Objectives: To evaluate the predictive value of preoperative CA125 in extra-uterine disease and its association with poor prognostic factors in endometrioid-type endometrial cancer (EC). Material and methods: A total of 423 patients with pathologically proven endometrioid-type EC were included in the study. The association between preoperative CA125 level and surgical–pathological factors was evaluated. The conventional cut-off value was defined as 35 IU/mL. Results: A high CA125 level ( > 35 IU/mL) was significantly associated with all of the studied poor prognostic factors, except grade. The risk of lymph node metastasis (LNM) increased from 15.9% to 45.7% when CA125 level was > 35 IU/mL (p < 0.05). The optimal cut-off value for the prediction of LNM in patients aged > 50 years was determined to be 16 IU/mL (sensitivity, specificity, positive predictive value, and negative predictive value were 71%, 60%, 35%, and 87%, respectively.) Conclusions: Preoperative CA125 level was significantly related with the extent of the disease and LNM. The age-dependent cut-off level of CA125 can improve the prediction of LNM in endometrioid-type EC. For older patients, CA125 level of > 16 IU/ml could be used to predict LNM. However, further studies are needed to evaluate the appropriate cut-off level of CA125 for younger patients. Objectives: To evaluate the predictive value of preoperative CA125 in extra-uterine disease and its association with poor prognostic factors in endometrioid-type endometrial cancer (EC). Material and methods: A total of 423 patients with pathologically proven endometrioid-type EC were included in the study. The association between preoperative CA125 level and surgical–pathological factors was evaluated. The conventional cut-off value was defined as 35 IU/mL. Results: A high CA125 level ( > 35 IU/mL) was significantly associated with all of the studied poor prognostic factors, except grade. The risk of lymph node metastasis (LNM) increased from 15.9% to 45.7% when CA125 level was > 35 IU/mL (p < 0.05). The optimal cut-off value for the prediction of LNM in patients aged > 50 years was determined to be 16 IU/mL (sensitivity, specificity, positive predictive value, and negative predictive value were 71%, 60%, 35%, and 87%, respectively.) Conclusions: Preoperative CA125 level was significantly related with the extent of the disease and LNM. The age-dependent cut-off level of CA125 can improve the prediction of LNM in endometrioid-type EC. For older patients, CA125 level of > 16 IU/ml could be used to predict LNM. However, further studies are needed to evaluate the appropriate cut-off level of CA125 for younger patients.

Objective: The first objective of this study was to investigate the relationship between gestational diabetes mellitus (GDM) and gestational weight gain (WG), waist circumference (WC), prepregnancy, and gestational body mass index (BMI). The second aim of our study was to assess the ability of WG, WC, prepregnancy, and gestational BMI with special reference to their cut-off points on predicting the risk of GDM in pregnant women in Turkey. Materials and Methods: A total of 261 women who underwent screening for GDM with the 75-g glucose tolerance test (GTT) between 24th and 28th gestational weeks were included. According to the 75-g oral Gil results, women were classified into two groups: the GDM group and non-GDM group. The data collected included age, parity, plasma glucose level for fasting, 1- and 2-h tests, WC, prepregnancy and gestational BMI, prepregnancy weight, WG during pregnancy, gestational age at birth, and birth weight. Results: WC at 20-24 weeks of gestation, prepregnancy BMI, and gestational BMI had a predictive capacity for GDM. According to our results, optimal cut-off points for the best predictive value of GDM were WC of 100 cm with a sensitivity of 84% and specificity of 70%, prepregnancy BMI of 25 kg/m(2) with a sensitivity of 81.8% and specificity of 76%, and gestational BMI of 28.3 kg/m(2) with a sensitivity of 75% and specificity of 77.4%. Conclusion: The measurement of prepregnancy BMI, gestational BMI, and WC may be useful in predicting the risk of GDM. Pregnant women with increased prepregnarrcy BMI, gestational BMI, and WC measurements may be susceptible to the development of GDM.

The aim of this study was to evaluate the prognostic factors for and determine the effect of neoadjuvant chemotherapy (NACT) on oncologic outcome in stage IVB pure serous endometrial carcinoma patients who received taxane and platinum. Forty-two patients with 2009 International Federation of Gynecology and Obstetrics (FIGO) stage IVB uterine serous carcinoma were enrolled from six gynecologic oncology centers and a study group was created. The study group had a 2-year disease-free survival (DFS) of 32% and 2-year disease-specific survival (DSS) of 73%. On univariate analysis; lymphadenectomy (not performed vs. performed), paraaortic lymph node metastasis (positive vs. negative) and number of metastatic lymph node count (≤5 vs. >5) were found to have statistical significance for DFS (p < 0.001, p = 0.026 and p = 0.044, respectively). Adnexal metastasis (positive vs. negative) and type of cytoreductive surgery (maximal vs. optimal and suboptimal) had statistical significance for DSS (p = 0.041 and p = 0.015, respectively). Receiving NACT did not affect DFS and DSS in stage IVB uterine serous carcinoma patients. As our sample size was small, precise conclusions could not be made for suggesting the use of NACT in advanced stage uterine serous carcinoma. For more accurate results, more randomized controlled studies are needed in this patient group.IMPACT STATEMENTWhat is already known on this subject? Endometrial carcinoma is the most common type of gynecologic tract malignancies and usually it is diagnosed at early stages. Although the favorable prognosis, uterine serous carcinoma (USC), one of the rarest subtypes, has a poorer prognosis when compared to other histological subtypes. USC has a propensity to spread beyond pelvis. Due to this aggressive behavior, surgical intervention could not be feasible in advanced stage disease.What do the results of this study add? Our study evaluated the prognostic factors that affect survival in advanced stage USC patients. Also we investigated that neoadjuvant chemotherapy (NACT) could improve oncologic outcomes. Performing lymphadenectomy, presence of paraaortic lymph node and adnexal metastasis, number of metastatic lymph nodes and type of cytoreductive surgery improved survival in advanced stage USC patients. However, NACT did not have a statistical significance as a predictor for disease-specific survival (DSS) and disease-free survival (DFS).What are the implications of these findings for clinical practice and/or further research? Maximal surgical effort should be performed in advanced stage USC according to our results. On the other hand, NACT had no impact on DSS and DFS rates. For this reason, we could not be able to suggest the routine use of NACT in advanced stage USC. But more randomized controlled trials are warranted for confirmation of our results.

Amaç: Üçüncü basamak bir doğum hastanesinde bir yılda gerçekleşen sezaryen doğumların Robson On Gruplu Sınıflandırma Sistemi kullanılarak analiz edilmesi amaçlanmıştır. Gereç ve Yöntem: 1 Ocak 2019 - 31 Aralık 2019 tarihleri arasında hastanemiz doğum salonuna kabul edilip, hastanemizde doğum yapmış olan ve herhangi bir obstetrik risk faktö rü olmayan gebeler çalışmaya dahil edilmiştir. Çalışmamız retrospektif olarak dizayn edilmiştir. Bulgular: Çalışmada 10781 doğuma ait veriler incelendi. Bu doğumların 4391’i sezaryen doğum ile gerçekleşmiştir. Tüm doğumlar içerisinde sezaryen doğum oranı %40,7’dir. Sezaryen doğum yapan gebelerin %9,3’lük kısmı Robson sınıflandırmasına göre birinci grupta, %13,6’sı Robson sınıflandırılmasına göre ikinci grupta yer almıştır. Sezaryen doğum yapan gebelerin %12,1’lik kısmı Robson sınıflandırmasına göre üçüncü grupta, %10,8’i dördüncü gruptadır. Grup 5, grup 6 ve grup 7’nin tüm sezaryen doğumlardaki oranları sırasıyla % 47,7, %2,5 ve %2,6’dır. Robson sınıflandırmasına göre Grup 9 ’un tüm sezaryen doğumlar arasındaki oranı ise %1,4’tür. Sonuç: Sonuç olarak, hastanelerin yıllık Robson On Gruplu Sınıflandırma Sistemi Formundaki yüzdelere gö re sezaryen doğumlarının izlenmesi ve değerlendirilmesi, kendi sezaryen eylem planlarını hazırlamaları ve belirledikleri sezaryen hedefine gö re kalite notlarının değerlendirilmesi de sezaryen oranının azaltılması hedefine katkı sağlayacaktır.

Objective: This study aimed to evaluate neoadjuvant chemotherapy (NACT) for locally advanced stage cervical carcinoma. Materials and Methods: Data of 43 patients with locally advanced cervical carcinoma who had NACT were reviewed. NACT protocols implemented included cisplatin/5-fluorauracil, cisplatin/UFT, and carboplatin/paclitaxel. After NACT, the patients were re-examined, and patients who had a tumor size =40 mm underwent Piver-Rutledge type III radical hysterectomy, while other patients received radiotherapy. Following NACT, clinical responses were assessed according to the criteria of the World Health Organization. Results: The mean age of the patients was 49.4 years, and the median follow-up duration was 48 (range, 5-228) months. The median tumor sizes were 50 and 30 mm before and after NACT, respectively. Complete clinical response was observed in 4 (9.3%) patients, partial clinical response in 8 (18.6%), and pathologic complete response in 3 (6.9%). Stable disease was noted in 30 (69.9%) patients and progression in 1 (2.3%) patient. After NACT, 31 patients have undergone radical surgical procedures. The 5-year disease-free survival rate was 72%, and the 5-year disease-specific survival rate was 91%. Age, International Federation of Gynaecology and Obstetrics 2009 stage, histopathologic type, NACT protocol, rate of decrease in tumor size after NACT, clinical response, number of courses, tumor size before NACT, tumor size after NACT, and lymph node metastasis were not associated with disease-free survival. Conclusion: Following NACT, a significant reduction in tumor dimension was observed, and the probability of radical surgery is increased. However, clinical response was not predictive of survival.