1.Prognostic factors of adult granulosa cell tumors of the ovary: a Turkish retrospective multicenter study
Okan OKTAR ; Vakkas KORKMAZ ; Alp TOKALIOĞLU ; Çağatayhan ÖZTÜRK ; Özgür ERDOĞAN ; Yeşim UÇAR ; Hande Esra KOCA YILDIRIM ; Candost HANEDAN ; Fatih KILIÇ ; Burak ERSAK ; Necim YALÇIN ; Fatma ÖZMEN ; Alper KAHRAMAN ; Selin Aktürk ESEN ; Sevda BAŞ ; Emel Doğan ÖZDAŞ ; İlker SELÇUK ; Gökhan UÇAR ; Özgür KOÇAK ; Caner ÇAKIR ; Sevgi KOÇ ; Çiğdem KILIÇ ; Günsu Kimyon CÖMERT ; Işın ÜREYEN ; Tayfun TOPTAŞ ; Mehmet Ali NARIN ; Tolga TAŞÇI ; Salih TAŞKIN ; Nurettin BORAN ; Muzaffer SANCI ; Fahriye Tuğba KÖŞ ; Özlem Moraloğlu TEKIN ; Yaprak Engin ÜSTÜN ; Fırat ORTAÇ ; Taner TURAN
Journal of Gynecologic Oncology 2024;35(3):e39-
Objective:
To define the clinical, histopathological features and the prognostic factors affecting survival in patients with adult granulosa cell tumors of the ovary (AGCT).
Methods:
A 322 patients whose final pathologic outcome was AGCT treated at nine tertiary oncology centers between 1988 and 2021 participated in the study.
Results:
The mean age of the patients was 51.3±11.8 years and ranged from 21 to 82 years.According to the International Federation of Gynecology and Obstetrics 2014, 250 (77.6%) patients were stage I, 24 (7.5%) patients were stage II, 20 (6.2%) patients were stage III, and 3 (7.8%) were stage IV. Lymphadenectomy was added to the surgical procedure in 210(65.2%) patients. Lymph node involvement was noted in seven (3.3%) patients. Peritoneal cytology was positive in 19 (5.9%) patients, and 13 (4%) had metastases in the omentum. Of 285 patients who underwent hysterectomy, 19 (6.7%) had complex hyperplasia with atypia/ endometrial intraepithelial neoplasia, and 8 (2.8%) had grade 1 endometrioid endometrial carcinoma. It was found that 93 (28.9%) patients in the study group received adjuvant treatment. Bleomycin, etoposide, cisplatin was the most commonly used chemotherapy protocol. The median follow-up time of the study group was 41 months (range, 1–276months). It was noted that 34 (10.6%) patients relapsed during this period, and 9 (2.8%)patients died because of the disease. The entire cohort had a 5-year disease-free survival (DFS) of 86% and a 5-year disease-specific survival of 98%. Recurrences were observed only in the pelvis in 13 patients and the extra-abdominal region in 7 patients. The recurrence rate increased 6.168-fold in patients with positive peritoneal cytology (95% confidence interval [CI]=1.914–19.878; p=0.002), 3.755-fold in stage II–IV (95% CI=1.275–11.063; p=0.016), and 2.517-fold in postmenopausal women (95% CI=1.017–6.233; p=0.046) increased.
Conclusion
In this study, lymph node involvement was detected in 3.3% of patients with AGCT. Therefore, it was concluded that lymphadenectomy can be avoided in primary surgical treatment. Positive peritoneal cytology, stage, and menopausal status were independent prognostic predictors of DFS.
2.Prognostic factors of adult granulosa cell tumors of the ovary: a Turkish retrospective multicenter study
Okan OKTAR ; Vakkas KORKMAZ ; Alp TOKALIOĞLU ; Çağatayhan ÖZTÜRK ; Özgür ERDOĞAN ; Yeşim UÇAR ; Hande Esra KOCA YILDIRIM ; Candost HANEDAN ; Fatih KILIÇ ; Burak ERSAK ; Necim YALÇIN ; Fatma ÖZMEN ; Alper KAHRAMAN ; Selin Aktürk ESEN ; Sevda BAŞ ; Emel Doğan ÖZDAŞ ; İlker SELÇUK ; Gökhan UÇAR ; Özgür KOÇAK ; Caner ÇAKIR ; Sevgi KOÇ ; Çiğdem KILIÇ ; Günsu Kimyon CÖMERT ; Işın ÜREYEN ; Tayfun TOPTAŞ ; Mehmet Ali NARIN ; Tolga TAŞÇI ; Salih TAŞKIN ; Nurettin BORAN ; Muzaffer SANCI ; Fahriye Tuğba KÖŞ ; Özlem Moraloğlu TEKIN ; Yaprak Engin ÜSTÜN ; Fırat ORTAÇ ; Taner TURAN
Journal of Gynecologic Oncology 2024;35(3):e39-
Objective:
To define the clinical, histopathological features and the prognostic factors affecting survival in patients with adult granulosa cell tumors of the ovary (AGCT).
Methods:
A 322 patients whose final pathologic outcome was AGCT treated at nine tertiary oncology centers between 1988 and 2021 participated in the study.
Results:
The mean age of the patients was 51.3±11.8 years and ranged from 21 to 82 years.According to the International Federation of Gynecology and Obstetrics 2014, 250 (77.6%) patients were stage I, 24 (7.5%) patients were stage II, 20 (6.2%) patients were stage III, and 3 (7.8%) were stage IV. Lymphadenectomy was added to the surgical procedure in 210(65.2%) patients. Lymph node involvement was noted in seven (3.3%) patients. Peritoneal cytology was positive in 19 (5.9%) patients, and 13 (4%) had metastases in the omentum. Of 285 patients who underwent hysterectomy, 19 (6.7%) had complex hyperplasia with atypia/ endometrial intraepithelial neoplasia, and 8 (2.8%) had grade 1 endometrioid endometrial carcinoma. It was found that 93 (28.9%) patients in the study group received adjuvant treatment. Bleomycin, etoposide, cisplatin was the most commonly used chemotherapy protocol. The median follow-up time of the study group was 41 months (range, 1–276months). It was noted that 34 (10.6%) patients relapsed during this period, and 9 (2.8%)patients died because of the disease. The entire cohort had a 5-year disease-free survival (DFS) of 86% and a 5-year disease-specific survival of 98%. Recurrences were observed only in the pelvis in 13 patients and the extra-abdominal region in 7 patients. The recurrence rate increased 6.168-fold in patients with positive peritoneal cytology (95% confidence interval [CI]=1.914–19.878; p=0.002), 3.755-fold in stage II–IV (95% CI=1.275–11.063; p=0.016), and 2.517-fold in postmenopausal women (95% CI=1.017–6.233; p=0.046) increased.
Conclusion
In this study, lymph node involvement was detected in 3.3% of patients with AGCT. Therefore, it was concluded that lymphadenectomy can be avoided in primary surgical treatment. Positive peritoneal cytology, stage, and menopausal status were independent prognostic predictors of DFS.
3.Prognostic factors of adult granulosa cell tumors of the ovary: a Turkish retrospective multicenter study
Okan OKTAR ; Vakkas KORKMAZ ; Alp TOKALIOĞLU ; Çağatayhan ÖZTÜRK ; Özgür ERDOĞAN ; Yeşim UÇAR ; Hande Esra KOCA YILDIRIM ; Candost HANEDAN ; Fatih KILIÇ ; Burak ERSAK ; Necim YALÇIN ; Fatma ÖZMEN ; Alper KAHRAMAN ; Selin Aktürk ESEN ; Sevda BAŞ ; Emel Doğan ÖZDAŞ ; İlker SELÇUK ; Gökhan UÇAR ; Özgür KOÇAK ; Caner ÇAKIR ; Sevgi KOÇ ; Çiğdem KILIÇ ; Günsu Kimyon CÖMERT ; Işın ÜREYEN ; Tayfun TOPTAŞ ; Mehmet Ali NARIN ; Tolga TAŞÇI ; Salih TAŞKIN ; Nurettin BORAN ; Muzaffer SANCI ; Fahriye Tuğba KÖŞ ; Özlem Moraloğlu TEKIN ; Yaprak Engin ÜSTÜN ; Fırat ORTAÇ ; Taner TURAN
Journal of Gynecologic Oncology 2024;35(3):e39-
Objective:
To define the clinical, histopathological features and the prognostic factors affecting survival in patients with adult granulosa cell tumors of the ovary (AGCT).
Methods:
A 322 patients whose final pathologic outcome was AGCT treated at nine tertiary oncology centers between 1988 and 2021 participated in the study.
Results:
The mean age of the patients was 51.3±11.8 years and ranged from 21 to 82 years.According to the International Federation of Gynecology and Obstetrics 2014, 250 (77.6%) patients were stage I, 24 (7.5%) patients were stage II, 20 (6.2%) patients were stage III, and 3 (7.8%) were stage IV. Lymphadenectomy was added to the surgical procedure in 210(65.2%) patients. Lymph node involvement was noted in seven (3.3%) patients. Peritoneal cytology was positive in 19 (5.9%) patients, and 13 (4%) had metastases in the omentum. Of 285 patients who underwent hysterectomy, 19 (6.7%) had complex hyperplasia with atypia/ endometrial intraepithelial neoplasia, and 8 (2.8%) had grade 1 endometrioid endometrial carcinoma. It was found that 93 (28.9%) patients in the study group received adjuvant treatment. Bleomycin, etoposide, cisplatin was the most commonly used chemotherapy protocol. The median follow-up time of the study group was 41 months (range, 1–276months). It was noted that 34 (10.6%) patients relapsed during this period, and 9 (2.8%)patients died because of the disease. The entire cohort had a 5-year disease-free survival (DFS) of 86% and a 5-year disease-specific survival of 98%. Recurrences were observed only in the pelvis in 13 patients and the extra-abdominal region in 7 patients. The recurrence rate increased 6.168-fold in patients with positive peritoneal cytology (95% confidence interval [CI]=1.914–19.878; p=0.002), 3.755-fold in stage II–IV (95% CI=1.275–11.063; p=0.016), and 2.517-fold in postmenopausal women (95% CI=1.017–6.233; p=0.046) increased.
Conclusion
In this study, lymph node involvement was detected in 3.3% of patients with AGCT. Therefore, it was concluded that lymphadenectomy can be avoided in primary surgical treatment. Positive peritoneal cytology, stage, and menopausal status were independent prognostic predictors of DFS.
4.Lupus nephritis presenting with massive ascites and pleural effusion (pseudo-pseudo Meigs’ syndrome)
Rabia DENIZ ; Gülşah HACIMURTAZAOĞLU-DEMIR ; Bilgin KARAALIOĞLU ; Duygu Sevinç ÖZGÜR ; Gamze AKKUZU ; Fatih YILDIRIM ; Cemal BES
Journal of Rheumatic Diseases 2024;31(2):116-119
The triad of ascites, pleural effusion, and elevated cancer antigen-125 (CA-125) levels in the absence of ovarian malignancy in systemic lupus erythematosus patients is specifically named pseudo-pseudo Meigs’ syndrome (PPMS) or Tjalma syndrome. In this case we reported a 33 years female patient with pleural effusion lasting for 3 years and new onset progressive massive ascites and increased level of CA-125. After she was evaluated for an underlying benign and malign ovarian tumor or any other malignancies, serologic tests were requested with respect to progressive renal dysfunction, proteinuria, lymphopenia, anemia, and effusion.She was diagnosed with systemic lupus erythamatosus (SLE) and renal biopsy showed class-V lupus nephritis. Immunosuppressive treatment led to improvement in both SLE activity and components of PPMS, including massive ascites and pleural effusion and without the need of diuretics. Co-existence of unexplained CA-125 increase, pleural effusion, and ascites might be related to PPMS and detailed examination to exclude malignancy and early and effective treatment of SLE are the mainstay of management.
5.Evaluation of the accuracy of dental casts manufactured with 3D printing technique in the All-on-4 treatment concept
Hilin TAS ; Fatih DEMIRCI ; Mesut TUZLALI ; Erkan BAHCE ; Guler Yildirim AVCU
The Journal of Advanced Prosthodontics 2022;14(6):379-387
PURPOSE:
. The aim of this study is to compare the casts obtained by using conventional techniques and liquid crystal display (LCD) three-dimensional (3D) print techniques in the All-on-4 treatment concept of the edentulous mandibular jaw. MATERIALS AND METHODS. In this study, a completely edentulous mandibular acrylic cast (typodont) with bone-level implants placed with the Allon-4 technique served as a reference cast. In this typodont, impressions were taken with the conventional technique and dental stone casts were obtained.In addition, after scanning the acrylic cast in a dental laboratory scanner and obtaining the Standard Tessellation Language (STL) data, 3D printed casts were manufactured with a 3D printing device based on the design. The stone and 3D printed casts were scanned in the laboratory scanner and STL data were obtained, and then the interimplant distances were measured using Geomagic Control X v2020 (3D Systems, Rock Hill, SC, USA) analysis software (n = 60). The obtained data were statistically evaluated with one-way analysis of variance (ANOVA) and Tukey’s pairwise comparison tests. RESULTS. As a result of the one-way ANOVA test, it was determined that the stone casts, 3D printed casts, and reference cast values in all distance intervals conformed to the normal distribution and these values had a significant difference among them in all distance intervals. In Tukey pairwise comparison test, significant differences were found between casts at all distance intervals. In all analyses, the level of significance was determined as .05.
CONCLUSION
. 3D printed casts obtained with a 3D LCD printing device can be an alternative to stone casts when implants are placed in edentulous jaws.
6.Investigation of Blood Betatrophin Levels in Obese Children with Non-Alcoholic Fatty Liver Disease.
Fatih BATTAL ; Hakan TÜRKÖN ; Nilüfer AYLANÇ ; Hakan AYLANÇ ; Sule YILDIRIM ; Nazan KAYMAZ ; Sema UYSAL
Pediatric Gastroenterology, Hepatology & Nutrition 2018;21(2):111-117
PURPOSE: The prevalence of obesity has significantly increased among children and adolescents worldwide and is becoming an important health care problem in parallel with the increased prevalence of obesity pediatric non-alcoholic fatty liver disease. Betatrophin is a newly define hormone that is commonly secreted by liver and plays role in glucose tolerance. This study aimed to investigate the relationship between serum betatrophin levels and non-alcoholic fatty liver disease in obese children. METHODS: The study included 40 obese children with a body mass index (BMI) above 95th centile, and 35 non-obese subjects with a BMI 3-85th centile, whose age and gender were similar to those of the patient group. For the evaluation of metabolic parameters fasting serum glucose, insulin, alanine aminotransferase, aspartate aminotransferase, lipid profile and serum betatrophin levels were measured. Total cholesterol: high-density lipoprotein cholesterol and low-density lipoprotein cholesterol: high-density lipoprotein cholesterol ratios were calculated as “atherogenic indices.” RESULTS: Serum betatrophin levels of the obese subjects were similar to that of non-obese subjects (p=0.90). Betatrophin levels were not correlated with the metabolic parameters. CONCLUSION: In the present study, levels of betatrophin are not different between obese and insulin resistant children and non-obese subjects, and they are not correlated with atherogenic indices. To elucidate the exact role of betatrophin in obesity, further studies are required to identify the betatrophin receptor and/or other possible cofactors.
Adolescent
;
Alanine Transaminase
;
Aspartate Aminotransferases
;
Blood Glucose
;
Body Mass Index
;
Child*
;
Cholesterol
;
Delivery of Health Care
;
Fasting
;
Glucose
;
Humans
;
Insulin
;
Lipoproteins
;
Liver
;
Non-alcoholic Fatty Liver Disease*
;
Obesity
;
Prevalence
7.Does the Modified STING Method Increase the Success Rate in the Management of Moderate or High-Grade Reflux?.
Osman Raif KARABACAK ; Fatih YALCINKAYA ; Ugur ALTUG ; Nurettin SERTCELIK ; Fuat DEMIREL
Korean Journal of Urology 2014;55(9):615-619
PURPOSE: To evaluate the efficacy of subureteral injection types in patients with middle- to high-grade vesicoureteral reflux (VUR). MATERIALS AND METHODS: Between June 1999 and September 2010, subureteral dextranomer was applied at our clinic to 149 patients (214 refluxing ureters) with grades II, III, and IV VUR. Group 1 consisted of 54 patients (80 ureters), and group 2 consisted of 95 patients (134 ureters). The standard subureteric transurethral injection (STING) procedure was applied to group 1, and the modified STING procedure was applied to group 2. A second and if needed a third injection was applied to unsuccessfully treated patients. The mean follow-up period was 2 years. Patients were evaluated by cystography and ultrasonography in the third month of follow-up. RESULTS: VUR was resolved completely after a single injection in 54/80 ureters (67.5%) in group 1 and in 94/134 ureters (70.1%) in group 2. Overall successes after a second or a third injection were 61/80 (76.2%) and 111/134 (82.8%), respectively. There was a statistically significant difference between the groups only for grade IV reflux following multiple injections (p<0.05). CONCLUSIONS: Endoscopic treatment of VUR is a recommended treatment because it is minimally invasive, efficient, and repeatable. Our study confirmed that a modified STING procedure can be an alternative treatment to the standard technique.
Administration, Intravesical
;
Adolescent
;
Child
;
Child, Preschool
;
Dextrans/*administration & dosage
;
Endoscopy
;
Female
;
Follow-Up Studies
;
Humans
;
Hyaluronic Acid/*administration & dosage
;
Infant
;
Male
;
Reproducibility of Results
;
Treatment Outcome
;
Ureter/*surgery
;
Urologic Surgical Procedures/*methods
;
Vesico-Ureteral Reflux/*drug therapy/ultrasonography
8.Does the Modified STING Method Increase the Success Rate in the Management of Moderate or High-Grade Reflux?.
Osman Raif KARABACAK ; Fatih YALCINKAYA ; Ugur ALTUG ; Nurettin SERTCELIK ; Fuat DEMIREL
Korean Journal of Urology 2014;55(9):615-619
PURPOSE: To evaluate the efficacy of subureteral injection types in patients with middle- to high-grade vesicoureteral reflux (VUR). MATERIALS AND METHODS: Between June 1999 and September 2010, subureteral dextranomer was applied at our clinic to 149 patients (214 refluxing ureters) with grades II, III, and IV VUR. Group 1 consisted of 54 patients (80 ureters), and group 2 consisted of 95 patients (134 ureters). The standard subureteric transurethral injection (STING) procedure was applied to group 1, and the modified STING procedure was applied to group 2. A second and if needed a third injection was applied to unsuccessfully treated patients. The mean follow-up period was 2 years. Patients were evaluated by cystography and ultrasonography in the third month of follow-up. RESULTS: VUR was resolved completely after a single injection in 54/80 ureters (67.5%) in group 1 and in 94/134 ureters (70.1%) in group 2. Overall successes after a second or a third injection were 61/80 (76.2%) and 111/134 (82.8%), respectively. There was a statistically significant difference between the groups only for grade IV reflux following multiple injections (p<0.05). CONCLUSIONS: Endoscopic treatment of VUR is a recommended treatment because it is minimally invasive, efficient, and repeatable. Our study confirmed that a modified STING procedure can be an alternative treatment to the standard technique.
Administration, Intravesical
;
Adolescent
;
Child
;
Child, Preschool
;
Dextrans/*administration & dosage
;
Endoscopy
;
Female
;
Follow-Up Studies
;
Humans
;
Hyaluronic Acid/*administration & dosage
;
Infant
;
Male
;
Reproducibility of Results
;
Treatment Outcome
;
Ureter/*surgery
;
Urologic Surgical Procedures/*methods
;
Vesico-Ureteral Reflux/*drug therapy/ultrasonography
9.How will surface treatments affect the translucency of porcelain laminate veneers?.
Sedanur TURGUT ; Bora BAGIS ; Elif Aydogan AYAZ ; Fatih Mehmet KORKMAZ ; Kivanc Utku ULUSOY ; Yildirim Hakan BAGIS
The Journal of Advanced Prosthodontics 2014;6(1):8-13
PURPOSE: The purpose of this study was to evaluate whether surface treatments affect the translucency of laminate veneers with different shades and thicknesses. MATERIALS AND METHODS: A total of 224 disc-shaped ceramic veneers were prepared from A1, A3, HT (High Translucent) and HO (High Opaque) shades of IPS e.max Press (Ivoclar Vivadent) with 0.5 mm and 1.0 mm thicknesses. The ceramics were divided into four groups for surface treatments. Group C: no surface treatments; Group HF: etched with hydrofluoric acid; Group SB: sandblasted with 50-microm Al2O3; and Group L; irradiated with an Er;YAG laser. A translucent shade of resin cement (Rely X Veneer, 3M ESPE) was chosen for cementation. The color values of the veneers were measured with a colorimeter and translucency parameter (TP) values were calculated. A three-way ANOVA with interactions for TP values was performed and Bonferroni tests were used when appropriate (alpha=0.05). RESULTS: There were significant interactions between the surface treatments, ceramic shades and thicknesses (P=.001). For the 0.5-mm-thick specimens there were significant differences after the SB and L treatments. There was no significant difference between the HF and C treatments for any shades or thicknesses (P>.05). For the 1-mm-thick ceramics, there was only a significant difference between the L and C treatments for the HT shade ceramics (P=.01). There were also significant differences between the SB and C treatments except not for the HO shades (P=.768). CONCLUSION: The SB and L treatments caused laminate veneers to become more opaque; however, HF treatment did not affect the TP values. When the laminate veneers were thinner, both the shade of the ceramic and the SB and laser treatments had a greater effect on the TP values.
Cementation
;
Ceramics
;
Dental Porcelain*
;
Hydrofluoric Acid
;
Resin Cements
10.Erratum: How will surface treatments affect the translucency of porcelain laminate veneers?.
Sedanur TURGUT ; Bora BAGIS ; Elif Aydogan AYAZ ; Fatih Mehmet KORKMAZ ; Kivanc Utku ULUSOY ; Yildirim Hakan BAGIS
The Journal of Advanced Prosthodontics 2014;6(2):150-150
There are some corrections in the body of the article.

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