This study aimed to investigate how gynecologic oncologists modified their patient management during Coronavirus disease-2019 (COVID-19) in Turkey. An online survey was sent to gynecologic oncology specialists and fellows in Turkey. It included management questions about strategies for newly diagnosed or recurrent endometrial, cervical, ovarian and vulvar cancer during the pandemic. Participants were asked if treatment of these cancers can be delayed or not and, if yes, the duration of delay. 32.9% of surgeons prescribed oral or intrauterine progesterone for early stage, low-grade endometrial cancer. Conversely, 65.7% and 45.7% of the most surgeons did not change their management for early stage high-grade and advanced stage endometrial cancers respectively, as they perform surgery. 58% and 67.1% of the surgeons continued to prefer standard surgical treatment for microinvasive and early stage cervical cancers, respectively. Radiotherapy was preferred administered with hypofractionated doses for locally advanced cervical cancer (57.1%). While 67.1% of surgeons operated early stage ovarian cancer patients, 50% administered neoadjuvant chemotherapy (NACT) to all advanced stage ovarian cancers and 50% administered more cycles of NACT in preference to interval debulking surgery. 93.7% of the surgeons responded that treatment should not be delayed beyond eight weeks. Most Turkish gynecologic oncologists modified their management of gynecologic cancers due to the COVID-19 pandemic. While chemotherapy was preferred for ovarian cancer, postponement of the surgery, with or without non-surgical options, was considered for early stage, low-grade endometrial cancer. Treatment of gynecologic cancers should be decided on a case by case basis, taking into account local COVID-19 infection rates and availability of health facilities. Prognosis is also an important consideration if delay is contemplated. Standard treatment and normal time-frames should be used if possible. If not, a postponement for a maximum of eight weeks or referral to another center were acceptable alternatives.

Purpose: The present study aimed to compare surgical outcomes and cost analysis of robotic-assisted surgery (RAS) and conventional laparoscopic surgery (CLS) hysterectomy procedures. Materials and Methods: The patients who underwent total robotic hysterectomy or total conventional laparoscopic hysterectomy with or without bilateral salpingo-oophorectomy due to benign gynecological disorders such as uterine fibroid, abnormal uterine bleeding, endometrial hyperplasia, adenomyosis, persistent ovarian cysts, chronic pelvic pain were retrospectively evaluated. Results: A total of 80 women underwent RAS or CLS hysterectomy during the study period. The mean total operative time was 187 ±10 min. in RAS and 133 ±24 min. in CLS groups, respectively. The mean total cost of the RAS hysterectomy group was 17.710 TL, and CLS hysterectomy group was 7000 TL. Conclusion: Both CLS and RAS hysterectomies for benign gynecological indications are safe surgical procedures with negligible complication rates. RAS is a more expensive procedure compared to CLS.

Purpose: High-grade serous ovarian cancer (HGSOC) has high recurrence and mortality rates despite treatment advances. The prognostic nutritional index (PNI) shows promise in other cancers, but its role in HGSOC is unclear. This study aimed to evaluate PNI's prognostic value in HGSOC and establish an optimal cutoff for mortality prediction. Materials and Methods: This retrospective cohort evaluated 332 patients with HGSOC from 2010-2020. The age range, body mass index (BMI), menopausal status, parity status, presence of comorbidities, American Society of Anesthesiologists (ASA) scores, the presence of ascites, cancer antigen 125 (CA-125), neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, disease stage, recurrence status, platinum resistance, attainment of optimal cytoreduction, and PNI were evaluated. PNI relationship with other factors affecting prognosis was evaluated. Results: The Mean PNI was 41.8±8.7, with a cutoff of ≤44.6 (96.84% sensitivity, 81.69% specificity) for mortality prediction. PNI was a stronger predictor (AUC=0.932) than CA-125 (AUC=0.588). Low PNI (≤44.6) was significantly linked with advanced disease, platinum resistance, preoperative ascites ≥ 1 L, more recurrences, lower 5-year survival, and higher mortality. Multivariate analysis showed low PNI as an independent mortality predictor (OR: 136.82, 95% CI: 54.6-342.4), along with preoperative ascites > 1 L and disease recurrence. Conclusion: A low preoperative PNI strongly predicts higher mortality in HGSOC patients than in CA-125 patients. This accessible and cost-effective biomarker may aid in assessing risks, guiding increased monitoring, and customizing treatments. Further studies are necessary to confirm these results in various populations.

Background/Objectives: This study aimed to assess additional findings reported on fetal magnetic resonance imaging (MRI) after targeted neurosonography in fetuses with agenesis of the corpus callosum (ACC). Methods: This retrospective cohort included 129 singleton pregnancies with complete or partial ACC evaluated at a tertiary referral center between January 2020 and January 2023. All underwent fetal MRI within 7 days of neurosonography. Incremental findings were abnormalities not identified on the preceding examination. Final isolated or non-isolated classification incorporated both modalities. Results: MRI reported at least one incremental intracranial or craniofacial finding in 42/129 fetuses (32.6%). The most frequent findings were cerebellar hypoplasia (15/129, 11.6%), vermian agenesis (11/129, 8.5%), and arachnoid cysts (9/129, 7.0%). Final classification identified 71 isolated and 58 non-isolated cases. Among 77 tested fetuses, 15 had aneuploidy; the frequency was higher in non-isolated cases (14/37 versus 1/40; p < 0.001). Conclusions: MRI provided additional anatomical information after neurosonography in approximately one-third of this referral cohort. These findings support assessment beyond confirmation of ACC, but do not establish diagnostic accuracy, improved parental decisions, or long-term prognostic benefit.

Bu eserimizde; karın bölgesindeki ağrılardan yola çıkılarak multidisipliner yaklaşım ile karın bölgesi patolojileri ve güncel tanı ile tedavi yöntemleri ele alınmaktadır. Karın bölgesinde oluşan ağrılar ve patolojiler hayatın her döneminde görülebilmektedir. Bu tabloya sebep olan durum; bazen karın içindeki, bazen karın dışındaki organlardan, bazen de sistemik hastalıklardan kaynaklanabilmektedir. Bu sebeple de karın bölgesindeki patolojilerde multidisipliner yaklaşım önem taşımaktadır.