Objective: Nurses are the class of health professionals who can give women accurate information about cancer. The study was planned to research the demographic characteristics of the nurses and their knowledge level about screening tests, risk factors of breast, cervical and colorectal cancers and to reveal the state of awareness about symptoms and also their attitudes about screening tests. Material and Methods: The research was designed as a cross-sectional study among female nurses in a Foundation University Research Center. The data collection tool is the self administered questionnaires. Data was evaluated by the SPSS for Windows. All tests were two-sided and the difference between the results was considered significant when p is

Objective: Nurses are the class of health professionals who can give women accurate information about cancer. The study was planned to research the demographic characteristics of the nurses and their knowledge level about screening tests, risk factors of breast, cervical and colorectal cancers and to reveal the state of awareness about symptoms and also their attitudes about screening tests. Material and Methods: The research was designed as a cross-sectional study among female nurses in a Foundation University Research Center. The data collection tool is the self administered questionnaires. Data was evaluated by the SPSS for Windows. All tests were two-sided and the difference between the results was considered significant when p is

Purpose Laparoscopy has been used in evaluation of ovarian cancer to assess the extent and surgical resectability of the disease, and to avoid futile laparotomy, where primary cytoreduction is not suitable. Aim of this study is to investigate the contribution of laparoscopy in predicting 'no gross residue' in advanced stage ovarian cancer. Methods Data of advanced stage ovarian cancer patients, who underwent diagnostic laparoscopy for prediction of complete cytoreduction due to an alternative model, are analyzed retrospectively. Accordingly, in the absence of obvious mesenteric retraction or extensive tumoral implants on small intestine in laparoscopic assessment, cases were deemed surgically resectable, and the operation was continued with laparotomy to achieve complete cytoreduction. Clinical features of the patients, surgical details, complete and optimal cytoreduction rates, and perioperative complications were evaluated. Results Out of 243 patients with advanced stage ovarian/tubal/peritoneal cancer, laparoscopy was performed at 93 patients, 77 of whom underwent primary cytoreduction subsequently. Complete cytoreduction (no gross residue) and optimal cytoreduction (< 1 cm residual tumor) rates were 75.3 and 100%, respectively. None of the patients had suboptimal surgery. Morbidity and mortality rates were acceptable. Conclusion Laparoscopic evaluation prior to cytoreductive surgery can highly contribute to prediction of complete or optimal cytoreduction in suitable patients. However, experience and skills of the surgeon, as well as technical equipment of the center, may affect surgery; therefore, the model to predict residual tumor should be individualized according to the set up and the surgical team of each center.

Background: The purpose of this study is to investigate the effect of an adsorbent-antioxidant vaginal gel, which contains micronized silicon dioxide and antioxidant deflamin, on high-risk human papillomavirus (hr-HPV) clearance within the follow-up periods specified in the guidelines. Methods: In the study, the data of 52 patients infected with hr-HPV using vaginal gel for 3 months and 115 patients who were not using vaginal gel were analyzed retrospectively. Demographic characteristics, Liquid-Based Cytology (LBC) at the time of presentation, colposcopy findings, and cervical biopsy results of both groups were investigated. After the LBC and hr-HPV results were evaluated at the end of the control period, both groups were compared in terms of hr-HPV clearance. The level of statistical significance was taken as 0.05 in all tests. Results: The two groups had similar demographic data, cytological findings, colposcopy findings, and cervical biopsy results (p > 0.05). During similar follow-up periods (13.6 ± 3.2 vs. 14.1 ± 3.4 months; p > 0.05), there was no significant difference in terms of hr-HPV clearance (46.2% vs. 51.3%; p > 0.05). Furthermore, the initial and follow-up cytology results of the patients were similar (p > 0.05). Conclusions: A significant effect of the absorbent antioxidant vaginal gel on hr-HPV clearance at approximately 1-year follow-up could not be demonstrated.Background: The purpose of this study is to investigate the effect of an adsorbent-antioxidant vaginal gel, which contains micronized silicon dioxide and antioxidant deflamin, on high-risk human papillomavirus (hr-HPV) clearance within the follow-up periods specified in the guidelines. Methods: In the study, the data of 52 patients infected with hr-HPV using vaginal gel for 3 months and 115 patients who were not using vaginal gel were analyzed retrospectively. Demographic characteristics, Liquid-Based Cytology (LBC) at the time of presentation, colposcopy findings, and cervical biopsy results of both groups were investigated. After the LBC and hr-HPV results were evaluated at the end of the control period, both groups were compared in terms of hr-HPV clearance. The level of statistical significance was taken as 0.05 in all tests. Results: The two groups had similar demographic data, cytological findings, colposcopy findings, and cervical biopsy results (p > 0.05). During similar follow-up periods (13.6 ± 3.2 vs. 14.1 ± 3.4 months; p > 0.05), there was no significant difference in terms of hr-HPV clearance (46.2% vs. 51.3%; p > 0.05). Furthermore, the initial and follow-up cytology results of the patients were similar (p > 0.05). Conclusions: A significant effect of the absorbent antioxidant vaginal gel on hr-HPV clearance at approximately 1-year follow-up could not be demonstrated.

Could the Long-Term Oncological Safety of Laparoscopic Surgery in Low Risk Endometrial Cancer be also 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) Aim : to compare the long-term oncological outcomes of laparotomy and laparoscopic surgeries in endometrial cancer under the light of 2016 ESMO-ESGO-ESTRO risk classification system with particular focus on the high intermediate and high-risk categories. Methods : Using multicentric database 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 difference in survival rates. Results : 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 LT group and 307 (30.7%) patients in the LS 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. Conclusions : Regardless of the endometrial cancer risk category, long-term oncological outcomes of 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.

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.

Purpose: In this study, we evaluated the significance of parenchymal, hilar, and capsular involvement of the spleen with regard to the overall survival of patients who required a splenectomy during cytoreduction procedures for primary or recurrent cancer. Methods: This study includes data from 287 patients who underwent a splenectomy during optimal cytoreduction in epithelial ovarian, tubal, and peritoneal cancers. Spleen involvement regions were divided into four main groups, and the groups were classified as capsule, hilus, capsule + hilus, and other region involvement (paranchyma ± other(s) involvement site). The overall survivals of these four groups were compared. Results: The mean age of the study group was 57.9 years, and the mean follow-up period of the patients was 43.2 months. The splenic involvement site was most frequently observed as hilus + capsule (42.2% n:121). Splenic parenchymal involvement was present in 27.9% (n: 80) of the patients. The overall survival for patients was 42 months. In the subgroup analysis, the worst overall survival was found in the group with capsule involvement at 33 months . Conclusion: While parenchymal involvement of the spleen was considered to be stage IV according to FIGO staging, we could not detect low overall survival in patients with parenchymal involvement in our study. Our study, which has the largest number in the literature examining the relationship between splenic involvement and overall survival, can provide a remarkable perspective on the relationship between parenchymal involvement of the spleen and prognosis.

Study objective: To evaluate the postoperative anatomic and functional outcomes of patients who underwent laparoscopic nerve-sparing sacrocolpopexy or sacrocervicopexy for pelvic organ prolapse (POP) POP-Q stage III and IV apical prolapse, and to delineate the contributing factors for recurrence. Study Design and Classification: The file records of patients who underwent sacropexy in the last five years were reviewed retrospectively and compared in terms of preoperative and postoperative anatomic findings and symptoms. Patients: Patients who underwent laparoscopic nerve-sparing surgery for treatment of POP-Q Stage III and IV/prolapse of uterine or vaginal cuff were included. Interventions: Postoperative anatomic and functional outcomes were evaluated using POP-Q classification and urinary/anal function by questioning during visits. Results: The mean follow-up duration was 24.2 +/- 17.6 months. Anatomic recovery was achieved in 104 (90.4 %) cases. Advanced age (>= 70 years), longer duration of symptoms, and low body mass index were determined as parameters related to recurrence risk. (C) 2020 Elsevier Masson SAS. All rights reserved.

OZET: Amac : Laparoskopi ile Sistemik Para-aortik Lenfadenektomi (PAL) yapilan olgularda kullanilan teknik ve deneyimlerimizin sunulmasi Yontem: Endometrium kanseri nedeniyle sistemik PAL yapilan ardisik 100 vakanin geriye donuk incelenmesi yapildi. Bu kapsamda olgularin yas, vucut kitle indeksi (BMI), ek hastalik gibi ozellikleri ve operasyon suresi, cikarilan lenf nodlarinin sayisi, komplikasyon tip ve oranlari gibi operasyona ait bilgiler gozden gecirildi. Bulgular: Olgularin yas ortalamasi 59.3 ± 8.3, BMI( vucut kutle indeksi): 45.5 ± 6.7 olarak bulundu. Final histopatolojik degerlendirme sonuclari, evre IA: 80 (%80); IB: 11 ( % 11); II: 1(%1); IIIC1: 3(%3); IIIC2: 5(%5) olarak belirlendi. Ikisi sol renal vende biri inferior mezenterik arter (IMA) seviyesinin inferiorunda vena kava inferiorda (VKI) olmak uzere 3 olguda vaskuler yaralanma nedeniyle laparatomiye gecildi. Sonuc: Laparoskopik paraaortik lenfadenektomi belirli deneyimlerden sonra uygulanabilir bir yontem olarak gozukmektedir. Anahtar Kelimeler: Para-aortik, Laparoskopik Lenfadenektomi, Endometrium Kanseri EVALUATION OF FIRST 100 CASES IN LAPAROSCOPIC PARA-AORTIC LYMPHADENECTOMY AND TECHNIQUE ABSTRACT Purpose: To present our experience and technique used in systemic paraaortic lymphadenectomy (PAL) cases Methods: A retrospective review of 100 consecutive cases of systemic PAL for endometrial cancer was performed. In this context, demographic features of cases such as age, body mass index (BMI), and additional disease and information about the operation such as duration of operation, number of lymph nodes removed, types and rates of complications were reviewed. Results: The mean age of the cases was 59.3 ± 8.3, and mean BMI was 45.5 ± 6.7. Final histopathologic evaluation results were reported as stage IA: 80(80%); IB: 11(11%); II: 1(1%); IIIC1: 3 (3%); IIIC2: 5 (5%). Laparotomy due to vascular injury was performed at three cases, two of whom had left renal vein injury and one of whom had vena cava inferior (VCI) injury below the level of inferior mesenteric artery (IMA). Conclusion: Laparoscopic paraaortic lymphadenectomy appears to be a feasible method after certain experiences. Key Words: Paraaortic, Lymphadenectomy, Endometrial Cancer.

Objective: To define normal values of second trimester fetal corpus callosum (CC) length and width in a low-risk population and to compare the presented nomograms to those in the literature. Methods: The prenatal records of singleton fetuses who underwent second trimester anomaly screening at 18.0–22.0 weeks of pregnancy were retrospectively analyzed for CC width and length. A total of 710 fetuses, whose anomaly scans were completely normal, were included in the study. The correlations between CC and biparietal diameter (BPD), head circumference (HC) and gestational age (GA) were evaluated. Results: At 18.0–22.0 weeks of pregnancy, the mean CC length was 19.7±2.8 mm, while the mean CC thickness was 1.98±0.4 mm. In assessment of the correlations between the CC length and thickness values and the HC, BPD and GA values by Pearson’s correlation coefficient, there was a stronger correlation between the CC length measurements and the BPD, HC and GA values (r=0.233 vs r=0.505, p<0.001). Conclusion: Assessment of the presence of corpus callosum as well as its length and thickness during routine fetal anomaly evaluation may be important owing to the relationship between corpus callosum measurements and certain neurological disorders. Studies indicate that populations should create their own nomograms due to different values reported in the literature.

78 Ovarian carcinosarcoma (OCS), accounting for only 1-4% of all ovarian malignancies, is a rare neoplasm characterized by sarcomatous and epithelial elements.1-3 Some authors have proposed that OCSs originate from the müllerian epithelium and then differentiation/metaplasia to a sarcomatous structure, supporting the hypothesis that OCS is a metaplastic epithelial carcinoma.4-6 OCS is highly aggressive and has a poor prognosis, presenting with a disease that has spread beyond the ovary in up to 90% of cases at Optimal Cytoreduction is an Independent Prognostic Factor in Ovarian Carcinosarcoma: A Turkish Gynecologic Oncology Group Study

Objective: Although extensive screening methods had been developed, cervical cancer remains to be an essential health problem. Early detection and administration of appropriate therapy is still a lifesaving procedure, especially for cervical cancer. The most common screening method for cervical cancer is still the cervical cytology (Pap-test). We aim to find out the advantages and disadvantages of a recently developed method, which is called as Polar Probe. Methods: Two different approaches had been used (conventional Pap test and Polar Probe), and 1438 patients were included in the study. Of these, 819 had been screened with Polar Probe. All eligible patients were firstly screened using Polar Probe and then using the Pap test. Each patient with an abnormal Polar Probe result was referred to colposcopy room, where she was re-evaluated using colposcopy. Results: The rate of abnormal smear result was 1.04%, and the corresponding percentage was calculated as 0.62% in LSIL, 0.34% in ASCUS, and 0.069% in HSIL. A total of 819 patients underwent Polar Probe, and the results were abnormal in 261 patients and normal in 558 patients. Abnormality rate was 1% in Pap test and 31.9% in Polar Probe. Although the positive predictive value was 27% for Polar Probe test and 16% for Pap test, as the colposcopy was indicated only for the patients with abnormal results in Polar Probe. The need for colposcopy dramatically increased with the use of Polar Probe. Conclusion: Use of Polar Probe alone was not found to be cost effective. Combination with other methods of screening would decrease the cost of the process.

Objective: The objective of this retrospective observational study is to analyse the properties of laparoscopic hysterectomy cases that are performed for benign indications and also endometrial cancer indications. Operation time, postoperative complicaton rate, blood transfusion need, and hospitalization time are compared according to benign and malign indications and also body mass index of the patients. Material and methods: Patients who were operated between September 2012 and December 2017 are included in this study. Patients' age, body mass index, medical histories, operation indications, operation time, pathology reports, pre and postoperative hemoglobine values and postoperative complications are obtained from medical records.Body mass index is classified as underweight for <19 ; normal for 19-25 ; overweight for 25-30 and obese for >= 30. Results: Operation and hospitalization times were significantly higher for high BMI and malign gynecologic indication groups than lower BMI and benign gynecologic indication groups (p:0.0001). Complication rates and transfusion needs were similar in between malign and benign gynecologic disease groups (p :0.443; P:0.670 respectively) and also in between high and lower BMI groups (P:0.813 ; P:0.468 respectively). Conclusion: Laparoscopic approach for hysterectomy operations in high BMI patients and endometrial cancer patients seem to be safe in terms of postoperative complication and bleeding that necessitate transfusion. (C) 2019 Elsevier Masson SAS. All rights reserved.

Objective: The purpose of this study was to determine the patterns of failure and prognostic factors for lymphovascular space invasion (LVSI)-positive endometrioid endometrial cancer (EC) patients in the setting of negative lymph nodes (LNs). Materials and methods: A multicenter, retrospective department database review was performed to identify LVSI-positive patients with disease surgically confined to the uterus at two gynecologic oncology centers in Turkey. Demographic, clinicopathological and survival data were collected. Results: We identified 185 LVSI-positive women with negative LNs during the study period. Fifty-five (29.7%) were classified as Stage IA, 94 (50.8%) as Stage IB, and 36 (19.5%) as Stage II. The median age at diagnosis was 59 years and the median duration of follow-up was 44 months. The total number of the recurrences was 12 (6.5%). We observed 5 (2.9%) loco-regional recurrences, 3 (1.5%) retroperitoneal failures, and 4 (2.0%) distant relapses. The 5-year progression-free survival (PFS) was 86.1% while the 5-year overall survival (OS) rate was 87.7%. Grade 3 histology (Hazard Ratio [HR] 2.9, 95% Confidence Interval [CI] 1.02-8.50; p = 0.04), cervical stromal invasion (HR 4.5, 95% CI 1.61-12.79; p = 0.004) and age > 60 years (HR 5.8, 95% CI 1.62-21.32; p = 0.007) were found to be independent prognostic factors for decreased OS. Adjuvant treatment did not appear as a prognostic factor for OS even in univariate analysis. Conclusion: The recurrence rate among LVSI-positive endometrioid EC patients is low in the setting of negative LNs. However, one out of three patients with a recurrence experiences distant relapses which usually portend worse outcomes. (C) 2018 Taiwan Association of Obstetrics & Gynecology. Publishing services by Elsevier B.V.

Introduction/Background In this study we aimed to compare the long-term oncological outcomes of laparotomy (LT) and laparoscopic (LS) surgeries in endometrial cancer under the light of 2016 ESMO-ESGO-ESTRO risk classification system, focusing on the high intermediate and high-risk categories. Methodology Using multicentric database, overall (OS) and disease-free survivals (DFS) of 2745 endometrial cancer cases were compared according the surgery route, laparotomy vs laparoscopy. A sub-analysis was performed considering the 2016 ESMO-ESGO-ESTRO risk classification for endometrial cancer. Thus, high intermediate and high-risk patients were grouped and a comparison was made between the groups. Results Among the enrolled patients 1743 (63.5%) were operated by laparotomy and 1002 (36.5%) were operated with laparoscopy. The total number of high intermediate and high-risk endometrial cancer cases was 734 (45%) patients in the LT group and 307 (30.7%) patients in the LS group. OS and DFS were not statistically different when compared between LS and LT groups in terms of low, intermediate, high intermediate and high-risk endometrial cancer. Conclusion Regardless of the endometrial cancer risk category, long-term oncologic outcomes of LS were found to be comparable to those treated classically with LT. Our results are encouraging for primarily considering laparoscopic surgery for high intermediate and high-risk endometrial cancer cases in order to minimize surgical morbidity, as adjuvant therapies will mostly be offered to this population. It should be strongly emphasized that this suggestion is limited to gynecological oncology centers with high laparoscopical experience. Disclosure Nothing to disclose.

Objective: In this study, we aimed to evaluate the clinicopathological features, obstetric, and oncological outcomes of patients diagnosed with a uterine smooth muscle tumors of uncertain malignant potential (STUMP). Methods: A dual-institutional, database review was carried out to screen patients with STUMP who were treated with upfront surgery between January 2006 and December 2017. Data including age at the time of diagnosis, recurrence rate, disease-free survival, overall survival, and fertility outcomes were retrospectively analyzed. Results: Fifty-seven patients with STUMPs were included in the study. The median age at the time of diagnosis was 42 (range, 16 to 75) years. The median follow-up was 57 (range, 16 to 125) months. Eight patients (14%) had recurrence during follow-up. Recurrent STUMPs were seen in seven patients and leiomyosarcoma after 14 months in one patient. Seven patients with a recurrent STUMP survived, while the remaining patient died. Recurrence rates were similar for women who underwent myomectomy and those who underwent hysterectomy. The presence of uterine localization of tumor (subserosal vs intramural-submucosal) statistically significantly affected recurrence rates (odds ratio=5.72; 95% confidence interval=1.349-24.290; p=0.018). Ten of 27 patients who underwent myomectomy for uterine myoma had fertility desire. Seven pregnancies were recorded. Conclusions: Our study results suggest that fertility-sparing approaches are feasible in patients with STUMP, although recurrence may be seen.

INTRODUCTION:We aimed to assess risk factors for lymph node (LN) metastasis among lymphovascular space invasion(LVSI)-positive women with pure endometrioid endometrial cancer (EC) clinically confined to the uterus.METHODS:Medical records of women who underwent primary surgery for EC between 2007 and 2016 at either of 2 gynecological oncology centers were retrospectively reviewed. Patient data were analyzed with respect to LN involvement, and predictive factors for LN metastasis were investigated.RESULTS:280 patients with surgically staged endometrioid-type EC with LVSI were identified. LN involvement was detected in 88 patients (31.4%) with a systematic LN dissection. In multivariate analysis, elevated baseline serum CA 125 levels, deep myometrial invasion (MMI), adnexal involvement and positive peritoneal cytology were found to be independent risk factors for LN metastasis. In women without deep MMI and elevated baseline serum CA 125 levels, the rate of LN metastasis was 19%. The presence of solely deep MMI increased this probability up to 29.1%. The rate of LN metastasis was found to be 46.8% for women with both deep MMI and elevated baseline serum CA 125 levels.CONCLUSION:These findings may be useful in the decision-making process for LVSI-positive women who are unstaged.

The purpose of this study was to compare the prognoses of women with pure ovarian clear cell carcinoma (OCCC) arising from endometriosis to those of women with pure OCCC not arising from endometriosis treated in the same manner.

Objective: Osteogenesis imperfecta (OI) is a genetic disorder in which collagen synthesis is defective. It causes skeletal anomalies, and fragility in bones and tissues. In this case report, we aimed to present the gestational management of an OI patient and to discuss potential complications. Case: Thirty-six-year-old patient diagnosed with Type I OI was followed up in our center due to her spontaneous pregnancy. A mutation was identified in COL1A1 gene of the patient. It was seen in her analysis by chorionic villus sampling that her fetal karyotype and COL1A1 gene were normal, and no pathology was found in the obstetric ultrasonography examinations. Fetal lung maturation of the patient, whose pain, respiratory distress and dyspeptic complaints increased as the week of gestation progressed, was evaluated by performing amniocentesis at 34 weeks of gestation, and a healthy baby was delivered by cesarean section at 35 weeks of gestation. Conclusion: The concern of transferring genetic structure, difficulty of carrying pregnancy due to anatomic deformity and frequent gestational and labor complications are the major problems of OI patients. Genetic consultancy should be offered such patients and their followup procedures should be carried out by a multidisciplinary approach.