mehmet coskun Salman

Hacettepe University · Department of Obstetrics and Gynecology

Introduction/Background To investigate the frequency and clinical significance of Microsatellite Instability (MSI) in endometrial cancer patients. Methodology The study included 174 patients who underwent total hysterectomy with the diagnosis of endometrial cancer in Hacettepe University Hospital, Department of Obstetrics and Gynecology between Ja...

Introduction/Background High grade serous carcinomas are the most common subtype of ovarian cancer. Mostly the patients diagnosed with advanced stage disease. The main approach for management consists of primary debulking surgery (PDS). However, some patients cannot be good candidates for primary surgery, and neoadjuvant chemotherapy (NACT) followe...

Objective: To evaluate the feasibility and oncological safety of ovarian preservation in early stage endometrial adenocarcinoma (EC) patients aged 40 and below. Methods: A total of 11 institutions from 8 countries participated in the study. One hundred and sixty-nine of 5.898 patients aged ≤ 40 years were eligible for the study. Patients with EC...

Cervical metastasis in ovarian cancer is a rare entity. Therefore, care should be taken in the differential diagnosis of cervical masses as it may mimic a primary tumor. This report aimed to emphasize the importance of a multidisciplinary approach in these tumors. We present a case of a 73-year-old female who presented with post-menopausal vaginal...

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, di...

Our goal was to address the safety of major gynaecologic cancer surgery without routine preoperative COVID-19 testing in the COVID-19 era. The databases of seven gynaecologic cancer centres were searched in order to identify all consecutive gynaecologic cancer patients undergoing major surgery between March 11, 2020 and May 15, 2020 for this retros...

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 lapar...

Purpose: To evaluate the clinicopathological characteristics and surgical outcomes in patients with pure ovarian immature teratomas (POITs). Materials and Methods: In this multicenter study, a retrospective review was made of the databases of six Gynecology Oncology Departments in Turkey to identify patients with POITs who had undergone surgery be...

Introduction/Background The ovaries are a frequent site of metastasis and tumors metastatic to the ovaries account for 5–6% of all ovarian tumors. In most cases, the primary tumor originates from gastrointestinal tract, breast, and gynaecologic organs including endometrium and cervix. The diagnosis is often made on final pathology since many metast...

Introduction/Background Oophorectomy which is the integral part of surgery in endometrial adenocarcinoma leads to some adverse effects in premenopausal patients. Therefore, ovarian preservation concept has recently emerged especially in early stage disease. Several studies have shown that such approach does not adversely impact oncologic prognosis....

Introduction/Background Endometrial intraepithelial neoplasia (EIN) is a premalignant lesion, but risk of concurrent endometrial adenocarcinoma (EAC) is also high. Although most patients with EIN diagnosed with concurrent EAC will have low risk disease, some will have high-risk disease who require. Clinical characteristics may help determine such p...

Introduction/Background To evaluate the role of transvaginal sonographic (tvUSG) endometrial thickness to detect endometrial cancers among postmenopausal women. Methodology Endometrial biopsy results of 1099 postmenopausal patients who have been evaluated at our hospital since 2015 are retrospectively collected. Age, symptoms (asymptomatic vs. pos...

Introduction/Background Novel Coronavirus Disease (COVID-19) pandemic has a significant impact on healthcare services. Non-emergent surgeries are being restricted since medical facilities are mostly occupied by or reserved for COVID-19 patients. However, postponing oncologic surgeries may have significant effects on survival. Also, many reports wer...

Objective Complex procedures such as distal pancreatectomy and splenectomy (DPS) may be required for R0 resection in patients with ovarian cancer (OC). These procedures can increase survival and cause serious morbidity. We aimed to present our experience in this field. Materials and methods Thirteen patients who underwent DPS for OC between Januar...

Objective To investigate the clinicopathologic characteristics, prognostic factors, outcome, and treatment of the neuroendocrine carcinoma (NEC) of the endometrium. Materials and methods We retrospectively reviewed the clinicopathologic and survival data of 10 patients who underwent surgery for NEC. The patients were collected between 1999 and 201...

Objective To evaluate the clinicopathological features and outcomes of patients undergone surgery for benign and metastatic adnexal masses during the surveillance of colorectal cancer (CRC). Methods A single institute retrospective study involving 90 patients diagnosed with CRC that undergone surgery at Hacettepe University Hospital between 2000-2...

Objective: To explore the relationship of lymph node ratio (LNR) and other lymph node parameters with disease-free (DFS) and overall (OS) survival among women with endometrial cancer. Methods: Retrospective analysis of data of women diagnosed with endometrial cancer at Hacettepe University Hospitals, Ankara, Turkey, between 2003 and 2013. Women...

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) a...

Introduction/Background The primary aim was to determine whether different adjuvant treatment modalities (CT, RT, and CRT) improve survival outcomes in stage III endometrioid EC patients based on the specific sub-stage of the disease. The secondary aim was to assess the prognostic factors in stage III endometrioid EC. Methodology SATEN III was a r...

Background/aim: We aimed to define the effect of tumor size on recurrence and survival rates in patients with stage I–II endometrioid-type endometrial cancer. Materials and methods: A total of 550 patients who had total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic-paraaortic lymphadenectomy were included. Patients with ext...

Purpose To investigate the clinico-pathological prognostic factors and treatment outcomes in patients with ovarian yolk sac tumors (YST). Methods A multicenter, retrospective department database review was performed to identify patients with ovarian YST who underwent surgery between 2000 and 2017 at seven Gynecologic Oncology Centers in Turkey. R...

e17107 Background: Endometrial cancer(EC) is a heterogeneous disease with diverse histological features and biological behaviour. Microsatellite instability (MSI) which occurs in cancerous tissue secondary to mismatch repair (MMR) defect of hereditary or somatic origin is a well-known feature further diversifying genetic tumor landscape. In this st...

Metastatic involvement of the ovaries is not rare. The most common tumor types metastasizing to the ovaries, from non-gynecological organs, are breast, colorectal, gastric, and appendix tumors. Lymphogenous, hematogenous, and transcoelomic pathways have all been proposed among potential pathways. Early diagnosis and treatment have an important pote...

Background: Uterine carcinosarcoma is rare neoplasm that mostly presents as metastatic disease. Stage is one of the most important prognostic factor, however, the management of the early stage uterine carcinosarcoma is still controversial. Aims: To evaluate prognostic factors, treatment options, and survival outcomes in patients with surgically...

Pregnancy luteoma (PL) is a rare cause of non-neoplastic masses in pregnancy. PLs are usually asymptomatic. However, general symptoms like pelvic pain, lumbalgia, constipation or virilization due to active hormone secretion can be detected as the clinical findings of these benign cysts. The definitive diagnosis of PL is most commonly possible with...

Objective: The aim of this study was to compare Mayo and Milwaukee risk stratification models for predicting lymphatic dissemination in patients with endometrial cancer (EC). Methods: A total of 904 patients with EC underwent surgical treatment between 2004 and 2016 at Hacettepe University Hospital, and clinicopathological data of patients were...

Objective: The objective of this study was to investigate the clinicopathological features and factors associated with recurrence in patients with uterine smooth muscle tumor of uncertain malignant potential (STUMP). Methods: Forty-six cases diagnosed between 2000 and 2014 from 2 tertiary centers underwent blind slide review. Initial diagnosis i...

Purpose: To investigate clinicopathological characteristics and oncological outcome of women with microinvasive BOTs. Methods: A retrospective multicenter case-control study was conducted on 902 patients with BOT, who underwent surgery from January 2002 to December 2015 at six participating gynecologic oncology centers from Turkey. Among 902 pat...

Objective: To investigate the incidence of retroperitoneal lymph node metastasis among patients with primary adult type granulosa cell tumor (AGCT) of the ovary. Study design: Between January 1982 and February 2017, patients with a pathological diagnosis of AGCT were identified. Clinical and pathological data were obtained from database records....

We aimed to identify the possible role of oxidant-antioxidant status in epithelial ovarian cancer (EOC) by measuring (a) antioxidant enzyme (AOE) activities [total superoxide dismutase (SODtotal ), manganese-SOD (Mn-SOD), copper,zinc-SOD (Cu,Zn-SOD), catalase (CAT) and glutathione peroxidase (GPx1)], (b) Mn-SOD protein expression, (c) lipid peroxid...

Objective: The aim of this study was to investigate the effect of different surgical approaches, adjuvant therapy, and pathological characteristics on oncological outcomes in patients with 2009 International Federation of Gynecology and Obstetrics (FIGO) stage II endometrial cancer (EC). Methods: A multicenter, retrospective department database...

Objective To assess the prognosis of surgically-staged non-invasive uterine clear cell carcinoma (UCCC), and to determine the role of adjuvant therapy. Methods A multicenter, retrospective department database review was performed to identify patients with UCCC who underwent surgical treatment between 1997 and 2016 at 8 Gynecologic Oncology Centers...

Objective: To determine factors influencing overall survival following recurrence (OSFR) in women with low-risk endometrial cancer (EC) treated with surgery alone. Methods: A multicenter, retrospective department database review was performed to identify patients with recurrent "low-risk EC" (patients having less than 50% myometrial invasion [MM...

Background/aim: Human papillomaviruses have been established as a risk factor for invasive carcinoma of the uterine cervix. HPV E6/E7 oncogene expression has recently emerged as a promising biomarker to determine the risk for progression to high-grade cervical lesions. The aim of this study was to evaluate HPV mRNA and DNA detection in samples wit...

Objective: The study aims to investigate effect of tumor size on lymphatic spread in patients with low-risk endometrial cancer (EC). Methods: This study included patients with EC who underwent staging surgery with systematic lymphadenectomy between 2002 and 2015 at the Hacettepe University Hospital. Patients with grade 1 or 2 endometrioid type t...

Objective Previous studies reported better outcomes for transitional cell carcinoma (TCC) of the ovary when compared with more common histologic types such as serous epithelial ovarian cancers (EOCs). The aim of this study was to compare the survival outcomes of platinum- based chemotherapy in patients with stage IIIC TCCs and serous EOCs. Materia...

Background: In women with endometrial hyperplasia, there is a risk for co-existent endometrial cancer when patients are subjected to immediate surgical treatment. Aims: The aim of this study was to investigate the frequency of endometrial cancer and the accuracy of frozen section analysis at the time of hysterectomy among patients with endometri...

Objectives: The aim of this retrospective multicenter study was to investigate the frequency of extrauterine metastasis and to evaluate the importance of surgical staging and adjuvant treatment among patients with noninvasive uterine papillary serous carcinoma (UPSC) of the endometrium. Materials and methods: A multicenter, retrospective departm...

Objectives: Since parametrial involvement is believed to be a crucial factor in the management of cervical cancer, our study was designed to investigate the clinical and pathological features which predicted parametrial involvement in patients with clinical early-stage cervical cancer. Material and methods: The study included patients with clini...

Aim: We primarily aimed to compare the levels of serum and cervicovaginal cancer antigen 125 (CA 125) in women with and without endometrial carcinoma in order to reveal whether cervicovaginal CA 125 could be used as a non-invasive method. Methods: A preliminary case-control study was designed. The study group consisted of patients who were opera...

The aim of this surgical video is to demonstrate en bloc radical removal of uterus and vagina in a patient with clinical early-stage vaginal cancer. Surgical treatment was offered to our patient for clinical early-stage primary vaginal cancer. An en bloc radical hysterectomy, systematic pelvic lymphadenectomy, and total abdominal vaginectomy were p...

Objective: Patients with endometrial intraepithelial neoplasia may have concurrent endometrial cancer if managed surgically or develop cancer in time if managed conservatively. Therefore, intraoperative assessment of the uterus may be helpful if a surgical approach is decided on. Our study aimed to investigate the role of frozen-section examinatio...

This study aims to assess the diagnostic performance of a novel intraoperative ex vivo ultrasonography technique in determining deep myometrial invasion (MI) in patients with apparently low-risk endometrial cancer (EC). This prospective study included patients with type I EC who underwent staging laparotomy at Hacettepe University Hospital from Dec...

Paraaortic lymph node metastasis is a frequent finding of advanced ovarian cancer in primary setting [1] or in case of recurrence [2]. Secondary cytoreductive surgery in patients presenting with recurrent nodal disease was found to be related with better oncological outcomes compared with those who had chemotherapy alone [3]. However, resection of...

Women with postmenopausal bleeding should be evaluated efficiently to exclude endometrial carcinoma. To estimate the risk of endometrial cancer using individual case characteristics among women with postmenopausal bleeding in whom the endometrial thickness is >4 mm. Women with postmenopausal bleeding underwent clinical evaluation followed by transv...

Purpose: To determine clinicopathological risk factors associated with lymph node metastasis in endometrial cancer (EC). Methods: Clinicopathological data of patients who underwent comprehensive surgical staging for clinical early stage EC between 2001 and 2010 at Hacettepe University Hospital was retrospectively reviewed. Results: Two hundred...

To determine the effects of chewing gum, early oral hydration and early mobilisation on the time of first bowel sounds, first passage of flatus and first defecation following abdominal gynaecologic surgery. A major complication of abdominal surgical procedures is paralytic ileus which results in patient discomfort, prolonged length of hospital stay...

Placental adhesive disorders involve the growth of placental tissue into or through the uterine wall. Among these disorders, placenta percreta is the rarest one. However, it may cause significant complications. This report aimed to report a neglected patient with placenta percreta who developed uterine rupture with life-threatening late postpartum...

To investigate the frequency of aberrations of retroperitoneal great vessels in patients with gynecologic cancers who were scheduled for pelvic and paraaortic lymphadenectomy, and to document the vascular complications which occurred during lymphadenectomy as well as the relationship of these vascular complications with vascular aberrations. Patien...

To investigate the prevalence of cervical human papilloma virus (HPV) with genotyping and simultaneous cervical cytology among Turkish women in a university hospital. A review of literature was done as well to summarize the results of similar Turkish studies based on hospital data. Women who were subjected to cervical HPV-DNA testing with simultane...

Carotid-cavernous aneurysm accounts for 2-9% of all intracranial aneurysms. The rupture of carotid-cavernous aneurysm is usually caused by a trauma. Nevertheless, spontaneous rupture may rarely be encountered. Here, we report a term pregnant woman who was diagnosed to have a spontaneous carotid-cavernous fistula due to carotid-cavernous aneurysm ru...

We aimed to evaluate the agreement of 2-dimensional (2D) and 3-dimensional (3D) ultrasonography (USG) with true ovarian volume (OV), as calculated precisely after oophorectomy. A total of 46 ovaries from 30 patients were prospectively enrolled. Preoperatively, all ovaries were assessed by 2D and 3D USG for volume estimation and results were compare...

To assess human papilloma viruses (HPV) DNA test for detection of recurrences in cervical intraepithelial neoplasia (CIN) patients after loop electrosurgical excision procedure (LEEP). Also effect of LEEP on the clearance of HPV infection was evaluated for CIN 1 lesions. HPV DNA positive 37 patients (25 CIN 2-3 and 12 CIN 1 cases proven by colposco...

Optimum therapeutic approach in vaginal agenesis has always been an area of extensive controversies. Although surgical management gained priority due to the evolution of techniques, there is currently no consensus in the literature regarding the best type of surgical approach. The most commonly preferred surgical procedure among gynecologists is Mc...

The most commonly used classification system for endometrial hyperplasia is the World Health Organization system which is based on subjective criteria. Another classification system is endometrial intraepithelial neoplasia (EIN) system which uses diagnostic criteria including cytological demarcation, crowded gland architecture, minimum size of 1 mm...

Lymphadenectomy, in general, is a safe and well-tolerated procedure in gynecologic oncology. However, some technical difficulties may be experienced in obese women which may result in inadequate lymphadenectomy and increased complications. The purpose of this study is to retrospectively evaluate the effect of obesity on lymph node counts retrieved...

Lipoleiomyoma is a very rare tumor which is composed of adipocytes and smooth muscle cells. It is most commonly located in uterine corpus although cervical, ovarian, and retroperitoneal locations were also reported. Lipoleiomyoma located in broad ligament is extremely uncommon and only five cases were reported to date. Here, we report the sixth cas...

Ectopic pregnancy is still one of the leading causes of maternal mortality. Due to the popularity of elective sterilization procedures, the incidence of ectopic pregnancies following tubal sterilization began to increase in recent years and post-sterilization ectopic pregnancies account more than 10% of all ectopic pregnancies. This case report des...

This study investigated light and electron microscopic findings in cardinal ligaments of women with or without uterine prolapse. Cardinal ligament samples were obtained from hysterectomy specimens of ten women with and ten women without uterine prolapse. Light microscopy showed altered connective tissue properties in eight of ten women with prolaps...

BackgroundAggressive angiomyxoma is an uncommon soft tissue tumor which preferentially involves pelvic and vulvoperineal regions of young adult females. The typical characteristics include gelatinous appearance and locally infiltrative nature without evidence of nuclear atypia or mitosis. Treatment involves surgery, but local recurrence is high in...

Ovarian granulosa cell tumors are rare malignancies with a relatively favorable prognosis. However, patients still suffer from disease-related mortality. Therefore, the prognostic factors should be clarified. The purpose of this study was to investigate the clinical and pathologic characteristics related with disease recurrence and mortality in adu...

Female reproductive tract abnormalities are common and may occur in various combinations. Management usually involves surgery. However, therapeutic failures may be experienced and repeated surgical interventions may be required. A 26-year-old woman who was subjected to surgery for imperforate hymen coexistent with transverse vaginal septum 10 years...

Aim To review the characteristics of women with abnormal cervical cytology. Methods Women who had abnormal cervical cytology on Papanicolaou (Pap) test obtained at Hacettepe University Hospital in 2007 constituted the study group. Cytological and pathological diagnoses, human papillomavirus (HPV) status, and follow-up procedures were investigated....

To evaluate survival estimates and clinico-pathological variables in women with primary vulvar squamous cancer. Retrospective observational study. Setting. University hospital in Turkey. Patients treated for primary vulvar squamous cancer. Retrospective evaluation of demographic, pathologic and follow-up data of 91 patients obtained from hospital r...

Von Willebrand disease is the most common inherited bleeding disorder caused by quantitative or qualitative defects of von Willebrand factor, which may lead to postpartum bleeding problems. In such patients, resistant postpartum hemorrhage may be treated effectively by using transcatheter arterial embolization. Life-threatening late postpartum blee...

Cornual (interstitial) pregnancy, a very rare form of ectopic pregnancy, accounts for 2–4% of all tubal pregnancies in which conception is located in the proximal interstitial portion of the fallopian tube. Cornual resection by laparotomy is generally the preferred method of treatment, although more conservative approaches have also been described....

The association between malignancy and venous thrombotic events is well established. However, arterial thrombosis among cancer patients is extremely rarely reported. There are several mechanisms of arterial thrombosis or embolism in malignancy. Important mechanisms in arterial thrombogenesis are shear stress-induced platelet aggregation and platele...

A 56-year-old post-menopausal woman presented with abdominal swelling and shortness of breath. An evaluation of abdomen and pelvis showed ascites and a solid mass. Serum CA-125 level was elevated (509 IU/ml). A computerized tomography-angiography was performed since the pulses of upper extremities could not be palpated. The patient was diagnosed to...

To detect risk factors for the appendiceal metastasis and to define the role of routine appendectomy in patients with epithelial ovarian carcinoma. A total of 285 patients with epithelial ovarian carcinoma who had undergone primary cytoreductive surgery including appendectomy were retrospectively evaluated. Appendiceal involvement was divided into...

Ovulation-inducing drugs have been widely used for various types of infertility since the beginning of 1960s and their use increases day by day parallel to the success achieved in fertility treatment. However, the researches performed in the last two decades have begun to discuss about the safety of these drugs and the risks associated with their u...

Neuroendocrine carcinomas arise from Kulchitsky cells and are frequently seen in gastrointestinal tract and lungs. But they are unusual in gynecology practice. The Fallopian tube is one of the rarest locations for the development of a female genital malignancy. The most common histologic subtype is adenocarcinoma in malignancies of fallopian tubes,...