) was significantly associated with deep stromal invasion and tumour size larger than 2 cm, whereas a high M/L was significantly related to advanced-stage CC (IB3-IIIC2), lymphatic metastasis (total) and pelvic lymph node metastasis (

Jinekolojik onkoloji pratiğinde preoperatif veya intraoperatif vasküler anomalilerin belirlenmesi komplikasyon oranlarının azalması açısından önemlidir. Abdominal cerrahide görülen en sık vasküler anomalinin renal vasküler anomaliler olduğu bilinmektedir. Vasküler komplikasyonun oluşması durumunda kanama, organ kaybı hatta ölüme sebebiyet verilebilir. 40 yaşında, ovaryan tümör nedeniyle evreleme cerrahisi geçiren hastada, intraoperatif tespit edilen sirkumaortik sol renal veni sunduğumuz bu yazıda renal vasküler anomalileri anatomik ve embriyolojik açıdan inceledik.

Cardiophrenic lymph node (CPLN) metastasis is detected at the time of diagnosis in 5% to 28% of patients with advanced-stage epithelial ovarian cancer (EOC) (Mert et al. 2018; Nishikimi et al. 2018...

In this retrospective study, we aimed to investigate the contraceptive choices before and after voluntary termination of pregnancy among adolescents. Seventy pregnant adolescents aged 17-19 and undergone voluntary pregnancy termination were included. Counseling about contraceptives was given before the procedure. Contraceptive choices before and after termination of pregnancy were evaluated. Before pregnancy termination, all of the adolescents reported the use of a contraceptive method. The most commonly used method was coitus interruptus (37.1%), followed by male condom (34.3%) and the rhythm method (18.6%). The use of oral contraceptive pills (7.1%) and intrauterine devices (IUDs; 2.9%) were very low. Implants and injections were not used. None of the methods used were dual methods (used with the male condom). After the termination procedure, IUD was main choice (54.3%) followed by oral contraceptive pills (31.4%). Four adolescents (5.7%) selected to insert subdermal implants and three adolescents (4.3%) preferred injections. All of these preferred methods were dual methods. The preference of male condom as a single method decreased by about 3%. The rhythm method and coitus interruptus were not preferred. As a conclusion, contraceptive choices of adolescents significantly change to more effective methods by sufficient counselling during the termination of an unintended pregnancy. Impact statement What is already known on this subject? Adolescent pregnancies are an important public health problem. The prevention of these pregnancies is important in this respect. However, especially in developing countries, adolescents do not have sufficient knowledge of effective contraceptive methods. What do the results of this study add? The contraceptive choices of adolescents significantly change to more effective methods by appropriate counselling during the termination of unintended pregnancies. What are the implications of these findings for clinical practice and/or further research? An unintended pregnancy termination may be an opportunity to provide appropriate counselling to prevent subsequent pregnancies in adolescents, especially in countries where the sexual and reproductive health or family planning services are inadequately used.

To evaluate the clinico-pathologic features, treatment options, prognostic factors, and survival outcomes of malignant struma ovarii based on a systematic literature review in association with our case study.A systematic review of the medical literature was performed to identify articles about malignant struma ovarii from January 1983 until July 2020. We evaluated 178 cases.The 5-year progression-free survival (PFS) and overall survival (OS) of the entire cohort was 72.5% and 91%, respectively. In univariate analysis, younger age (43 years), whole strumal cyst diameter95 mm, presence of a histologic type other than papillary classic-type thyroid carcinoma within the tumor and lymphovascular space invasion were related to poor PFS. Patients who received radioactive iodine ablation (RIA) before the treatment failure had significantly higher PFS than those who did not receive RIA (94.9% vs. 64.8%, p = 0.041, respectively). In univariate analysis, PFS was significantly higher in patients who underwent gynecologic surgery followed by thyroidectomy and RIA compared with those who had surgical treatment only (94.5% vs. 64.3%, p = 0.05, respectively). However, this result could not be identified as an independent prognostic factor in multivariate analysis (p = 0.207). Younger age and absence of capsular involvement were related to significantly increased OS. Histologic type was the only independent prognostic factor for PFS (hazard ratio: 3.30, 95% confidence interval: 1.122-9.748; p = 0.030) CONCLUSION: The most common histologic subtype was the papillary classic type. The presence of a histologic type other than the classic papillary thyroid carcinoma within the tumor was an independent adverse prognostic factor.

The aim of this study was to evaluate clinicopathological features, oncological outcome and prognostic factors for recurrence in advanced stage uterine serous carcinoma (USC) patients.Patients with 2009 International Federation of Gynecology and Obstetrics stage IIIIV uterine serous carcinoma were enrolled from 4 gynecologic oncology centers and a study group was created. Response to therapy was evaluated according to the WHO criteria. Progression-free survival (PFS) and overall survival (OS) estimates were determinated by using the Kaplan-Meier method. Survival curves were compared with the log-rank test. Multivariate analysis was performed using the Cox proportional hazards model.Entire cohort included 63 patients. Median age of cohort was 64 years. Thirty-five (55.6 %) patients were stage IV. Lymphadenectomy was performed in 57 (90.5 %) patients and lymph node metastasis was positive in 45 (71.4 %) patients. Maximal cytoreduction (no residue tumor) was achieved in 53 (84.1 %) patients. However, optimal cytoreduction (residue tumor ≤1 cm) was achieved in 6 (9.5 %) patients and suboptimal cytoreduction (residue tumor1 cm) was achieved in 3 (4.8 %) patients. Median follow-up time was 19 (range;1-152) months. Complete clinical response was obtained in 58 (92.1 %) patients after standard adjuvant therapy. Disease failure was detected in 25 patients. Study group had a 2-year PFS of 51 % and 2-year OS of 80 %. On multivariate analysis, performing lymphadenectomy was an independent prognostic factor for PFS (Odds ratio: 24.794, 95 % Confidence Interval: 4.214-145.869; p0.001).Lymphadenectomy should be a part of the standard surgical therapy in advanced stage USC.

Amaç: Sezaryen ile doğumun postpartum depresyona ve maternal bağlanmaya etkisini incelemekGereç ve Yöntem: Sezaryen doğum yapan 90 kadın ve vajinal doğum yapan 90 kadın çalışmaya dahil edilmiştir. Tüm kadınlara postpartum 2. Haftada depresif belirtilerinin taranması için Edinburg Doğum Sonrası Depresyon Ölçeği, maternal bağlanmanın değerlendirilmesi için ise Maternal Bağlanma Ölçeği uygulanmıştır.Bulgular: İki grup arasında Edinburg Doğum Sonrası Depresyon Ölçeği ve Maternal Bağlanma Ölçeği ortalama puanları açısından istatistiksel olarak anlamlı bir fark yoktu. Ayrıca gruplardaki postpartum depresyon gelişimi için riskli olabilecek puanlara (Edinburg Doğum Sonrası Depresyon Ölçeği puanı >12 olanlar) sahip kadın sıklığı da benzerdi. Sonuç: Sezaryen ile doğumun postpartum depresyona ve maternal bağlanmaya etkisi yoktur.

Sperm-associated antigen 9 (SPAG9) has been recently proposed as a novel biomarker for early diagnosis of several human tumors, including ovarian, cervical and breast cancers. Its clinical value remains to be clarified for endometrial cancer (EC). In this study, we investigated the utility of serum SPAG9 levels in diagnosis of EC and its association with important clinicopathological parameters.This cross-sectional study was performed at a tertiary women's referral center in Ankara, Turkey. Preoperative serum samples were collected from patients surgically treated for endometrial cancer between June 2012-April 2013. Similar aged women with a biopsy proven benign endometrium were used as controls. Serum SPAG9 levels were measured with an enzyme-linked immunosorbent assay (ELISA) method and assessed for links with clinicopathological factors. Receiver operating characteristic (ROC) curve analysis was performed to assess power of SPAG9 levels for EC prediction. P values less than 0.05 were considered statistically significant.A total of 63 women with EC and 27 with benign endometrium were included in the study. Mean age in the EC group was 58.7±1.1. Median SPAG9 levels in the EC and control groups were 18.3 (range, 12.7-53.8) and 14.1 (range, 4.3-65.3), respectively (p0.001). A cut-off value of 17 ng/ml for SPAG9 predicted presence of malignant endometrium with 74% sensitivity and 83% specificity [Area under curve (AUC)=0.82, p0.001]. SPAG9 levels did not demonstrate any significant association with histological type, FIGO stage, tumor grade, size, myometrial invasion, lymphovascular space invasion, cervical involvement, adnexal involvement, peritoneal cytology or lymph node status (all p0.05).Testing for SPAG9 may be useful for early detection of EC in asymptomatic high-risk women. Its role in post-treatment follow-up and early detection of recurrence should be assessed in future trials.

Aim of this study is to investigate the predictive role of transvaginal ultrasonographic measurement of cervical length (CL) at 22-26 weeks of gestation in determining preterm deliveries in twin pregnancies. CL was measured by transvaginal ultrasonography at 22-26 weeks in 75 twin pregnancies. Signs of preterm labor, ruptured membranes, vaginal bleeding, patients with systemic disease, cervical incompetence were excluded. The primary outcome was spontaneous preterm birth at before 37 weeks of gestation. 63 pregnancies delivered with cesarean section and 10 (% 13.3) babies had NICU requirement. The mean CLM was 37±7.26 mm in patients. Twenty patient (%27) were hospitalized with a diagnosis of preterm labor. 46 patients were delivered at small than 37 gestational weeks and the mean CLM was 37.63±6.53 mm. 29 patients occurred term delivery with 38.64±6.23mm CLM. According to the ROC curve analysis CLM was found to be a discriminative parameter in patients. The area under curve (AUC), cut off values, sensitivity and specificity were 0.794, 34.95 and %70-80; respectively (p=0.029). In twin pregnancies, measurement of CL with transvaginal ultrasonography at 22-26 weeks of gestation can be of beneficial in predicting the risk of preterm deliveries

This study investigated the effects of motivation to work, job satisfaction, and sociodemographic characteristics on nurses' intention to quit. The questionnaire used was designed to focus on 23 job satisfaction items, 4 sociodemographic items, and 4 motivation to work questions. Nine hundred thirty-six completed questionnaires were used for analyses. An ordinal regression model was proposed to explore the impact of the factors on nurses' intention to quit. Two motivation to work and 8 job satisfaction items were proven to be significant predictors of nurses' intention to quit. Clinicians and clinic researchers can be guided by suggestions and insights from this study that organizational, motivation, and sociodemographic factors contribute to nurses' intention to quit.