• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6233-6237
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• 2014

Background: Intraperitoneal spread of gynecologic cancers is a major cause of mortality and morbidity and often presents with malignant ascites. Microscopic tumor spread can be demonstrated by a peritoneal wash cytology and help assess the prognosis of the disease. In our study, the roles of paraoxonase and ceruloplasmin, measured in peritoneal washing fluid of patients operated for gynecologic pathologies in differential diagnosis was investigated. Materials and Methods: Patients operated for malign or benign gynecologic pathologies in Antalya Education and Research Hospital Gynecology Clinic between 2010-2012 were included in the study. Samples were obtained during surgery. Results: A statistically significant difference was detected between patients with benign and malign diseases with regards to PON1 levels measured in peritoneal washing fluid (p:0.044), the average values being $64.2{\pm}30.8$ (Range 10.8-187.2) and $41.4{\pm}21.4$ (Range 10.4-95.5), respectively. No significant variation was evident for ceruloplasmin. Conclusions: Paraoxonase levels measured in peritoneal washing fluid may contribute to the differentiation of malign-benign diseases in gynecologic pathologies.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1487-1489
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• 2012

Objective: To compare the clinical efficacy of concurrent chemoradiotherapy, neoadjuvant chemotherapy, and intracavity brachytherapy in comprehensive treatment for young patients with stage Ib2 cervical cancer. Methods: One hundred and twelve young patients with stage Ib2 cervical cancer were enrolled retrospectively in our hospital from January 2003 to June 2005. They were categorized into three groups according to preoperative regimens, including the concurrent chemoradiotherapy group (Group 1, n=38), the neoadjuvant chemotherapy (Group 2, n=49), and the intracavity brachytherapy group (Group 3, n=25). Radical hysterectomy was performed following these regimens. Chemotherapy and radiotherapy were given according to pelvic lymph node metastasis, deep cervical stromal invasion, intravascular cancer emboli, histological grading, vaginal stump and positive surgical margin. Results: The cancer disappearance and superficial muscle invasion rates were statistically significantly better in the concurrent chemoradiotherapy group than in the other two groups (P<0.01). No statistically significant difference was noted in the deep muscle invasion rate, surgical time and intraoperative blood loss among three groups, but significantly more postoperative complications occurred in the concurrent chemoradiotherapy group. The 2-year pelvic recurrence was statistically significantly lower in the concurrent chemoradiotherapy group compared to other two groups, while the 5-year survival was higher. Conclusion: Concurrent chemoradiotherapy is efficacious for young patients with stage Ib2 cervical cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2461-2464
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• 2014

Background: Cancer accounts for 12.6% of total deaths in the world (just after heart disease). Materials and Methods: Frequency and age-specific incidence rates of breast and gynecologic cancers in Iran are calculated based on the dataset of the National Cancer Registry of Iran in 2005. Results: Gynecologic and breast cancer accounted for 7.6% and 25.6% of total cancer cases, respectively. Ovarian cancer was the most frequent gynecologic cancer followed by endometrium. Endometrial cancer revealed the highest age specific incidence rate followed by ovary (after 59 years). Conclusions: Regarding disease burden, breast and gynecologic cases account for 33.4% of total cancer patients. The age specific incidence rate is a useful guide in epidemiologic and future plans.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.10
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• pp.4247-4250
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• 2015

Objective: To determine the predictors of lympho-vascular space invasion (LVSI) in endometrial cancers which contain mucinous carcinomatous histology. Materials and Methods: Clinical and histopathological data of endometrial carcinomas with a mucinous carcinomatous component diagnosed between January 2007 and January 2014 at the Gynecologic Oncology Department of Zekai Tahir Burak Women's Health Education and Research Hospital were reviewed retrospectively. Results: Twelve patients (25.5%) were positive for LVSI and 35 (74.5%) patients were negative. Patients with LVSI were mostly staged higher than 1A. Mean age, BMI and parity were not significantly different between patient groups. Larger tumor diameter (${\geq}2cm$) (p=0.04) and elevated Ca125 and Ca-19.9 (p=0.01) levels were significant for predicting LVSI. We also found>1/2 myometrial invasion (p<0.001), cervical stromal involvement (p=0.002) and higher grade (2-3) (p=0.001) significant for predicting LVSI. In multivariate analysis we found only grade significant for predicting LVSI. Conclusions: Especially grade of tumor is a crucial factor for determining LVSI in endometrial cancers with mucinous carcinomatous components.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.10
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• pp.4257-4260
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• 2015

Background: Uterine papillary serous tumors are rarely seen and behave aggressively. Our aim was to evaluate uterine papillary serous tumors arising from polyps. Materials and Methods: Clinicopathological data of patients with uterine serous cancer arising from a polyp at the Gynecological Oncology Department of Zekai Tahir Burak Women's Health Education and Research Hospital were reviewed retrospectively. Results: We analyzed patients according to FIGO 2009 staging system as stage 1A and higher than stage 1A (3 and 6, respectively). All the patients were postmenopausal. Mean CA-125, CA-19.9 and CA15.3 levels were elevated in higher than stage 1A group. However we did not find a statistical difference between age, parity, polyp size, CA-125, CA-15.3, CA-19.9 and CEA levels. Lympho-vascular space invasion (LVSI) showed predictivity for advanced disease (p=0.025). Conclusions: The histopathologic nature of uterine serous carcinoma is a unique entity. LVSI is a prognosticator for defining an advanced stage uterine papillary tumor.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.8
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• pp.3461-3464
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• 2014

Background: To determine the frequency of dysplastic lesions in the endocervical curettage (ECC) specimens of women with ASC-US and LSIL Pap and to evaluate the possible factors associated with high grade dysplasia in those ECC specimens. Materials and Methods: Two hundred and sixty patients with ASC-US and LSIL cytologic smears who underwent an ECC at the time of colposcopic examination during January 2010 and December 2012 were reviewed. Demographic and clinicopathologic data were collected. Multivariate analysis using binary logistic regression was used to identify factors that might be associated with high grade endocervical dysplasia. Results: The frequency of endocervical dysplasia was 7.7% (20 out of 260 patients). Cervical intraepithelial neoplasia (CIN) 1 and CIN 2-3 lesions in the endocervical canal were observed in 12 and 8 patients, respectively. No microinvasive or invasive cervical cancers were identified. There was no difference in the frequency of high grade endocervical dysplasia between the patients with satisfactory and unsatisfactory colposcopic examinations (1.4% vs 5.1%, respectively, p=0.087). A multivariate logistic regression analysis demonstrated a significant association between high grade CIN on ectocervical biopsy as well as LSIL cytologic smears and high grade dysplasia in endocervical canal (OR=0.046, 95%CI=0.007-0.288; p=0.001 and OR=0.154, 95%CI=0.025-0.942; p=0.043, respectively). Conclusions: The frequency of high grade endocervical dysplasia in women with ASC-US and LSIL cytologic smears was low. Therefore, routine performance of ECC in those women is debatable. High grade ectocervical dysplasia and LSIL cytologic smears may be used as predictors for high grade dysplasia in endocervical canal and ECC in these patients is reasonable.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.3
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• pp.933-939
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• 2015

Malignant tumors are often accompanied by increased risk of hematological abnormalities. However, few studies have reported any prognostic impact of preoperative thrombocytosis, leukocytosis and anemia in epithelia ovarian cancer (EOC). This study aimed to investigate preoperative hematological parameters for anemia, leukocytosis and thombocytosis in relation to established prognostic factors and survival in EOC cases. A total of 816 Chinese women treated for EOC were retrospectively included in the study focusing on the relationship between preoperative hemoglobin, leukocyte and platelet counts, and a panel of clinicopathologic characteristics and outcome. Preoperative anemia was present in 13.4%, leukocytosis in 16.7% and thrombocytosis in 22.8%. Additionally, EOC patients with low differentiation grade, advanced stage, lymph node (LN) metastasis, residual disease ${\geq}1cm$, ascites volume >1,000ml, serum cancer antigen 125 (CA125) >675U/ml, and disease recurrence had the higher prevalence of preoperative anemia, leukocytosis and thrombocytosis (all p<0.05). Moreover, EOC patients with older age or postmenopausal EOC patients had the higher prevalence of thrombocytosis (28.7% vs 17.3% or 26.0% vs 17.7%). Furthermore, in a Cox proportional hazard model, thrombocytosis was an independent factor for progression-free survival (PFS) and overall survival (OS) (p<0.001). Conclusively, preoperative anemia, leukocytosis or thrombocytosis in EOC patients is closely associated with more malignant disease phenotype and poorer prognosis. Significantly, thrombocytosis may independently predict the disease-specific survival for EOC patients.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.5
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• pp.2163-2170
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• 2012

Aim: This one group semi-experimental study was performed to develop and adapt flow charts of nursing practices applied to gynecologic oncology patients to the field. Methods: The research was conducted between October 2008 and March 2009 in 6 hospitals in Istanbul (3 health ministry hospitals, 2 private hospitals and 1 university hospital) with effective programs. The scope of the study included 97 midwives/nurses who had been working as caregivers of gynecologic oncology patients in this unit at least for 6 months and who participated in this study voluntarily; 87 people composed the sample because of the absence of others on vacation or sick leave when the data were collected or who did not wish to participate. The data were in descriptive information form collected via "Forms to Determine the Efficiency of Flow Charts". Before data collection, risks related to gynecologic oncology problems were identified, a literature scanning was made for existing flow charts based on actual practices and the discovered charts were reviewed. As a result of the evaluations, it was decided to create 15 flow charts intended for risks, symptoms, operation processes and discharge. Questionnaires to determine activity were applied to participants before and after practice. Results: As a result of the study, it was determined that the efficiency of the flow charts increased significantly (p <0.01) after practice of the participants, nosignificant relationships (p>0.01) being apparent with age group, education level, occupational period in the job and in the gynecologic oncology field and evaluations of the practice before and after it was applied. Conclusion: The results of the study revealed that nursing participants in university and private hospitals and who supported the existence of a flow chart in the field evaluated the flow charts positively.

• Journal of Korean Neurosurgical Society
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• v.59 no.4
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• pp.392-399
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• 2016

Objective : Brain metastases in gynecologic cancer (ovarian, endometrial, and cervical cancer) patients are rare, and the efficacy of Gamma Knife Radiosurgery (GKRS) to treat these had not been evaluated. We assessed the efficacy of GKRS and prognostic factors for tumor control and survival in brain metastasis from gynecologic cancers. Methods : This retrospective study was approved by the institutional review board. From May 1995 to October 2012, 26 women (mean age 51.3 years, range 27-70 years) with metastatic brain tumors from gynecologic cancer were treated with GKRS. We reviewed their outcomes, radiological responses, and clinical status. Results : In total 24 patients (59 lesions) were available for follow-up imaging. The median follow-up time was 9 months. The mean treated tumor volume at the time of GKRS was $8185mm^3$ (range $10-19500mm^3$), and the median dose delivered to the tumor margin was 25 Gy (range, 10-30 Gy). A local tumor control rate was 89.8% (53 of 59 tumors). The median overall survival was 9.5 months after GKRS (range, 1-102 months). Age-associated multivariate analysis indicated that the Karnofsky performance status (KPS), the recursive partitioning analysis (RPA) classification, and the number of treated lesions were significant prognostic factors for overall survival (HR=0.162, p=0.008, HR=0.107, p=0.038, and HR=2.897, p=0.045, respectively). Conclusion : GKRS is safe and effective for the management of brain metastasis from gynecologic cancers. The clinical status of the patient is important in determining the overall survival time.

• Women's Health Nursing
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• v.12 no.1
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• pp.53-60
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• 2006

Purpose: This study aimed to explore changes in symptom distress and functional status in gynecologic cancer patients during the entire treatment cycles of chemotherapy. Methods: A prospective and longitudinal study with repeated measures was designed. Symptom Distress Scale and Karnofsky Performance Status Index were included in a daily log developed for self-administration. A total of 39 patients with a mean age of 48.4 years participated. Results: The levels of symptom distress and functional status changed significantly over the six cycles. Symptom distress kept increasing until its peak at the fourth cycle, while the functional status scored lowest at the first cycle, then it improved as the cycle repeated. In each cycle, symptom distress was marked higher during the first 6 days accompanying poor functional status. However, both changes did not recover completely until the end of each cycle. Conclusion: Nursing assessment and intervention need to be provided based on these changing patterns to help cancer patients cope and adjust successfully during the long treatment period. Further studies are needed to examine the impact of the major symptoms on psychological responses, quality of life, and outcomes of the cancer treatments.