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Permanent URI for this collectionhttps://hdl.handle.net/11443/932

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Author: search.filters.author.Kose, FarukHas files: Yes

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    Sentinel lymph node biopsy in early stage endometrial cancer: a Turkish gynecologic oncology group study (TRSGO-SLN-001)
    (BMJ PUBLISHING GROUP, 2020-01-01) Taskin, Salih; Altin, Duygu; Vatansever, Dogan; Tokgozoglu, Nedim; Karabuk, Emine; Turan, Hasan; Takmaz, Ozguc; Kahramanoglu, Ilker; Naki, Mehmet Murat; Gungor, Mete; Kose, Faruk; Ortac, Firat; Arvas, Macit; Ayhan, Ali; Taskiran, Cagatay
    Objective The aim of this multicenter study was to evaluate the feasibility of sentinel lymph node (SLN) mapping in clinically uterine confined endometrial cancer. Methods Patients who underwent primary surgery for endometrial cancer with an SLN algorithm were reviewed. Indocyanine green or blue dye was used as a tracer. SLNs and/or suspicious lymph nodes were resected. Side specific lymphadenectomy was performed when mapping was unsuccessful. SLNs were ultrastaged on final pathology. Results 357 eligible patients were analyzed. Median age was 59 years. Median number of resected SLNs was 2 (range 1-12) per patient. Minimal invasive and open surgeries were performed in 264 (73.9\%) and 93 (26.1\%) patients, respectively. Indocyanine green was used in 231 (64.7\%) and blue dye in 126 (35.3\%) patients. The dyes were injected into the cervix in 355 (99.4\%) patients. The overall and bilateral SLN detection rates were 91.9\% and 71.4\%, respectively. The mapping rates using indocyanine green or blue dye were comparable (P=0.526). There were 43 (12\%) patients with lymphatic metastasis. The SLN algorithm was not able to detect 3 of 43 patients who had isolated paraaortic metastasis. After SLN biopsy, complete pelvic lymphadenectomy was performed in 286 (80.1\%) patients. Sensitivity and negative predictive value were both 100\% for the detection of pelvic lymph node metastases. In addition, 117 (32.8\%) patients underwent completion paraaortic lymphadenectomy after SLN biopsy. In these patients, sensitivity for detecting metastases to pelvic and/or paraaortic lymph nodes was 90.3\% with a negative predictive value of 96.6\%. The risk of non-SLN involvement in patients with macrometastatic SLNs, micrometastatic SLNs, and isolated tumor cells in SLNs were 61.2\%, 14.3\% and 0\%, respectively. Conclusions SLN biopsy had good accuracy in detecting lymphatic metastasis. However, one-third of cases with metastatic SLNs also had non-SLN involvement and this risk increased to two-thirds of cases with macrometastatic SLNs. The effect of leaving these nodes in situ on survival should be evaluated in further studies.
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    Microcystic, elongated, and fragmented pattern of invasion in relation to histopathologic and clinical prognostic factors in endometrioid endometrial adenocarcinoma
    (GALENOS YAYINCILIK, 2017-01-01) Naki, M. Murat; Oran, Gulbin; Tetikkurt, Seza Umit; Sonmez, Cavide Fatma; Turkmen, Ilknur; Kose, Faruk
    Objective: To investigate the association of microcystic, elongated, and fragmented (MELF) pattern of invasion with prognostic factors in endometrioid endometrial adenocarcinoma (EEA). Material and Methods: Stained tissue sections from 83 cases of EEA operated by the same gynecologic oncologist were reviewed to identify cases showing MELF-type invasion in this retrospective study. The association of MELF pattern with age, tumor grade, depth of myometrial invasion, and presence of lymphovascular space invasion (LVSI) was analyzed. Results: FIGO grade 2 and grade 1 tumors were evident in 53.0\% and 38.6\% of patients, respectively. Depth of myometrial invasion was <50\% in 72.0\% of patients, and LVSI was absent in 77.1\%. MELF pattern was confirmed in 35 (42.2\%) patients. Presence of MELF pattern was associated with significantly higher mean +/- standard deviation age (62.9 +/- 6.9) years vs. 58.9 +/- 9.1 years, p=0.033), and found to be more likely in patients with high-grade tumor (FIGO grade III
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    Laparoscopic assisted robotic myomectomy of a huge myoma
    (GALENOS YAYINCILIK, 2019-01-01) Takmaz, Ozguc; Gundogan, Savas; Ozbasli, Esra; Karabuk, Emine; Naki, Murat; Kose, Faruk; Gungor, Mete
    Today, the adoption of minimal invasive gynecologic procedures is expanding their routine use in clinical practice. Until recently, a diameter of 8 cm was the recommended maximal size for laparoscopic removal of fibroids. However, robot-assisted laparoscopy improved the capacity and the feasibility of the many gynecologic procedures. Here, we report a video of robotic myomectomy of a huge myoma.