Person: OZAN, HAKAN
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Publication Omental micrometastasis in endometrial cancer(Karger, 2019-01-01) Bayrak, Mehmet; Yılmaz, Alpay; Yılmaz, Fatih; İlhan, Olcay; Atalay, Fatma Öz; Ozan, Hakan; Bayrak, Mehmet; Yılmaz, Fatih; İlhan, Olcay; ÖZ ATALAY, FATMA; OZAN, HAKAN; Tıp Fakültesi; Cerrahi Patoloji Kliniği; 0000-0002-9910-8032; 0000-0002-5820-3754; DUU-5336-2022; C-5252-2015; CXA-2700-2022; JHC-4482-2023; DKZ-4159-2022Introduction: Although there are several reports on omentum metastasis, limited studies have evaluated omental micrometastases, particularly isolated microscopic metastases in endometrial cancer (EC). We performed this study to assess the frequency of omental micrometastasis in EC, especially when the omentum is the only site of extrauterine spread. Methods: A retrospective study was conducted to assess cases of EC with an omental sample during primary surgical treatment for EC at the Gynecological Oncology Unit, Uludag University Hospital, Bursa, Turkey, between January 2005 and May 2018. Results: In total, 435 patients fulfilled the inclusion criteria, which comprised a complete surgical staging. The prevalence of omental metastases was 5.3% (n = 23), regardless of the subtype or clinical stage. Omental micrometastasis was detected in four cases (17.4%). In half of these patients, the omentum was the only site of disease outside the uterus, with an estimated 0.46% of isolated omental involvement. The grade of the endometrioid tumor was found to be statistically correlated with omental metastases (p = 0.01). There was a significant correlation between omental metastasis and positive peritoneal cytology, as well as adnexal involvement (p = 0.001 and p = 0.03, respectively). Conclusion: We recommend omentectomy routinely in serous EC. In addition, we suggest selective omentectomy in patients with EC who have concomitant adnexal involvement or grade 3 tumors.Publication The impact of ki-67 index, squamous differentiation, and several clinicopathologic parameters on the recurrence of low and intermediate-risk endometrial cancer(Assoc Basic Medical Sci Federation Bosnia & Herzegovina Sarajevo, 2021-01-01) Ocak, Birol; Atalay, Fatma Oz; Sahin, Ahmet Bilgehan; Ozsen, Mine; Dakiki, Bahar; Ture, Seray; Mesohorli, Merve; Odman, Hikmet Utku; Tanriverdi, Ozgur; Ocakoglu, Gokhan; Bayrak, Mehmet; Ozan, Hakan; Demiroz, Candan; Sali, Seda; Orhan, Sibel Oyucu; Deligönül, Adem; Çubukcu, Erdem; Evrensel, Turkkan; Ocak, Birol; OCAK, BİROL; Sahin, Ahmet Bilgehan; ŞAHİN, AHMET BİLGEHAN; Atalay, Fatma Oz; ÖZ ATALAY, FATMA; Ozsen, Mine; ÖZŞEN, MİNE; Dakiki, Bahar; DAKİKİ KORUCU, BAHAR; Ture, Seray; TÜRE AYDIN, SERAY; Mesohorli, Merve; Odman, Hikmet Utku; Ocakoglu, Gokhan; OCAKOĞLU, GÖKHAN; Bayrak, Mehmet; Ozan, Hakan; OZAN, HAKAN; Demiroz, Candan; DEMİRÖZ ABAKAY, CANDAN; Sali, Seda; SALİ, SEDA; Orhan, Sibel Oyucu; OYUCU ORHAN, SİBEL; Deligonul, Adem; DELİGÖNÜL, ADEM; Cubukcu, Erdem; ÇUBUKÇU, ERDEM; Evrensel, Turkkan; EVRENSEL, TÜRKKAN; Tıp Fakültesi; Onkoloji Ana Bilim Dalı; 0000-0001-7537-1699; 0000-0002-7188-6115; 0000-0002-7846-0870; 0000-0002-5771-7649; 0000-0001-9255-2475; 0000-0002-1114-6051; 0000-0003-1600-333X; AEC-2238-2022; ABA-2897-2021; AAH-5180-2021; AAM-4927-2020; AAJ-8314-2021Endometrial endometrioid carcinoma (EEC) represents approximately 75-80% of endometrial carcinoma cases. Three hundred and thirty-six patients with EEC followed-up in the authors' medical center between 2010 and 2018 were included in our study. Two hundred and seventy-two low and intermediate EEC patients were identified using the European Society for Medical Oncology criteria and confirmed by histopathological examination. Recurrence was reported in 17 of these patients. The study group consisted of patients with relapse. A control group of 51 patients was formed at a ratio of 3:1 according to age, stage, and grade, similar to that in the study group. Of the 17 patients with recurrent disease, 13 patients (76.5%) were Stage 1A, and 4 patients (23.5%) were Stage 1B. No significant difference was found in age, stage, and grade between the case and control groups (p > 0.05). Body mass index, parity, tumor size, lower uterine segment involvement, squamous differentiation (SqD), and Ki-67 index with p<0.25 in the univariate logistic regression analysis were included in the multivariate analysis. Ki-67 was statistically significant in multivariate analysis (p = 0.018); however, there was no statistical significance in SqD and other parameters. Our data suggest that the Ki-67 index rather than SqD needs to be assessed for recurrence in patients with low- and intermediate-risk EEC.Publication Why do some patients with stage 1a and 1b endometrial endometrioid carcinoma experience recurrence? A retrospective study in search of prognostic factors(Via Medica, 2022-01-01) Tanrıverdi, Özgür; Ocak, Birol; OCAK, BİROL; Şahin, Ahmet Bilgehan; ŞAHİN, AHMET BİLGEHAN; Atalay, Fatma Oz; ÖZ ATALAY, FATMA; Özsen, Mine; ÖZŞEN, MİNE; Dakiki, Bahar; DAKİKİ KORUCU, BAHAR; Türe, Seray; TÜRE AYDIN, SERAY; SALİ, SEDA; Bayrak, Mehmet; OZAN, HAKAN; DEMİRÖZ ABAKAY, CANDAN; Deligönül, Adem; DELİGÖNÜL, ADEM; Evrensel, Turkkan; ÇUBUKÇU, ERDEM; EVRENSEL, TÜRKKAN; Tıp Fakültesi; İç Hastalıkları Ana Bilim Dalı; 0000-0001-7537-1699; 0000-0002-7846-0870; 0000-0002-5771-7649; 0000-0001-9255-2475; 0000-0001-8407-0169; ABA-2897-2021; AEC-2238-2022; AAM-4927-2020Objectives: Endometrial endometrioid carcinoma (EEC) is the most encountered subtype of endometrial cancer (EC). Our study aimed to investigate the factors affecting recurrence in patients with stage 1A and 1B EEC. Material and methods: Our study included 284 patients diagnosed with the International Federation of Gynecology and Obstetrics stage 1A/1B EEC in our center from 2010 to 2018. The clinicopathological characteristics of the patients were obtained retrospectively from their electronic files. Results: The median age of the patients was 60 years (range 31-89). The median follow-up time of the patients was 63.6 months (range 3.3-185.6). Twenty-two (7.74%) patients relapsed during follow-up. Among the relapsed patients, 59.1% were at stage 1A EEC, and 40.9% were at stage 1B. In our study, the one-, three-, and five-year recurrence-free survival (RFS) rates were 98.9%, 95.4%, and 92.9%, respectively. In the multivariate analysis, grade and tumor size were found to be independent parameters of RFS in all stage 1 EEC patients. Furthermore, the Ki-67 index was found to affect RFS in stage 1A EEC patients, and tumor grade affected RFS in stage 1B EEC patients. In the time-dependent receiver operating characteristic curve analysis, the statistically significant cut-off values were determined for tumor size and Ki-67 index in stage 1 EEC patients. Conclusions: Stage 1 EEC patients in the higher risk group in terms of tumor size, Ki-67, and grade should be closely monitored for recurrence. Defining the prognostic factors for recurrence in stage 1 EEC patients may lead to changes in follow-up algorithms.Publication The ki-67 index and neutrophile-lymphocyte ratio are prognostic factors in patients with low-risk endometrial cancer(Mre Press, 2021-04-21) Çubukcu, Erdem; Şahin, Ahmet Bilgehan; Atalay, Fatma Öz; Ocak, Birol; Özşen, Mine; Abakay, Candan Demiröz; Özerkan, Kemal; Hasanzade, Ulviyya; Mesahorlı, Merve; Deligönül, Adem; Ozan, Hakan; Evrensel, Türkkan; ÇUBUKÇU, ERDEM; ŞAHİN, AHMET BİLGEHAN; ÖZ ATALAY, FATMA; OCAK, BİROL; ÖZŞEN, MİNE; DEMİRÖZ ABAKAY, CANDAN; ÖZERKAN, KEMAL; HASANZADE, ULVIYYA; Mesahorlı, Merve; DELİGÖNÜL, ADEM; OZAN, HAKAN; EVRENSEL, TÜRKKAN; Tıp Fakültesi; Patoloji Ana Bilim Dalı; 0000-0002-7846-0870; 0000-0001-7537-1699; 0000-0002-5771-7649; 0000-0001-5380-5898; AAH-9791-2021; K-2269-2016; AAM-4927-2020; ETP-1691-2022; JHC-4482-2023; HHA-1866-2022; AAI-1609-2021; AAH-3855-2021; EXU-7466-2022; FNB-4540-2022; ESM-4544-2022; DKZ-4159-2022; EXJ-0967-2022Objective: To investigate the prognostic factors comparing clinical, histopathological, and laboratory parameters in low-risk endometrial cancer (EC). Methods: In the present single-center study, multivariate Cox regression analysis was performed on retrospective clinical and laboratory data and histopathological features obtained from the re-evaluation of 253 patients with low-risk EC. Receiver operating characteristic curves (ROC) were plotted for neutrophile-lymphocyte ratio (NLR), platelet-lymphocyte ratio, lymphocyte-monocyte ratio and Ki-67 index for recurrence. Kaplan-Meier analysis was employed for survival rates. Results: The median age was 58.5 years (32.0-75.4). Most of the patients were obese and post-menopausal. In nearly half of the patients, lymphadenectomy was performed in addition to hysterectomy and oophorectomy. The median tumor size was 30 mm (range 2-80), and the median Ki-67 index was 25 (1-90). According to the ROC curve analysis, the cut-off values for the Ki-67 index, NLR, PLR, and LMR were determined as >= 22, >= 1.98, >= 115.3, and >= 4.71, respectively. The log-rank test revealed that the patients with a Ki67 index lower than 22% and NLR lower than 1.98 had statistically longer recurrence-free survival (RFS) (p = 0.002 for Ki-67 index and p = 0.004 for NLR). The multivariate analysis revealed that the Ki-67 index and NLR were statistically significant factors for RFS (p = 0.012 and p = 0.029, respectively). Conclusion: The present study highlights the prognostic implications of both the Ki-67 index and NLR in lowrisk EC.Publication Drain-site metastasis observed following surgery and radiotherapy of an endometrial carcinoma figo stage ic patient: Case report(Galenos Yayıncılık, 2008-03-01) Ozan, Hakan; Özdil, Murat; Özyürek, Eser Tefik; Özerkan, Kemal; Kıran, Beray; Aker, Sibel; OZAN, HAKAN; Özdil, Murat; Özyürek, Eser Tefik; ÖZERKAN, KEMAL; Kıran, Beray; Aker, Sibel; Tıp Fakültesi; Kadın Hastalıkları ve Doğum Ana Bilim Dalı; DKZ-4159-2022; AAH-9791-2021; JLF-4109-2023; INC-9610-2023; FDT-3930-2022; EJH-8721-2022Endometrial carcinoma is the most prevalent malignancy of the genital tract. With early diagnosis and treatment, its prognosis is more favorable than other gynecological malignancies. The objective of this case study is to present a very rare condition of a drain site metastasis following the treatment of a low stage endometrial carcinoma.A 63 year old woman was operated for endometrial carcinoma (histological subtype: Endometrioid) FIGO Stage IC (Grade I) and treated with the brachytherapy protocol, postoperatively. During the routine postoperative follow-up exams every three months, she presented with a mass in the right lower abdominal quadrant located at the drain site in the 15th postoperative month. Biopsy sampling of this mass revealed metastatic endometrioid adenocarcinoma. Radiotherapy followed by chemotherapy and eventually surgery was planned forthe resection of the regressed mass.Similar metastatic lesions in gynecological cancers are mostly restricted to high stage ovarian and peritoneal malignancy conditions, and are usually located at trochar port sites and paracentesis puncture points. Nevertheless, this case shows that other early stage malignancies may as well metastasize in a similar fashion and should not be overlooked in the follow-up examinations.