Araştırma Çıktıları

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Author: search.filters.author.Ayhan, AliHas files: Yes

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    Could the Long-Term Oncological Safety of Laparoscopic Surgery in Low-Risk Endometrial Cancer also Be Valid for the High-Intermediate- and High-Risk Patients? A Multi-Center Turkish Gynecologic Oncology Group Study Conducted with 2745 Endometrial Cancer Cases. (TRSGO-End-001)
    (MDPI, 2021-01-01) Vardar, Mehmet Ali; Guzel, Ahmet Baris; Taskin, Salih; Gungor, Mete; Ozgul, Nejat; Salman, Coskun; Kucukgoz-Gulec, Umran; Khatib, Ghanim; Taskiran, Cagatay; Duender, Ilkkan; Ortac, Firat; Yuce, Kunter; Terek, Cosan; Simsek, Tayup; Ozsaran, Aydin; Onan, Anil; Coban, Gonca; Topuz, Samet; Demirkiran, Fuat; Takmaz, Ozguc; Kose, M. Faruk; Gocmen, Ahmet; Seydaoglu, Gulsah; Gumurdulu, Derya; Ayhan, Ali
    This study was conducted to compare the long-term oncological outcomes of laparotomy and laparoscopic surgeries in endometrial cancer under the light of the 2016 ESMO-ESGO-ESTRO risk classification system, with particular focus on the high-intermediate- and high-risk categories. Using multicentric databases between January 2005 and January 2016, disease-free and overall survivals of 2745 endometrial cancer cases were compared according to the surgery route (laparotomy vs. laparoscopy). The high-intermediate- and high-risk patients were defined with respect to the 2016 ESMO-ESGO-ESTRO risk classification system, and they were analyzed with respect to differences in survival rates. Of the 2745 patients, 1743 (63.5\%) were operated by laparotomy, and the remaining were operated with laparoscopy. The total numbers of high-intermediate- and high-risk endometrial cancer cases were 734 (45\%) patients in the laparotomy group and 307 (30.7\%) patients in the laparoscopy group. Disease-free and overall survivals were not statistically different when compared between laparoscopy and laparotomy groups in terms of low-, intermediate-, high-intermediate- and high-risk endometrial cancer. In conclusion, regardless of the endometrial cancer risk category, long-term oncological outcomes of the laparoscopic approach were found to be comparable to those treated with laparotomy. Our results are encouraging to consider laparoscopic surgery for high-intermediate- and high-risk endometrial cancer cases.
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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.