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Objective In this study, we aimed to evaluate the clinicopathological features, obstetric, and oncological outcomes of patients diagnosed with a uterine smooth muscle tumors of uncertain malignant potential (STUMP). Methods A dual-institutional, database review was carried out to screen patients with STUMP who were treated with upfront surgery between January 2006 and December 2017. Data including age at the time of diagnosis, recurrence rate, disease-free survival, overall survival, and fertility outcomes were retrospectively analyzed. Results Fifty-seven patients with STUMPs were included in the study. The median age at the time of diagnosis was 42 (range, 16 to 75) years. The median follow-up was 57 (range, 16 to 125) months. Eight patients (14%) had recurrence during follow-up. Recurrent STUMPs were seen in seven patients and leiomyosarcoma after 14 months in one patient. Seven patients with a recurrent STUMP survived, while the remaining patient died. Recurrence rates were similar for women who underwent myomectomy and those who underwent hysterectomy. The presence of uterine localization of tumor (subserosal vs intramural-submucosal) statistically significantly affected recurrence rates (odds ratio=5.72; 95% confidence interval=1.349–24.290; p=0.018). Ten of 27 patients who underwent myomectomy for uterine myoma had fertility desire. Seven pregnancies were recorded. Conclusions Our study results suggest that fertility-sparing approaches are feasible in patients with STUMP, although recurrence may be seen.

BACKGROUND AND PURPOSE: Prediction of survival in patients with glioblastomas is important for individualized treatment planning. This study aimed to assess the prognostic utility of presurgical dynamic susceptibility contrast and diffusion-weighted imaging for overall survival in patients with glioblastoma.

ORIGINAL ARTICLE PURPOSE Endovenous laser ablation has replaced surgical methods in the treatment of saphenous insufficiency. The aims of this study were to compare the effectiveness of 1470-and 980-nm wavelength (WL) laser systems, to compare the postoperative complication rates, and to determine the effect of laser WL on postoperative pain scores. MATERIALS AND METHODSBetween October 2010 and November 2011, 79 consecutive patients with saphenous vein insufficiency were examined. The patients who received the 980-nm treatment were defined as Group 1; 54 extremities of 47 patients were treated in this group. The patients who received the 1470-nm treatment were defined as Group 2; 36 extremities of 32 patients were treated in this group. RESULTSEarly technical success was 100% in both groups. Both major and minor complications were seen in Group 2. The complications in Group 1 were mostly major; however, three minor complications were reported in this group. The complication rates of the two groups were not significantly different. There was no statistically significant difference between the pain scores of the two groups. CONCLUSION Early postoperative pain was the major factor that impaired quality of life. There was no relationship between the postoperative pain scores and laser WL or energy density. The laser WL did not affect technical success or occurrence of complications. Use of a suitable energy density resulted in complete occlusion in all patients with saphenous vein insufficiency. Lower extremity venous insufficiency is a very common medical condition that affects approximately 25% of females and 15% of males (1). Great saphenous vein reflux is the most common underlying cause of symptomatic varicose veins. Other causes are reflux in other truncal veins, such as the small saphenous vein, the anterior or posterior thigh circumflex vein, the Giacomini vein, and perforating veins. Treatment options for varicose veins include conservative management, minimally invasive procedures, and surgery.In 1999, Salat (2) first reported the delivery of endoluminal laser energy with an 810-nm diode laser for the treatment of varicose veins. Early success with this device prompted development of other devices that supplied wavelengths (WLs) more specific to the hemoglobin chromophore (810-, 940-, and 980-nm devices) in an effort to achieve 100% saphenous vein closure (2-7). In contrast to these laser systems, the 1320-and 1470-nm WL laser systems affect interstitial water (8, 9). Goldman (6) introduced the 1320-nm WL, which better exploits water as the energy-absorbing molecule. Two comparative studies indicated that patients treated with water-specific laser WLs reported less postoperative pain, used less painkillers, and were less likely to have ecchymosis (8, 10).There is increasing focus on reducing postoperative pain and bruising, while maintaining high saphenous vein ablation rates. Because the 1470-nm WL is absorbed by water at a level 40-times more than the 980-nm WL, the manufacturer hypothesized that it woul...

ObjectiveTo determine factors influencing overall survival following recurrence (OSFR) in women with low-risk endometrial cancer (EC) treated with surgery alone.MethodsA multicenter, retrospective department database review was performed to identify patients with recurrent “low-risk EC” (patients having less than 50% myometrial invasion [MMI] with grade 1 or 2 endometrioid EC) at 10 gynecologic oncology centers in Turkey. Demographic, clinicopathological, and survival data were collected.ResultsWe identified 67 patients who developed recurrence of their EC after initially being diagnosed and treated for low-risk EC. For the entire study cohort, the median time to recurrence (TTR) was 23 months (95% confidence interval [CI]=11.5–34.5; standard error [SE]=5.8) and the median OSFR was 59 months (95% CI=12.7–105.2; SE=23.5). We observed 32 (47.8%) isolated vaginal recurrences, 6 (9%) nodal failures, 19 (28.4%) peritoneal failures, and 10 (14.9%) hematogenous disseminations. Overall, 45 relapses (67.2%) were loco-regional whereas 22 (32.8%) were extrapelvic. According to the Gynecologic Oncology Group (GOG) Trial-99, 7 (10.4%) out of 67 women with recurrent low-risk EC were qualified as high-intermediate risk (HIR). The 5-year OSFR rate was significantly higher for patients with TTR ≥36 months compared to those with TTR <36 months (74.3% compared to 33%, p=0.001). On multivariate analysis for OSFR, TTR <36 months (hazard ratio [HR]=8.46; 95% CI=1.65–43.36; p=0.010) and presence of HIR criteria (HR=4.62; 95% CI=1.69–12.58; p=0.003) were significant predictors.ConclusionLow-risk EC patients recurring earlier than 36 months and those carrying HIR criteria seem more likely to succumb to their tumors after recurrence.

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Introduction: We aimed to assess risk factors for lymph node (LN) metastasis among lymphovascular space invasion(LVSI)-positive women with pure endometrioid endometrial cancer (EC) clinically confined to the uterus. Methods: Medical records of women who underwent primary surgery for EC between 2007 and 2016 at either of 2 gynecological oncology centers were retrospectively reviewed. Patient data were analyzed with respect to LN involvement, and predictive factors for LN metastasis were investigated. Results: 280 patients with surgically staged endometrioid-type EC with LVSI were identified. LN involvement was detected in 88 patients (31.4%) with a systematic LN dissection. In multivariate analysis, elevated baseline serum CA 125 levels, deep myometrial invasion (MMI), adnexal involvement and positive peritoneal cytology were found to be independent risk factors for LN metastasis. In women without deep MMI and elevated baseline serum CA 125 levels, the rate of LN metastasis was 19%. The presence of solely deep MMI increased this probability up to 29.1%. The rate of LN metastasis was found to be 46.8% for women with both deep MMI and elevated baseline serum CA 125 levels. Conclusion: These findings may be useful in the decision-making process for LVSI-positive women who are unstaged.

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