Browsing by Author "Yetimalar M.H."

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Does Cervicovaginal Cytology Have a Role in the Diagnosis and Surveillance of Endometrial Adenocarcinoma?
(John Wiley and Sons Inc., 2020) Kilic D.; Yetimalar M.H.; Bezircioglu I.; Yigit S.; Yigit, Seyran; Kilic, Derya; Bezircioglu, Incim; Yetimalar, Mehmet Hakan
Objective: To examine the role of cervicovaginal cytology in diagnoses and surveillance of the patients with endometrial carcinoma (EC). Methods: Patients who underwent EC surgery that included a follow-up were reviewed retrospectively. The cohort was limited to the patients who had an available cervical cytology result within 12 months before the primary surgery took place. The glandular abnormalities were classified in the following subclassifications: “atypical glandular cells” (AGC)-not otherwise specified (NOS), AGC-favor neoplasia, endocervical AIS, and adenocarcinoma. Results: A total of 411 patients were eligible for the study. The cervical cytology was found to be normal and recorded as negative for intraepithelial lesion or malignancy in 368 (89.5%) patients. In 43 (10.5%) patients, cervical cytology was interpreted as: AGC-NOS (n = 11), AGC-FN (n = 7), adenocarcinoma (n = 20), malignant epithelial tumor (n = 3), and squamous carcinoma (n = 2). During the follow-up, recurrence was observed in 53 (12.9%) patients. Among six isolated vaginal cuff recurrences, two of the cases presented with malignant cytology, and the additional four cases were suspected during clinical examination. Among women with recurrence (n = 53), there were malignant cytological findings in four of the patients. In the whole population (n = 411), there were four other abnormal cytological findings detected within the surveillance. These four cytology results were nonmalignant and no recurrence was identified. Conclusion: There is no significant clinical advantage of cervicovaginal cytology testing before diagnosis or during the surveillance of EC. © 2020 Wiley Periodicals, Inc.
Factors Affecting the Prognosis and Overall Survival in Patients With Uterine Papillary Serous Carcinoma
(Journal of Clinical and Diagnostic Research, 2018) Bezircioglu I.; Yetimalar M.H.; Kilic D.
Introduction: Uterine Papillary Serous Carcinoma (UPSC) is a prototype of Type II Endometrial Cancers (EC) and represents 5-10% of all EC. It is clinically aggressive and responsible for over 50% of relapses and deaths in EC patients. Aim: To investigate factors affecting the overall survival in patients with UPSC. Materials and Methods: Forty-three women treated for UPSC between January 2006 and October 2015 were analysed retrospectively. Subjects were included if histology revealed a minimum of 10% component of serous carcinoma. Patients who required neoadjuvant therapy were excluded. All women underwent surgical treatment with at least total hysterectomy and bilateral salpingo-oophorectomy. The effect of age, tumour size, myometrial invasion, presence of malignant peritoneal cytology, lymph node metastasis, presence of the tumour outside the uterus and in the upper abdomen on the survival were investigated. The Kaplan-Meier method was used for survival analysis. Univariate analysis was used to evaluate the importance of each parameter and log rank test was used for significance. Significant parameters were analysed by multivariate Cox regression. Results: Forty-three patients diagnosed and treated for UPSC were analysed. Out of them, 38 (88.4%) underwent surgical staging. Relapse and disease progression despite therapy was observed in 9 (20.9%) cases. The overall survival was estimated to be 46.5%. Conclusion: The present study demonstrated that myometrial invasion, lymphovascular space involvement, and presence of a tumour in the upper abdomen were statistically significant parameters affecting the overall survival in UPSC patients. © 2018, Journal of Clinical and Diagnostic Research. All rights reserved.
Citation - Scopus: 3
The Impact of Uterine Adenomyosis on the Histopathological Risk Factors and Survival in Patients With Endometrial Adenocarcinoma
(Taylor and Francis Ltd., 2022) Yetimalar M.H.; Kilic D.; Bezircioglu I.; Yigit S.; Yigit, Seyran; Kilic, Derya; Bezircioglu, Incim; Yetimalar, Mehmet Hakan
A retrospective cohort study was performed on patients diagnosed with endometrial adenocarcinoma (EC) during a 9-year period to investigate the impact of co-existing adenomyosis on patients with EC. Group A included women with EC and adenomyosis and Group B EC cases without the presence of adenomyosis. Group A was more likely to have early-stage disease, tumours without deep myometrial invasion, low-grade tumours and tumours with negative lymphovascular space invasion when compared to Group B (p = 0.012, p = 0.004, p < 0.001, p = 0.02). There were no statistically significant difference between Group A and Group B for lymph node metastasis (p = 0.064). There was no significant relation between the adenomyosis and survival outcomes in the multivariant analysis (p = 0.437). As a conclusion, patients with adenomyosis were more likely to accompany good histopathologic prognostic factors. Multivariate analysis showed no significant effect of adenomyosis on recurrence and survival parameters.IMPACT STATEMENTWhat is already known on this subject? Adenomyosis is one of the most common accompanying benign histopathological findings of type 1 endometrial carcinomas (EC). Adenomyosis comprises some characteristics similar to malignant tumours, such as invasion, abnormal tissue growth and angiogenesis. Despite concerns have arisen due to both their high incidence and similar molecular links, the possible relation between EC and adenomyosis is still not well grounded. What the results of this study add? We presented a 9-year period retrospective cohort of a tertiary referring single centre and evaluated the prognostic effect of adenomyosis in patients with EC as well as the survival outcomes of these patients. The co-occurrence of adenomyosis was more likely to accompany early-stage (stages 1–2) disease, low-grade tumours (grades 1–2) and tumours with negative LVSI in patients with EC. However, multivariate and survival analysis showed no significant effect of adenomyosis on recurrence and survival parameters. What the implications are of these findings for clinical practice and/or further research? Based on these findings, we suggest that the presence of adenomyosis should not be considered as a prognostic factor in EC. Our results support the overriding opinion about the prognostic value of co-occurrence of adenomyosis and EC. However, further studies exploring the molecular and genomic markers in these two groups are needed to uncover the exact relation of adenomyosis on the prognosis of EC. © 2022 Informa UK Limited, trading as Taylor & Francis Group.
Post Hysterectomy Occurrence of Endometrial Adenocarcinoma in Association With Granulosa Cell Tumour: a Case Report
(Taylor and Francis Ltd, 2017) Bezircioglu I.; Yetimalar M.H.; Ocal I.
[No abstract available]