In our cohort, we found that endometrioid/endometrioid type synchronous primary endometrial and ovarian cancer had different clinical histopathologic characteristics and favorable prognosis compared to the other histologic types of these cancers. Histopathologic type of the ovarian cancer component, stage of endometrial cancer and level of cancer antigen 125 at diagnosis were observed to have a great influence on the development of recurrence and survival of synchronous primary carcinomas of the endometrium and ovary.

The complication rate of intraperitoneal access devices is comparatively low.

Background: In subtypes of non-endometrioid endometrium cancers (non-ECC), it is not clear whether the omentectomy is a part of debulking if visual assessment is normal. Recently, the ESMO-ESGO-ESTRO Endometrial Consensus Conference Working Group in their report titled “Endometrial Cancer: diagnosis, treatment and follow-up” recommended that omentectomy be performed in the serous subtype, but not in carcinosarcoma, undifferentiated endometrial carcinoma or clear cell. In this study, the question is whether omentectomy should be a part of a staging procedure in patients with non-ECC. Besides, the sensitivity and specificity of the visual assessment of omentum were analyzed. Methods: Patients diagnosed with non-ECC in 2 gynecological oncology clinics between 2005 and 2015 were retrospectively reviewed. Occult (absence of visible lesions) and gross (presence of visible lesions) omental metastasis rates of histological subtypes were analyzed. Results: We identified 218 patients with non-ECC. Thirty-four of them (15.1%) had omental metastases and 44.1% of these metastases (n = 15) were occult metastases. The sensitivity of the surgeon's visual assessment of an omentum (positive or negative) was 0.55. The highest rate of omental metastasis was found in carcinosarcoma followed by serous, mixed subtypes, and clear-cell (20.4, 17.3, 16.6, 10.0%, respectively). Adnexal metastasis was the only factor associated with occult omental metastasis (p = 0.003). Conclusion: Omental metastases occur too often to omit omentectomy during surgical procedures for non-ECC regardless of histological subtypes, and visual assessment is insufficient in recognizing the often occult metastases. Omentectomy should be a part of the staging surgery in patients with non-ECC.

The most common primary sites for ovarian metastasis are gastrointestinal tract. Metastasectomy may have beneficial effects on survival, especially if the residual disease is less than 5 mm. Prospective studies warranted to evaluate the value of metastasectomy in patients with ovarian metastasis.

Background and Objectives:In ovarian cancer, development of safe and effective methods for providing long-term access to the peritoneal cavity has become increasingly important. Methods: A modified Port-A-Cath (Celsite-port and catheters, B. Braun, Chasseneuil, France) was used in 56 patients with presumed epithelial ovarian cancer at the conclusion of primary or second-look laparotomy. In 37 patients, ports were located on the right costal margin in the midclavicular region and in 19 in the xiphoid region. Results: In 56 catheters, 8 (13.8%) complications of severe or moderate degree during the treatment were registered. In-flow obstruction of device occurred in 6 patients, and there was 1 viscous perforation and 1 catheter related infectious peritonitis. Grade III-IV pain and in-flow obstruction were developed in the patients with ports implanted on the right costal margin but not with ports implanted in the xiphoid region. Conclusion:The complication rate of intraperitoneal access devices is comparatively low.

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The aim of the study was to define the prognostic role of the metastasis suppressor gene, nm23, in 50 patients with primary ovarian cancer. Immunohistochemical analysis was performed on formalin-fixed, paraffin-embedded specimens by the primary nm23 monoclonal antibody (Novocastra, NCL-nm23 clone 37.6). Forty-two specimens (84%) showed a positive nm23 staining. The nm23 staining was more intensive in patients with normal serum CA19.9 levels, patients with nonrecurrent disease, and alive patients (p < 0.05). Nm23 expression did not correlate with common clinicopathologic parameters such as histology, grade of differentiation, International Federation of Gynecology and Obstetrics stage, and CA-125. Although the difference was not statistically significant (p = 0.11), we found that nm23 may have a favorable prognostic factor in ovarian cancer. To clarify this subject further, prospective studies on a larger population are needed.

Objective To evaluate the outcomes of surgical treatment in patients with chemoradiotherapy (CRT)-resistant and locally advanced cervical cancer (LACC). Methods Patients with LACC who underwent surgery due to resistance to CRT between 2005 and 2015 were reviewed retrospectively. Disease-free survival (DFS) and overall survival (OS) related factors were analyzed. Results A total of 23 patients were included in the study and the median age was 51 years old. A total of 14 patients (60.8%) experienced recurrence; among these recurrences, 8 of them were local, 5 were distant, 1 was both distant and local. A total of 9 patients (39%) died. The Median DFS and OS durations were 15 and 32 months, respectively. A total of 17 patients (74%) had undergone simple hysterectomy, 4 (17%) radical hysterectomy, and 2 (9%) total pelvic exenteration. Postoperative grade 3 and 4 complications were seen in 12 patients (52%). Macroscopic tumor presence in the pathology specimen was associated with distant recurrence and positive surgical margins with local recurrence (Log-Rank test p = 0.029 and p = 0.048, respectively). The only factor associated with OS was surgical margin positivity (Log-Rank test p = 0.008). The type of surgery, grades 3 and 4 postoperative complications, brachytherapy, and tumor histology were not associated with recurrence. Conclusion In patients with LACC, hysterectomy is an option in the presence of a central residual tumor after CRT. However, the risk of grades 3 and 4 complications of performed surgery is high. The presence of macroscopic tumor in the pathology specimen and positive surgical margins are poor prognostic factors. The goal of the surgeon should be to achieve a negative surgical margin. It does not seem important if the surgery is simple or radical.