Nejat Ozgul

• Hacettepe University

Background/Objectives: To investigate the risk factors for CIN2+ lesions (cervical intraepithelial neoplasia 3 or worse) in endocervical curettage (ECC) and to evaluate the relationship between the addition of ECC to punch biopsy in terms of the yield of CIN2+ lesions. Methods: Between February 2018 and 2019, data on colposcopy results from 11,944...

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 sur...

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...

Introduction/Background* To assess the clinicopathological features, prognostic factors, and survival rates associated with uterine leiomyosarcoma (uLMS). Methodology Databases from 15 participating gynecological oncology centers in Turkey were searched retrospectively for women who had been treated for stage I-IV uLMS between 1996 and 2018. Resu...

Ovarian mucinous tumors are one of the common epithelial tumors in the ovary, but their recurrence is extremely rare. In a 37‐year‐old female patient who had had five operations in 7 years due to recurrent mucinous neoplasms, a mass extending to the umbilicus was recently detected during a routine examination. With this finding the patient underwen...

Background and objectives: The aim of this study was to analyze the factors affecting recurrence-free (RFS) and overall survival (OS) rates of women diagnosed with low-grade serous ovarian cancer (LGSOC). Methods: Databases from 13 participating centers in Turkey were searched retrospectively for women who had been treated for stage I-IV LGSOC b...

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 Loop electrosurgical excision procedure (LEEP) is the most frequently used therapeutic approach in pre-invasive cervical diseases. Surgical margin positivity is a big debate among gynecologists and there are several reports showing the importance of HPV 16–18, pap-smear results, age of the patient, or size of the lesion. Thi...

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 To investigate factors associated with refractory disease, recurrence, or death as well as disease-free survival (DFS) and overall survival (OS) in low-grade endometrial sarcoma (LGESS). Methods A multi-institutional, retrospective study was conducted in a total of 124 patients, who received a curative-intent surgery. The exclusion crite...

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...

PurposeTo demonstrate and understand the association of HPV infection and biofilm formation.Methods The study consisted of cervicovaginal samples of 72 women who were evaluated at the colposcopy unit. Papanicolaou staining was used for cytological examination while “Crystal Violet Binding” assay was performed to detect biofilm formation.ResultsHPV-...

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 evaluate the Turkey's nationwide HPV DNA screening program on the basis of first 4 million screened women. Methods Women over age 30 were invited for screening via HPV DNA and conventional cytology. Single visit screen strategy was used to collect for both screening and triage (extended genotyping and conventional pap-smear). Results...

Introduction/Background Low-grade serous ovarian carcinoma (LGSOC) is a rare subtype of epithelial ovarian cancers (EOC), and is molecularly and clinically distinct from its high-grade counterpart. The aim of this study was to describe the clinico-pathological features of patients diagnosed with LGSOC and to analyse the factors affecting recurrence...

Ovarian cancer has a high mortality rate. Serous carcinoma is the most common subtype and can be detected by distant or lymph node metastasis in advanced stages. Apelin, an adipokine associated with obesity, and its receptor, APJ, participate in lymphatic invasion. Angiogenesis also can affect lymph node involvement in serous ovarian carcinomas. We...

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...

Aim: The aim of this study was to investigate the risk factors for recurrence in patients with low-risk endometrial cancer (EC). Patients and methods: This retrospective study was performed using 10 gynecological oncology department databases. Patients who met the following criteria were included in the study: (a) endometrioid-type histology, (b...

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...

Context Atypical glandular cells (AGCs) result in the Papanicolaou (Pap) smear may be associated with significant genital and nongenital neoplastic processes. Aims To evaluate the underlying histopathology in women who had AGCs on Pap smears. Settings and Design Retrospective cross-sectional study. Patients and Methods Clinicopathological data o...

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....

Stevens-Johnson syndrome (SJS) is a rare and acute life-threatening condition which is almost always precipitated by drugs. Genital mucositis in female patients may also be an important cause of long-term morbidity secondary to mucosal scarring. We present the case of a 33-year-old nulligravid woman with distal vaginal synechiae necessitating a sur...

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: 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...

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...

Objective: The first cohort of Turkish fellows has begun to graduate from a newly accredited training program on gynecologic oncology. This study aimed to investigate the value of experience on the confidence of these fellows to perform surgical procedures. Methods: We assessed the characteristics of 32 fellows, including the perceived adequacy...

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...

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...

Nonbacterial thrombotic endocarditis (NBTE) is a rare manifestation of hypercoagulability in patients with malignant neoplasms. Case Report. A fifty-six-year-old woman presented to the emergency service; the clinical workup revealed deep vein thrombosis in right leg and bilateral massive PTE. As the abdominal sections on the spiral CT revealed a gi...

Objective: Patients with advanced or recurrent ovarian cancer often have metastatic disease in the upper abdominal region, especially to the right hemidiaphragm, which requires diaphragmatic resection in order to achieve optimal cytoreduction. The aim of this surgical video is to demonstrate repair of a diaphragmatic injury and placement of tube t...

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...

Cervical cancer is the third most common female cancer worldwide and the use of routine screening resulted in earlier stage and younger age at diagnosis. Fertility preservation via radical trachelectomy comes up as an option in such patients. Recent literature reviews confirm the safety of this operation with excellent oncologic outcomes in appropr...

Objective To evaluate the accuracy of intraoperative frozen section in the evaluation of patients with adnexal mass and to define the clinicopathological factors associated with misdiagnosis during frozen section evaluation. Methods The clinicopathological data of patients who underwent exploratory laparotomy for adnexal mass were reviewed. Resu...

The objective of our study was to evaluate the accuracy of frozen section (FS) in borderline ovarian tumours (BOT) and to define the factors associated with misdiagnosis during FS evaluation. We performed a retrospective review of patients who underwent exploratory laparotomy for an adnexal mass, from January 2007 to July 2012, at a tertiary oncolo...

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...

Background: To investigate the impact of ovarian transposition (OT) on survival rates of the patients with stage Ib squamous cell cervical cancer. Materials and methods: Ninety-two subjects who underwent a radical hysterectomy including oophorectomy were evaluated. For nineteen (20.7%) , OT was performed. Patients were divided into two groups, O...

Aim: To define a high-risk group for paraaortic (PA) lymph node metastasis among endometrial carcinoma patients. Materials and methods: Prognostic factors determining PA lymph node metastasis were defined. Using these factors in different combinations, 14 risk groups were formed. A patient with at least one of these factors was considered as high-r...

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...

Chylous ascites is the pathologic accumulation of lymphatic fluid in the peritoneal cavity. Patients who underwent surgery for gynecologic malignancy and had postoperative chylous ascites were evaluated retrospectively. We reviewed 1514 patients who had staging surgery for gynecologic malignancy at our institution from January 2003 to February 2012...

Introduction: Alopecia in paclitaxel and platinum combination treatment that is widely used in gynecological oncology was evaluated. Materials and Method: The study evaluated retrospectively and the data of toxicity belonging to 470 patients who underwent surgery in the period from 1993 to 2006 because of epithelial ovarian cancer, fallopian tube...

The purpose of this study was to correlate the histological diagnosis made during intraoperative frozen section (FS) examination of hysterectomy samples with complex atypical endometrial hyperplasia (CAEH) diagnosed with definitive paraffin block histology. FS pathology results of 125 patients with a pre- operative biopsy showing CAEH were compared...

An analysis of the current nuclear medicine (NM) status and future demand in Turkey in line with the international benchmarks was conducted to establish a comprehensive baseline reference. Data from all NM centers on major equipment and manpower in Turkey were collected through a survey and cross-checked with the primary research and governmental d...

An organized palliative care system was lacking in Turkey before 2010. One of the pillars of Turkish Cancer Control Programme is palliative care. The Pallia-Turk project in this respect has been implemented by the Ministry since 2010. The project is unique since it is population based and organized at the primary level. This means, the whole popula...

Aim: The cervical and breast cancer screening programme to report the results between 2008 and 2010 at KETEM in Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital. Method: Populations of healthy women between 2008 and 2010 with a total of 5253 case were evaluated with community-based and opportunistic screening. The cervical cancer s...

Purpose:To investigate the effects of information acquired by KETEM’s staff on the diagnosis and treatment of breast cancer.Patients and Methods:Between 2007-2010, BSE was first taught and performed in all women. USG was performed for those ≤40, and MG for those ≥40; also, USG and MRI were ordered, if necessary. For patients with BIRADS 4-5 lesions...

Palliative care is an emerging topic in Turkey within recent years. Currently, there are only few number of palliative care services across the country and majority of the centers are pain control units. Morphine consumption rate per capita is low, accessibility and availability of morphine products are also limited. One of the main headings of Tur...

Cancer is one of the leading diseases responsible for a majority of deaths in human beings. The incidence of cancer is increasing both in Turkey and in the world, globally. The level of awareness is very important in directing the health policies of cancer prevention, particularly in terms of preventive and screening measures. However, there is not...

An analysis of the current radiotherapy status in Turkey was conducted to establish a comprehensive baseline. Turkey's future demand analysis in view of international benchmarks was conducted. Moreover, the ministerial plans are shared to present an example for making a comprehensive planning in developing countries. The data from all radiotherapy...

In order to develop cost effective health strategies regarding HPV screening and prevention methods, determining the incidence and prevalence of HPV as well as the diseases it gives rise to such as cervical cancer and genital warts is essential. This study is a first step in determining nationwide annual prevalence of genital warts in Turkey. Throu...

Determining the prevalence of obesity is a crucial step in combating with obesity and devising national health strategies. It is particularly important to better understand prevalence of obesity among women as women in Turkey also highly impacts the dietary habits of the whole household. This article determines the prevalence of obesity among adult...

Endometrial hyperplasia is a commonly seen clinical entity. A great majority of patients present with abnormal uterine bleeding. Unopposed estrogen either from an endogenous or exogenous source is the most important etiologic factor. Etiologic evaluation and cause specific treatment is a must for these patients instead of direct biopsies and treatm...

Objective: To evaluate the effectiveness of routine Pap smear screening in postmenopausal women. Study deSign: 2060 women applied to menopause outpatient clinic were reviewed retrospectively. Demographic characteristics, the use of hormone therapy, and the history of previous Pap smear were analyzed. ReSultS: The Pap smear results were as; normal i...

Epithelial ovarian carcinoma is considered to be one of the most lethal genital cancer types. Incomplete surgery, even far away from a basic staging procedure such as simple adnexectomy, hysterectomy, or even only cystectomy operation, is in question. Presently, there are no data on the role of reoperation and re-debulking in such previously incomp...

Objective: To evaluate retrospectively the prevalence of cervical cytological abnormalities in patient records obtained from healthcare centers in Turkey. Method: Demographic characteristics and data on cervical cytological abnormalities were evaluated from patients who underwent Pap tests in healthcare centers in 2007. Results: Data were coll...

The aims of this study were to evaluate the efficiency of p16INK4a in showing cervical lesions and to determine any relationship between lesion grade and high-risk human papilloma virus (HR-HPV) infection and p16INK4a staining characteristics. Immunohistochemical analysis of p16INK4a was performed on 13 low-grade squamous intraepithelial lesions (L...

Girifl: Bu çal›flmada evre IB serviks kanserinde, radikal histerek-tomi geçiren ve lenf nodu tutulumunun, parametrial yay›l›m›n ve cer-rahi s›n›r›n pozitifli¤inin olmad›¤› hastalarda sa¤ kal›m› belirleyen faktörler araflt›r›ld›. Materyal ve Metot: Klini¤imizde 1993-2007 y›llar› aras›nda evre IB serviks kanseri tan›s› al›p tip III radikal histerekto...

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....

Hydatidiform mole (HM) is the most common form of gestational trophoblastic neoplasia and is characterized by atypical hyperplastic trophoblasts and hydropic villi. Recurrence of HM is extremely rare. Here, we report the case of a patient with three consecutive partial HMs without normal pregnancy. A 28-year-old woman with gravida 3, para 0, was re...

Hydatidiform mole (HM) is the most common form of gestational trophoblastic neoplasia and is characterized by atypical hyperplastic trophoblasts and hydropic villi. Recurrence of HM is extremely rare. Here, we report the case of a patient with three consecutive partial HMs without normal pregnancy. A 28-year-old woman with gravida 3, para 0, was re...

This is not an article. That was a conference session!

Chylous ascites is an uncommon complication following para-aortic lymph node dissection in the management of gynecologic malignancies. Treatment options are serial paracentesis, medium-chain triglyceride diet, total parenteral nutrition and somatostatin as conservative management and peritoneovenous shunting, and surgical exploration for refractory...

This retrospective multicenter study aimed to assess the survival and prognostic factors of primary fallopian tube carcinoma. The medical records of 29 patients with fallopian tube carcinoma from two centers were reviewed for age, stage, surgical intervention, relapse and survival. The mean age of the patients was 56 years (range, 37-76). Six patie...