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Publications (3)8.78 Total impact

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    ABSTRACT: To evaluate the clinical, laboratory and diagnostic features in women with peritoneal tuberculosis that resembled advanced ovarian malignancy. A retrospective review of women with peritoneal tuberculosis who were managed at TCSB Ankara Etlik Maternity and Women's Health Teaching and Research Hospital from July 1992 to November 2004 was undertaken. Among the 1,826 women treated during the study period, 22 women with peritoneal tuberculosis (1.2%) were identified. The mean age was 36.9 years (range 21-68 years); the mean Ca125 level was 564.95 U/ml (3-2021 U/ml). All patients with peritoneal tuberculosis had ascites, 20 patients (90.91%) had elevated CA125 levels and 17 patients (77.27%) had detectable pelvic masses in the preoperative period. During preoperative diagnostic work-up, pulmonary tuberculosis was diagnosed and antituberculosis therapy had begun in two of 22 patients (9.09%). Among 20 patients, 11 (55%), 8 (40%) and 1 (5%) underwent exploratory laparotomy, diagnostic laparoscopy and laparoscopy converted to laparotomy due to dense pelvic adhesions, respectively. Since frozen section was not available during the surgery in 5 of 20, 3 patients (10%) underwent extended surgery. Frozen section was performed in 15 patients and revealed chronic granulomatous changes and final pathological examination confirmed the diagnosis. Our data indicate that the majority of the cases with peritoneal tuberculosis can be diagnosed intraoperatively through the use of frozen section in conjunction with clinical features. Ascites and high levels of Ca125 do not necessarily indicate that the clinical picture is malignant in reproductive women. Laparoscopic tissue biopsy may be a fundamental tool in the management of such cases to avoid extended surgery.
    Gynecologic Oncology 12/2006; 103(2):565-9. · 3.93 Impact Factor
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    ABSTRACT: To evaluate the fertility and recurrence outcomes in women treated with fertility-sparing surgery for borderline ovarian tumors. A total of 142 patients with borderline ovarian tumors managed surgically from 1993 to 2004 were identified from gynecologic oncology and pathology files of SSK Ankara Maternity and Women's Health Teaching Hospital. Sixty-two of those patients who had conservative surgery were eligible for the study. Information was acquired by retrospective medical record review and patient interview. The observed recurrence rates after radical and fertility-sparing surgery were 0.0% and 6.5%, respectively. Four patients from the conservative surgery group developed recurrence, in contrast to none of the patients from the non-conservative surgery group. No disease-related deaths occurred in any group. In the conservatively managed group, ten women had successful pregnancies, with a total of 10 live births and 3 abortions. The mean duration of follow-up for the conservative surgery group was 44.3 months (range, 3-128). Fertility-sparing surgery for borderline ovarian tumors should be considered for women in the reproductive age group who desire preservation of fertility. Recurrence is noted significantly more often after this type of treatment and close follow-up is needed to detect recurrent disease.
    Gynecologic Oncology 07/2005; 97(3):845-51. · 3.93 Impact Factor
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    ABSTRACT: The aim of this study was to evaluate patients with metastatic ovarian tumors from extragenital primary sites. The medical records of 75 patients were reviewed retrospectively for age at diagnosis, presenting symptoms, preoperative tumor marker levels, preoperative diagnostic workup, operative technique, intraoperative evaluation, frozen-section and pathology results, laterality of metastasis, and primary tumor site. The specific impact of metastasis from colorectal and gastric primary sites on laterality, gross features and dimensions of ovarian mass, volume of ascites and tumor marker levels was investigated. Primary sites were stomach (37.3%), colorectal region (28%), lymphoma (12%), breast (6.7%), biliary system (2.7%), appendix (1.3%) and small intestine (1.3%). It was not possible to identify the primary tumor site in 8 (10.7%) patients. Bilateral metastasis was found in 86.4% patients; 42.7% of the metastatic ovarian tumors were Krukenberg tumors; 50.7% of the ovarian masses were solid. Frozen section was confirmed by postoperative pathological results in 98% of the patients. The mean preoperative serum levels of tumor markers were 298.7 U/mL, 178 U/mL and 113.3 U/mL for CA 125, CA 19-9 and CA 15-3, respectively. CA 125 levels were above 35 U/mL in 81.3% of the patients. The presence of ascites was more frequent in ovarian tumors originating from colorectal and gastric primaries. Surgery is essential for the diagnosis of the primary tumor and necessary for relief of symptoms. The identification of the primary site is required to plan adequate treatment.
    Tumori 92(6):491-5. · 0.92 Impact Factor

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