Browsing by Author "Demirkiran, F"

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    A Turkish Gynecologic Oncology Group study of fertility-sparing treatment for early-stage endometrial cancer
    Dursun, P; Erkanli, S; Güzel, AB; Gultekin, M; Tarhan, NC; Altundag, O; Demirkiran, F; Bese, T; Yildirim, Y; Bozdag, G; Yarali, H; Simsek, T; Ozcelik, B; Ortaç, F; Taskin, S; Guvenal, T; Ozgul, N; Haberal, A; Vardar, MA; Dede, M; Yenen, M; Altintas, A; Arvas, M; Ayhan, A
    Objective: To analyze the results of fertility-sparing treatment of early-stage endometrial cancer (EC) in patients treated at Turkish gynecologic oncology centers, and to present a review of the literature. Methods: Thirteen healthcare centers in Turkey were contacted to determine if they were eligible to participate in the study. Centers that were eligible and agreed to participate were sent a database form to record the demographic characteristics, clinicopathologic findings, and follow-up results for their EC patients. Results: Eleven Turkish healthcare centers provided data on 43 EC patients. Mean duration of treatment was 5 months and mean follow-up was 49 months. In total, 35 (81.4%) patients were tumor free following primary progesterone therapy. Mean time from the end of progesterone therapy to pregnancy was 10.6 +/- 4.3 months (range, 3-18 months). Two patients had tumor recurrence during follow-up. The pregnancy rate among the 31 women who actively sought pregnancy was 41.9% (n = 13). Conclusion: Conservative management of early-stage EC in women of reproductive age using oral progestins was effective and did not compromise oncological outcome. Pregnancy in the study patients was achieved spontaneously and artificially. (C) 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
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    Management of gynecological cancers in the COVID-19 era: a survey from Turkey
    Altin, D; Yalcin, I; Khatib, G; Kelesoglu, MD; Akgol, S; Önder, AB; Kahramanoglu, I; Güvenal, T; Topuz, S; Demirkiran, F
    Objective: This study aimed to investigate how gynecologic oncologists modified their patient management during Coronavirus disease-2019 (COVID-19) in Turkey. Material and Methods: An online survey was sent to gynecologic oncology specialists and fellows in Turkey. It included management questions about strategies for newly diagnosed or recurrent endometrial, cervical, ovarian and vulvar cancer during the pandemic. Participants were asked if treatment of these cancers can be delayed or not and, if yes, the duration of delay. Results: 32.9% of surgeons prescribed oral or intrauterine progesterone for early stage, low-grade endometrial cancer. Conversely, 65.7% and 45.7% of the most surgeons did not change their management for early stage high-grade and advanced stage endometrial cancers respectively, as they perform surgery. 58% and 67.1% of the surgeons continued to prefer standard surgical treatment for microinvasive and early stage cervical cancers, respectively. Radiotherapy was preferred administered with hypofractionated doses for locally advanced cervical cancer (57.1%). While 67.1% of surgeons operated early stage ovarian cancer patients, 50% administered neoadjuvant chemotherapy (NACT) to all advanced stage ovarian cancers and 50% administered more cycles of NACT in preference to interval debulking surgery. 93.7% of the surgeons responded that treatment should not be delayed beyond eight weeks. Conclusion: Most Turkish gynecologic oncologists modified their management of gynecologic cancers due to the COVID-19 pandemic. While chemotherapy was preferred for ovarian cancer, postponement of the surgery, with or without non-surgical options, was considered for early stage, low-grade endometrial cancer. Treatment of gynecologic cancers should be decided on a case by case basis, taking into account local COVID-19 infection rates and availability of health facilities. Prognosis is also an important consideration if delay is contemplated. Standard treatment and normal time-frames should be used if possible. If not, a postponement for a maximum of eight weeks or referral to another center were acceptable alternatives.
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    CLINICOPATHOLOGIC AND SURGICAL ANALYSIS OF 1090 PATIENTS WITH BORDERLINE OVARIAN TUMORS: A TURKISH SOCIETY GYNECOLOGIC ONCOLOGY (TRSGO) MULTI-INSTITUTIONAL RETROSPECTIVE TRIAL
    Guvenal, T; Demirkiran, F; Simsek, E; Yalcin, Y; Khatib, G; Gokulu, SG; Simsek, T; Dolapcioglu, K; Onan, A; Ozgul, N; Ortac, F; Yuksel, H; Altintas, A; Boso, B; Seyfettinoglu, S; Celik, C; Ureyen, I; Yalcin, I; Gungorduk, K; Senturk, B; Ayhan, A
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    Multicenter Analysis of Gestational Trophoblastic Neoplasia in Turkey
    Ozalp, SS; Telli, E; Oge, T; Tulunay, G; Boran, N; Turan, T; Yenen, M; Kurdoglu, Z; Ozler, A; Yuce, K; Ulker, V; Arvas, M; Demirkiran, F; Bese, T; Tokgozoglu, N; Onan, A; Sanci, M; Gokcu, M; Tosun, G; Dikmen, Y; Ozsaran, A; Terek, MC; Akman, L; Yetimalar, H; Kilic, DS; Gungor, T; Ozgu, E; Yildiz, Y; Kokcu, A; Kefeli, M; Kuruoglu, S; Yuksel, H; Guvenal, T; Hasdemir, PS; Ozcelik, B; Serin, S; Dolanbay, M; Arioz, DT; Tuncer, N; Bozkaya, H; Guven, S; Kulaksiz, D; Varol, F; Yanik, A; Ogurlu, G; Simsek, T; Toptas, T; Dogan, S; Camuzoglu, H; Api, M; Guzin, K; Caliskan, E; Doger, E; Cakmak, B; Ilhan, TT
    Background: To evaluate the incidence, diagnosis and management of GTN among 28 centers in Turkey. Materials and Methods: A retrospective study was designed to include GTN patients attending 28 centers in the 10-year period between January 2003 and May 2013. Demographical characteristics of the patients, histopathological diagnosis, the International Federation of Gynecology and Obstetrics (FIGO) anatomical and prognostic scores, use of single-agent and multi-agent chemotherapy, surgical interventions and prognosis were evaluated. Results: From 2003-2013, there were 1,173,235 deliveries and 456 GTN cases at the 28 centers. The incidence was calculated to be 0.38 per 1,000 deliveries. According to the evaluated data of 364 patients, the median age at diagnosis was 31 years (range, 15-59 years). A histopathological diagnosis was present for 45.1% of the patients, and invasive mole, choriocarcinoma and PSTTs were diagnosed in 22.3% (n=81), 18.1% (n=66) and 4.7% (n=17) of the patients, respectively. Regarding final prognosis, 352 (96.7%) of the patients had remission, and 7 (1.9%) had persistence, whereas the disease was mortal for 5 (1.4%) of the patients. Conclusions: Because of the differences between countries, it is important to provide national registration systems and special clinics for the accurate diagnosis and treatment of GTN.