OBJECTIVE:This study aimed to assess the predictive performance of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Surgical Risk Calculator in estimating 30-day post-operative complications and mortality among patients undergoing elective gynecologic oncology surgery. METHODS:This single-center retrospective cohort study included 789 patients who underwent elective gynecologic oncology surgery at a tertiary center between January 2016 and February 2025. Pre-operative data for 19 risk factors included in the ACS NSQIP calculator were extracted from patient records. Individual complication risks were calculated and compared with actual post-operative outcomes using binary logistic regression analysis, receiver operating characteristic curve analysis, and the Brier score. RESULTS:Severe complications, defined on the basis of ACS NSQIP composite criteria, occurred in 6.5% of patients, while "any complication" was observed in 10.1%. The ACS NSQIP model demonstrated excellent predictive performance for mortality (area under the curve [AUC] = 0.965, Brier = 0.006), good performance for cardiac complications (AUC = 0.885), although calibration was moderate (Brier = 0.077), and acceptable performance for venous thromboembolism (AUC = 0.789, Brier = 0.006). The model showed acceptable discrimination and calibration for serious complications (AUC = 0.701, Brier = 0.057), whereas predictive accuracy for "any complication" was fair but statistically significant (AUC = 0.657, Brier = 0.086). Acceptable discriminatory performance was also observed for surgical site infection (AUC = 0.776, Brier = 0.037) and re-operation (AUC = 0.725, Brier = 0.011). In contrast, despite moderate AUC values, predictive performance for renal failure and pneumonia was limited, as associations were not statistically significant in logistic regression analyses. The model performed poorly for sepsis, urinary tract infection, and re-admission. CONCLUSIONS:The ACS NSQIP Surgical Risk Calculator provides a clinically applicable tool for pre-operative risk assessment in gynecologic oncology surgery, particularly for predicting mortality and selected systemic complications, including cardiac events and venous thromboembolism.

OBJECTIVES: LBN is a rare variant of uterine smooth muscle tumors. Although LBN is a benign variant of leiomyoma, recurrent cases have been reported. In our study, we aimed to evaluate the clinicopathological features of LBN cases and to define the characteristics of recurrent cases. MATERIAL AND METHODS: Seventy-six cases with LBN identified in the final pathology were included in the study. The patients’ physical examination findings, imaging reports, postoperative complications, and medical data related to recurrence, metastasis, disease-free survival, and overall survival after LBN diagnosis were retrospectively evaluated. An immunohistochemical evaluation of the cases was conducted. RESULTS: Average patient age: 42.3 years. Myomectomy: 46.1%; hysterectomy: 53.9%. Mean follow-up: 40.4 months. Recurrence: 2 cases (2.6%), both in the uterus and myomectomy group. Post-myomectomy pregnancies: 8 out of 35 cases (22.9%). Mitotic count: 2.7. ER positivity: 30%; PR positivity: 33.8%. Ki-67: negative in 56.6%, focal positivity in 42.1%, diffuse positivity in 1.3%. p16 positivity: 14.5%; p53 positivity: 22.4%. PHH3 distribution: various levels from 0/10 to 9/10 BBA. Both recurrences managed with myomectomy, identified as LBN recurrences. CONCLUSIONS: LBN is a rare type of uterine smooth muscle tumor with a low recurrence rate, primarily affecting women of reproductive age, making conservative treatments like myomectomy appropriate. However, concerns about morcellation remain. While immunohistochemistry markers and the mitotic index help differentiate between LBN and LMS, their effectiveness in predicting recurrence and prognosis in LBN is limited.

Background/Objectives: Uterine adenosarcoma is a rare uterine malignancy with limited evidence on prognostic factors and long-term outcomes. We aimed to evaluate clinicopathological characteristics, treatment patterns, oncologic outcomes, and prognostic factors associated with disease-free survival (DFS) and overall survival (OS) in patients with uterine adenosarcoma. Methods: This multicenter retrospective cohort study included 43 patients with histopathologically confirmed uterine adenosarcoma who underwent primary surgery at seven tertiary referral centers in Türkiye between 2016 and 2026. Clinicopathological features, treatment modalities, recurrence patterns, and survival outcomes were assessed. Survival was analyzed using Kaplan–Meier and log-rank methods, and multivariable Cox proportional hazards regression was performed to identify independent prognostic factors. Results: The mean age at diagnosis was 59.1 ± 10.8 years, and 83.7% of patients were postmenopausal. Pelvic pain (62.8%) and abnormal uterine bleeding (60.5%) were the most common presenting symptoms. Most patients (79.1%) underwent laparotomy, and 79.1% had stage I disease. Sarcomatous overgrowth (SO) was present in 44.1% and lymphovascular space invasion (LVSI) in 18.6%. During a median follow-up of 72 months, 34.9% experienced recurrence, most commonly in the pelvis. The five-year DFS and OS rates were 59.9% and 80.4%, respectively. SO was independently associated with DFS (HR 4.41, 95% CI 1.21–16.08; p = 0.025) and OS (HR 10.23, 95% CI 1.16–89.80; p = 0.036), while LVSI was independently associated with OS (HR 11.17, 95% CI 1.34–93.14; p = 0.026). Conclusions: Uterine adenosarcoma showed favorable long-term survival but substantial recurrence risk. SO and LVSI may have potential prognostic relevance and could contribute to postoperative risk assessment and individualized follow-up.

Objective: We aimed to compare the oncological outcomes of patients with bilateral sentinel lymph nodes (SLNs) detection and removed with those who underwent pelvic lymphadenectomy (PLA) in addition to bilateral SLNs removal. Methods: This multicenter, retrospective study included cases of endometrioid type, grade I-II endometrial cancer, in which bilateral SLNs were detected and removed. Patients who had only bilateral SLNs detected and removed (group I) and patients who had bilateral SLNs detected and removed and subsequent additional bilateral PLA (group II) were included in the evaluation. Results: In group I (n=216), SLN metastasis rate was 5.5% and in group II (n=251), it was 10.3%. The low-volume disease detection rate was 4.6% in group Iand 4.8% in group II. In group II, in patients with SLN macrometastasis had also 28.6% non-SLN macrometastasis. No false-negative results occurred in group II. Recurrence was detected 1.8% in group Iand 5% in group II; however, there was no significant difference (p=0.083). Disease-free survival and overall survival, were almost same between the groups (hazard ratio [HR]=2.11; 95% confidence interval [CI]=0.681-6.588; p=0.187) and (HR=1.531; 95% CI=0.392-5.975; p=0.537), respectively. Conclusion: SLN mapping, ultrastaging, and immunohistochemical staining can identify low-volume metastases that may not be identified with classic lymphadenectomy and hematoxylin & eosin staining. It has been observed that adding PLA beyond SLN mapping did not provide an additional positive contribution to survival. For endometriod type grade I-II patients, detection of bilateral SLNs in both hemipelvis only, if detectable, is an adequate approach.

Background/objectives: The study aimed to present cases of malignant struma ovarii from seven centers in Türkiye and evaluate them within the context of the existing literature. Methods: We retrospectively analyzed clinical data from 17 patients treated at seven centers, focusing on clinical features, surgical management, pathology, thyroid function, adjuvant treatment, and outcomes. Additionally, a literature review including eight studies with 178 patients was conducted. Results: The mean age of patients was 44.7 years, with a mean tumor size of 9.2 cm. Elevated Ca 125 was found in 33.3% of patients, while thyroid function abnormalities and hyperthyroidism signs were rare. Pelvic pain and menstrual irregularities were common presenting symptoms. A total of 16 patients (94.1%) had unilateral tumors. Total abdominal hysterectomy with bilateral salpingo-oophorectomy and unilateral salpingo-oophorectomy were the most frequent surgical approaches. Histopathology predominantly showed classical papillary thyroid carcinoma (13 patients, 76%). All patients were FIGO stage I, with no metastasis. Thyroidectomy was performed in seven patients, identifying two concurrent thyroid cancers. Four patients received adjuvant radioactive iodine therapy. During a median follow-up of 43 months, no deaths and one recurrence were observed. The literature review showed a diagnosis age ranging 43–53 years and papillary thyroid carcinoma as the most common subtype. Thyroidectomy and RAI treatment were selectively applied. Among the reported studies, recurrence occurred in 7 of 76 patients (9.2%), while 5-year disease-free and overall survival rates exceeded 94% and 100%, respectively. BRAF mutations were uncommon. Conclusions: Malignant struma ovarii is a rare tumor with a favorable prognosis when diagnosed early and managed appropriately.

Background: The aim of this study was to determine the association of clinicopathological features with disease-free survival (DFS), overall survival (OS), and Cyclooxygenase-2 (COX-2) expression in ovarian cancer patients. Methods: Data from 74 ovarian cancer patients were retrospectively reviewed. COX-2 expression was determined by an immunohistochemical method. Kaplan-Meier and Cox regression analysis were performed to determine the relationship between clinicopathological features of the patients and DFS and OS. Results: Recurrence was observed in 31 (41.9%) patients, and 9 (12.2%) patients died during the study period. OS of patients with postoperative residual volume >1 cm (p < 0.001), OS of chemotherapy-resistant patients (p = 0.001), and OS of stage III-IV patients (p = 0.056) were lower. Age, histological subtype, stage, and chemotherapy resistance were predictors of DFS, while chemotherapy resistance was predictive of OS. Thirty-nine (52.7%) patients were COX-2 positive and COX-2 positivity in Stage III-IV ovarian cancer was significantly higher than in Stage I-II ovarian cancer (p = 0.032). CA125 level, tumor size, number of patients with ascites, number of patients with residual >1 cm, and number of stage III patients were numerically higher in COX-2 positive ovarian cancer patients than in COX-2 negative ovarian cancer patients. DFS and OS in COX-2 positive ovarian cancer patients were numerically lower than in COX-2 negative ovarian cancer patients. However, these differences were not statistically significant. Conclusion: The higher COX-2 positivity in stage III-IV ovarian cancer suggests that COX-2 may contribute to cancer progression. Larger sample size studies are needed to clarify the relationships between COX-2 expression and ovarian cancer progression.

Background/Objectives: Ovarian germ cell tumors are rare, and determining prognostic factors is crucial for individualizing management strategies. We aimed to determine an optimal neutrophil-to-lymphocyte ratio (NLR) cut-off value for predicting survival outcomes in malignant ovarian germ cell tumors, and to evaluate the prognostic significance of NLR in these tumors. Methods: This retrospective cohort study included women diagnosed with malignant ovarian germ cell tumors who underwent surgery at Istanbul University-Cerrahpasa between 2000 and 2024. Patients with benign tumors; incomplete follow-up; inaccessible data; history of hematological or rheumatic diseases; inflammatory conditions such as diabetes mellitus, asthma, or renal failure; as well as those with acute/chronic infections or sepsis were excluded. Data collected included demographic characteristics, surgical and pathological findings, chemotherapy details, disease progression, survival outcomes, and laboratory values at preoperative, postoperative, and post-chemotherapy time points. The NLR was calculated and compared for overall survival and disease-free survival. Results: The study included 44 patients with a pathologically confirmed diagnosis of malignant ovarian germ cell tumors. The NLR cut-off value for survival prediction was determined as 3.69 using the ROC curve. The effect of preoperative NLR on overall survival was found to be significant. The median overall survival was significantly lower in the group with NLR ≥ 3.69 (153.2 months) compared to the group with NLR < 3.69 (234 months) (p = 0.010). However, there was no statistically significant difference in median disease-free survival between the NLR ≥ 3.69 group (159.3 months) and the NLR < 3.69 group (215 months). Conclusions: The preoperative NLR was found to have a significant impact on overall survival but not on disease-free survival. A cut-off value of 3.69 can be used to assess short survival time.

Background: Endometrial cancer (EC) incidence is increasing. This study determined prognostic factors for disease-free survival (DFS) and overall survival (OS) in EC patients from a single tertiary center over 22 years. Methods: 1028 patients who underwent surgery for EC between 2000-2022 were evaluated retrospectively using International Federation of Gynecology and Obstetrics (FIGO) 2009 staging. Statistical analysis included Kaplan-Meier survival analysis and Cox proportional hazards regression modeling. Results: 899 (87.7%) patients had endometrioid histology. Grade distribution: 475 (46.2%) grade 1, 371 (36.1%) grade 2, 170 (16.75%) grade 3. FIGO staging: 833 (81.0%) stage I, 71(7%) stage II, 87 (9%) stage III, 31 (3.0%) stage IV. 368 (35.8%) patients had >= 50% myometrial invasion, 130 (12.7%) cervical involvement, 384 (37.4%) lymphovascular space invasion (LVSI), 80 (7.8%) lymph node metastases. Risk classification: 520 (50.6%) low risk, 195 (19.0%) intermediate risk, 121 (11.8%) high-intermediate risk, 190 (18.6%) high risk. Lower OS and DFS rates were significantly associated with non-endometrioid histology, advanced stage, high grade, high risk classification, >= 50% myometrial invasion, cervical involvement, lymph node metastases, and LVSI (all p <0.001). In multivariate analysis, independent DFS prognostic factors were FIGO stage (hazard ratios (HR): 4.37 for stage II, HR: 8.68 for stage III, both p < 0.001) and tumor grade (HR: 2.26 for grade 2, p = 0.039; HR: 4.52 for grade 3, p < 0.001). Independent OS prognostic factors were risk classification (HR: 2.12 for intermediate-high risk, p = 0.031; HR: 2.75 for high risk, p = 0.003) and tumor grade (HR: 1.86 for grade 2, p = 0.024; HR: 2.71 for grade 3, p = 0.002). Median follow-up was 84 months. Conclusions: FIGO staging, tumor involvement, LVSI, and lymph node metastases significantly affected survival outcomes. These findings support comprehensive surgical staging and histopathological assessment for prognostic stratification.

OBJECTIVE:To identify molecular subgroups in endometrioid endometrial cancer (EEC), evaluate their association with clinicohistopathological characteristics, and define low-intermediate risk groups by integrating these parameters. METHODS:This retrospective-cohort study included 1,040 patients who underwent surgery between January 2000 and June 2022. Among 900 EEC cases, 72 recurred. Patients with tumor recurrence (n=62) and those without (n=52) were matched. POLE exons 9-14 were examined using Sanger sequencing. p53 and mismatch repair (MMR) protein expression were assessed via immunohistochemistry. RESULTS:The molecular subgroups were POLE mutation (POLE-mut) 5%, mismatch repair-deficient (MMR-d) 43%, p53 mutation (p53-mut) 5%, and non-specific molecular profile (NSMP) 42%. 5% of cases displayed multiple molecular mutations. POLE-mut were more prevalent in high-grade tumors (p=0.026). MMR-d tumors exhibited higher rates of lymphovascular space invasion and myometrial invasion ≥50% (p=0.032, p=0.020). No recurrences occurred in POLE-mut tumors (p=0.002), while MMR-d was significantly associated with recurrence (p=0.002). Median disease-free survival (DFS) for MMR-d, p53-mut, and NSMP were 34, 49, and 107 months, respectively. Median overall survival (OS) for these groups was 128, 102, and 181 months. Multivariate Cox-regression analysis employing the Backward-Stepwise method identified stage as the strongest predictor of DFS, and grade and stage as predictors of OS. CONCLUSION:POLE mutations were linked to the most favorable molecular prognostic factor. NSMP cases showed the longest DFS and OS, while p53-mut had the shortest OS. Except for POLE, molecular features alone were insufficient for establishing risk groups, highlighting the continued importance of histopathology in EEC management.

OBJECTIVE:This research was undertaken to identify risk factors for the involvement of sentinel lymph nodes (SLNs) in cases of endometrial cancer. METHODS:From February 2016 to April 2021, the cases of 874 women with endometrial cancer treated with the SLN algorithm at 11 institutions were analyzed in this retrospective study. Clinical and pathologic data were reviewed, and logistic regression was applied to identify predictive factors for SLN involvement. RESULTS:After the exclusion of 81 patients, the remaining cohort of 793 patients was analyzed. The involvement of SLNs occurred in 9.2% of these cases (n = 73). In univariate analysis, the risk of SLN involvement was seen to be significantly higher among patients aged >60 years and those with high-grade tumors, non-endometrioid histology, lymphovascular space invasion, deep myometrial invasion, tumor diameters of ≥2 cm, and cervical stromal invasion. Multivariate analysis identified the occurrence of deep myometrial invasion (OR 2.42, 95% CI 1.29 to 4.56; p = .006), cervical stromal invasion (OR 2.18, 95% CI 1.13 to 4.21; p = .020), and lymphovascular space invasion (OR 7.27, 95% CI 3.82 to 13.81; p < .001) as risk factors independently predictive of SLN involvement in the treatment of endometrial cancer. CONCLUSION:Deep myometrial invasion, cervical stromal invasion, and lymphovascular space invasion were found to be independently predictive of the involvement of SLNs in cases of endometrial cancer. For cases in which SLN dissection was not or could not be performed, the identified independent risk factors are crucial for guiding adjuvant therapy.

Objective The aim of this study was to investigate the impact of adjuvant treatments, factors influencing recurrence, and survival data in patients with 2023 International Federation of Gynecology and Obstetrics (FIGO) stage IIB endometrial cancer. Methods A retrospective analysis was conducted on patients with endometrial cancer who underwent surgery between 2005 and 2022 at seven different centers in Turkey. Demographic, clinicopathological, and survival data were collected and analyzed. Results Among 7323 patients, 565 (7.7%) were classified as 2023 FIGO stage IIB based on pathological results. Of 565 patients, 214 were followed without receiving adjuvant treatment, while 335 (95.4%) received adjuvant radiotherapy, and 16 (4.6%) received radiotherapy and chemotherapy. The locoregional recurrence rate was higher in patients with a tumor size >4 cm (p=0.038) and myometrial invasion >50% (p=0.045). In patients with distant metastasis, the recurrence rate was lower in those with myometrial invasion <50% compared with myometrial invasion ≥50% (p=0.031). The impact of adjuvant treatment on endometrial cancer patients revealed no significant differences for both disease free survival (p=0.85) and overall survival (p=0.54). Subgroup analyses showed that in patients with deep myometrial invasion, adjuvant treatment was associated with a significant increase in overall survival (p=0.044), but there was no effect on disease-free survival (p=0.12). Conclusions Patients with stage IIB endometrial cancer with myometrial invasion ≥50% were more likely to have locoregional and distant metastases. Adjuvant radiotherapy or chemoradiotherapy did not demonstrate an overall survival benefit in these patients.

Introduction: The aim of this study was to compare the disease-free survival (DFS) and overall survival (OS) of patients who underwent interval cytoreductive surgery after 3-4 cycles or 6 cycles of neoadjuvant chemotherapy (NACT) in advanced epithelial ovarian cancer patients. Methods: Out of 219 patients with advanced epithelial ovarian cancer, 123 patients received 3-4 cycles and 96 patients received 6 cycles of platinum-based NACT. Afterward, laparotomy was performed for interval cytoreductive surgery. Results: No statistically significant difference was found for DFS and OS of the patients who received 3-4 cycles and those who received 6 cycles of NACT (HR: 1.047, 95.0% CI [0.779-1.407]; p: 0.746 for DFS, and HR: 1.181, 95.0% CI [0.818-1.707]; p: 0.368 for OS). Evaluating 123 patients who received 3-4 cycles of NACT, 87 patients (70.7%) without macroscopic residual tumor after interval cytoreductive surgery had significantly longer DFS and OS compared to 36 patients (29.3%) with any residual tumor (HR: 1.830, 95.0% CI [1.194-2.806]; p: 0.003 for DFS, and HR: 1.946, 95.0% CI [1.166-3.250]; p: 0.009 for OS). 96 patients who received 6 courses of NACT were evaluated; 63 patients (65.6%) without macroscopic residual tumor after interval cytoreductive surgery had significantly longer DFS and OS than 33 patients (34.4%) with any residual tumor (HR: 1.716, 9 5.0% CI [1.092-2.697]; p: 0.010 for DFS, and HR: 1.921, 95.0% CI [1.125-3.282]; p: 0.013 for OS). Conclusion: In patients with advanced ovarian cancer, there is no significant difference in DFS and OS between 3 and 4 cycles or 6 cycles of NACT. The most important factor determining survival is whether macroscopic residual tumor tissue remains after interval cytoreductive surgery following NACT.

Purpose: We investigated the outcome of neoadjuvant chemotherapy (NACT) followed by interval cytoreductive surgery and primary cytoreductive surgery (PCS) in patients with platinum-sensitive or resistant advanced epithelial ovarian cancer. Materials and methods: The inclusion criteria fit 298 patients who underwent primary cytoreductive surgery (PCS group n=158) or neoadjuvant chemotherapy (NACT group n=140). Differences in characteristic features, chemotherapy responses, and prognosis were compared. Results: Although the median DFS was similar between the two groups, the median OS was significantly longer in the PCS (p=0.025). There was no survival advantage between the two groups regarding OS in platinum-sensitive patients. However, OS was significantly longer in platinum-resistant patients who underwent PCS (p=0.011). The rate of complete cytoreduction (R=0) was 47.5% in the PCS and 67.1% in the NACT group (p=0.001). Although DFS and OS advantages were observed in the PCS group in R=0 patients with a residual tumor, no significant difference was noticed between the two groups. The two groups had no OS advantage when platinum-sensitive patients were assessed for residual tumor. Meanwhile, in platinum-resistant patients, R=0 provided OS advantage in the PCS group (p=0.008). However, no significant difference was observed if there was any residual tumor (p=0.091). Conclusion: OS was significantly longer in the PCS group. Survival is better in platinum-resistant patients if no residual tumor exists after PCS. There was no difference in OS between the PCS and NACT groups in platinum-sensitive patients, regardless of residual tumor. Specific methods and markers are needed before initial treatment in epithelial ovarian cancer.

Introduction/Background There is limited consensus on the optimal management approach for patients experiencing mapping failure in endometrial cancer (EC). Understanding the risk factors that contribute to sentinel lymph node(SLN) metastasis is of paramount importance. This manuscript aims to provide a comprehensive analysis of the risk factors associated with SLN metastasis. Methodology A total of 874 women with EC were included in this retrospective study. Out of the initial cohort of 874 patients, a total of 793 patients with successful SLN mapping were included and analysed to investigate the risk factors for SLN metastasis in EC. Results SLN metastasis was detected in 73 (9.2%) patients. Among the metastatic cases, 20 (27.4%) patients had isolated tumour cells (ITC), 17 (23.3%) patients had micrometastasis, and 36 (49.3%) patients had macrometastasis in the sentinel lymph nodes. The results of the univariate analysis demonstrated a significant association between SLN metastasis and several factors, including age over 60 years, histology other than endometrioid, tumor grade 3, deep myometrial invasion, lymphovascular space invasion (LVSI), primary tumour diameter of 2 cm or larger, and cervical stromal invasion (p < 0.05). At the end of multivariate analysis, deep myometrial invasion [odds ratio (OR), 2.42; 95% confidence interval (CI), 1.29–4.56; p = 0.006], LVSI (OR, 7.27; 95% CI, 3.82–13.81; p < 0.001) and cervical stromal invasion (OR, 2.18; 95% CI, 1.13–4.21; p = 0.020) remained as independent risk factors for SLN involvement in women with EC. Conclusion LVSI, deep myometrial invasion, and cervical stromal invasion emerged as independent risk factors for SLN metastasis in patients diagnosed with EC. In cases where the identified risk factors are absent, the omission of lymphadenectomy may be considered in instances of SLN mapping failure. Disclosures The authors has no competing financial interests or conflicts of interest to disclose.

Introduction/Background Uterine sarcomas (US) are aggressive tumors with a 45–73% recurrence rate. Cytoreductive surgery is the mainstay treatment in uterine sarcoma management. Systemic chemotherapy is also an option for pati-ents with recurrent, metastatic, irresectable leiomyosarcoma. This study aims to compare the efficacy of secondary cytoreductive surgery and chemotherapy in patients with recurrent uterine sarcoma Methodology Recorded data from 45 patients with recurrent uterine sarcoma were analyzed retrospectively. Twenty-three recurrent US cases treated with secondary cytoreductive surgery and 22 with chemotherapy were included in the study. Results Median follow-up of the patients was 57 months. Complete secondary CRS was accomplished in 18 of 23 (78,2%) recurrent patients. Median survial after recurrens was 19 months for surgery group and 9,5 months for chemoteharpy group (p = 0.288). Median overall survival was 36 months in the surgery and 30.5 months in the chemotherapy group and did not show a significant difference (p= 0.236). The 5-year overall survival was 30% for CRS and 20% for chemotherapy groups. Median OS was 13 months in pati-ents with DFS less than 12 months and 46.5 months in patients with DFS more than 12 months. Patients with DFS longer than 12 months had better OS (P= 0.019). Conclusion Patients who relapse within the first year have worse survival. Although CRS after recurrence provides a partial survival advantage, this does not show any statistical significance. Patient selection for CRS should be patient-tailored. Disclosures none

Melatonin has antiproliferative, antiangiogenic, apoptotic, and immunomodulatory properties in ovarian cancer. Considering those, we evaluated the relationship between melatonin 1 (MT1) and melatonin 2 receptor (MT2) expression in tumor tissues of patients with epithelial ovarian cancer, disease-free survival (DFS), and overall survival (OS). Patients who received primary surgical treatment for epithelial ovarian cancer in our clinic between 2000 and 2019 were retrospectively scanned through patient files, electronic databases, and telephone calls. One hundred forty-two eligible patients were included in the study, their tumoral tissues were examined to determine MT1 and MT2 expression by immunohistochemical methods. The percentage of receptor-positive cells and intensity of staining were determined. MT1 receptor expression ( P = 0.002 for DFS and P = 0.002 for OS) showed a significant effect on DFS and OS. MT2 expression had no effect on survival ( P = 0.593 for DFS and P = 0.209 for OS). The results showed that the higher the MT1 receptor expression, the longer the DFS and OS. It is suggested that melatonin should be considered as adjuvant therapy for ovarian cancer patients in addition to standard treatment, and clinical progress should be observed.