To validate the oncological safety of fertility preservation in malignant ovarian germ cell tumors (MOGCTs) and to define the significance of maximal cytoreduction in early stage MOGCTs. Sixty-nine patients with stage I and II MOGCTs who underwent surgical treatment were included in the study. Fertility-sparing surgery is defined as conservative surgery and hysterectomy and contralateral salpingo-oophorectomy were defined as definitive surgery. Both surgical approaches involved lymphadenectomy and omentectomy. Most patients received platinum-based combinations for adjuvant therapy. Survival outcomes of the conservative surgery group were compared with the definitive surgery group. Median age of the study group was 21 years (range: 12-40 years). Median tumor size measured 150 mm (range, 20-300 mm). Surgery type (conservative surgery vs. definitive surgery) and lymphadenectomy (performed vs. not performed) were insignificant for the recurrence (p = 0.758, p = 0.271). However, surgical outcome (maximal vs. optimal and suboptimal) and type of tumor (dysgerminoma vs. nondysgerminoma) determined the recurrence (p = 0.001, p = 0.021). Fertility-conserving approach is safe in early stage MOGCTs. However, maximal cytoreduction should be achieved in this group of patients, without conceding fertility-conserving approach. On the other hand, development of chemotherapy options with less gonadotoxic effects, but equal or stronger efficiency in comparison with platinum-based chemotherapy, will certainly facilitate management of this patient group.

The purpose of the present study was to evaluate the clinical and pathological features and oncological outcomes of Brenner tumors (BT). Evaluation was performed on the data of 46 patients with BTs retrieved from the oncology clinic database and pathology reports between 2005 and 2020. The median (range) age of the patients was 52 (22-75) years. Median (range) tumor size was 52.5 (5.0-300) mm. The tumor was benign in 37 (80.4%), borderline in one (2.2%), and malignant in the remaining eight (17.4%). Ten (21.7%) of the tumors were detected incidentally. Mixed tumor, BT plus another ovarian pathology, was found in 13 (28.2%). Recurrence developed in 2/8 (25%) with malignant BT (MBT). The stage of these patients was 3C, and both received chemotherapy after surgery. BTs are rare and generally detected incidentally. MBTs are treated in the same way as epithelial tumors. Due to the rarity of these tumors, lymphadenectomy and optimal chemotherapy regimens are controversial issues.

Purpose: Adult granulosa cell tumor (AGCT) of ovary is a rare tumor and usually has a benign course. Due to its indolent nature, recurrences are observed in a wide period and data on management of recurrences in AGCT are relatively sparse. We aimed to evaluate the clinical features, management, and survival of patients with recurrent AGCT. Methods: The data of 144 patients with AGCT treated in Etlik Zubeyde Hanim Teaching and Research Hospital between 1990 and 2013 were retrospectively evaluated. Patients with radiologic or pathologic recurrences were included in the analysis. Results: A total of 18 patients (12.5%) with recurrent AGCT were included. Median follow-up was 97.5 months (range 6-255 months). A total of 16 patients underwent salvage surgery and maximal debulking was achieved in 13 patients. Ten patients had unifocal and 8 had multifocal tumors. Maximal debulking could be achieved in all patients with unifocal recurrence. On the other hand, maximal debulking could only be obtained in 3 patients (37%) with multifocal recurrence (p = 0.031). Multifocality of recurrent disease and the presence of residual tumor after surgery were associated with diminished progression-free survival and overall survival (31 vs 207 months, p = 0.031; and 22 vs 220 months, p = 0.005, respectively). Conclusions: Multifocal recurrence and suboptimal surgery were related with poor survival outcomes in patients with AGCT recurrence. Surgical treatment of recurrent AGCT should aim to achieve no visible disease.

Independent predictors of survival in endometrium cancer: platelet to lymphocyte ratio and plateletneutrophilmonocyte to lymphocyte ratio

Objective: The aim of this study was to evaluate the prognostic factors of recurrence in uterine tumors resembling ovarian sex-cord tumors (UTROSCT) and to determine clinical-pathological characteristics, treatment options and outcome. Material and Method: An electronic literature search was conducted from 1976 to 2018. After the comprehensive evaluation and conjunction with our case, the study included 79 cases. Results: The median age at initial diagnosis was 49 years (range; 16-86 years). The age was under 40 years in 21 (26.6%) patients. Whereas 68 patients underwent at least hysterectomy, 9 patients had organ sparing surgery. There was necrosis in 4 (5.1%) patients, atypia in 16 (20.3%) patients, and infiltrative tumor border in 34 (43%) patients. At least one mitosis per 10 high power fields was determined in 36 (45.5%) patients. The tumor involved at least part of the myometrium in 54 (68.3%) patients. Median follow-up time was 30 months (range; 3-296 months). Recurrence was determined in 5 (6.3%) patients. The disease free survival (DFS) was significantly related only to surgery type. None of the pathologic features were associated with DFS. The 5-year DFS was 86% and 96% in patients who underwent organ sparing surgery or not, respectively (p=0.038). Conclusion: The accurate pathologic diagnosis of UTROSCT has great value in shaping surgical management and management during the follow-up period. Organ sparing surgery was related to poor DFS. Although recurrence is rare, it should be kept in mind for patients with UTROSCT.