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Introduction: To assess the rate of disease control and survival after adjuvant treatment in patients with uterine papillary serous (PSC) and clear cell carcinoma (CCC) and compare the results between these two subtypes. Methods: The medical charts of 199 patients with de novo uterine PSC or CCC who underwent radiotherapy (RT) following surgery between 2001 and 2019 in three radiation oncology departments were retrospectively evaluated. Adjuvant treatment was decided by a multidisciplinary tumor board. All patients were planned to undergo adjuvant 4–6 cycles of chemotherapy with external beam RT (EBRT) and/or vaginal brachytherapy (VBT). Results: Median age was 63 years for all, 64 years for PSC, and 59 years for CCC, respectively. Complete surgical staging was applied in 98% of patients. Histopathologic subtype was PSC in 142 (71%) and pure CCC in 57 (29%) patients, respectively. FIGO stage was I in 107 (54%), II in 35 (18%), and III in 57 (28%) patients, respectively. Lympho‐vascular space invasion and positive peritoneal cytology (PPC) were present in 42% and 10% of patients, respectively. All patients but 23 (12%) underwent adjuvant chemotherapy. Median follow‐up was 49.5 months for all patients, 43.9 months for patients with PSC, and 90.4 months for patients with CCC, respectively. During follow‐up, 20 (10%) patients developed pelvic recurrence (PR) and 37 (19%) developed distant metastasis (DM). PSC subtype increased the PR and DM rates, although the latter not statistically significant. The 5‐year overall survival and disease‐free survival rate was 73% and 69% for all patients, 71% and 66% for patients with PSC, and 77% and 75% for patients with CCC, respectively. The difference was more prominent in patients with stage ≥ IB disease. In multivariate analysis, advanced age and PPC significantly decreased all survival rates. Conclusion: PSC has a worse prognosis than CCC with regard to pelvic and distant recurrence with a trend for decreased survival rates. Therefore, a more aggressive therapy is needed for patients with uterine PSC, particularly in patients with stage ≥ IB disease. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to evaluate the prognostic significance of adequate lymph node dissection (LND) (≥10 pelvic lymph nodes (LNs) and ≥ 5 paraaortic LNs removed) in patients with International Federation of Gynecology and Obstetrics (FIGO) stage II endometrioid endometrial cancer (EEC). Methods: A multicenter department database review was performed to identify patients who had been operated and diagnosed with stage II EEC at seven centers in Turkey retrospectively. Demographic, clinicopathological, and survival data were collected and analyzed. Results: We identified 284 women with stage II EEC. There were 170 (59.9%) patients in the adequate lymph node dissection (LND) group and 114 (40.1%) in the inadequate LND group. The 5‐year overall survival (OS) rate of the inadequate LND group was significantly lower than that of the adequate LND group (84.1% vs. 89.1%, respectively; p = 0.028). In multivariate analysis, presence of lymphovascular space invasion (LVSI) (hazard ratio [HR]: 2.39, 95% confidence interval [CI]: 1.23–4.63; p = 0.009), age ≥ 60 (HR: 3.30, 95% CI: 1.65–6.57; p = 0.001], and absence of adjuvant therapy (HR: 2.74, 95% CI: 1.40–5.35; p = 0.003) remained as independent risk factors for decreased 5‐year disease‐free survival (DFS). Inadequate LND (HR: 2.34, 95% CI: 1.18–4.63; p < 0.001), age ≥ 60 (HR: 2.67, 95% CI: 1.25–5.72; p = 0.011), and absence of adjuvant therapy (HR: 4.95, 95% CI: 2.28–10.73; p < 0.001) were independent prognostic factors for decreased 5‐year OS in multivariate analysis. Conclusion: Adequate LND and adjuvant therapy were significant for the improvement of outcomes in FIGO stage II EEC patients. Furthermore, LVSI was associated with worse 5‐year DFS rate in stage II EEC. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To identify factors predictive of poor prognosis in women with stage III nonserous epithelial ovarian cancer (EOC) who had undergone maximal or optimal primary cytoreductive surgery (CRS) followed by six cycles of intravenous carboplatin/paclitaxel chemotherapy. Methods: A multicenter, retrospective department database review was performed to identify patients with stage III nonserous EOC who had undergone maximal or optimal primary CRS followed by six cycles of carboplatin/paclitaxel chemotherapy at seven gynecological oncology centers in Turkey. Demographic, clinicopathological and survival data were collected. Results: A total of 218 women met the inclusion criteria. Of these, 64 (29.4%) patients had endometrioid, 61 (28%) had mucinous, 54 (24.8%) had clear‐cell and 39 (17.9%) had mixed epithelial tumors. Fifty‐five (25.2%) patients underwent maximal CRS, whereas 163 (74.8%) had optimal debulking. With a median follow‐up of 31.5 months, the 5‐year progression‐free survival (PFS) and overall survival (OS) rates were 34.8% and 44.2%, respectively. Bilaterality (hazard ratio [HR] 1.44, 95% CI 1.01–2.056; P = 0.04), age (HR 2.25, 95% CI 1.176–4.323; P = 0.014) and maximal cytoreduction (HR 0.34, 95% CI 0.202–0.58; P < 0.001) were found to be independent prognostic factors for PFS. However, age (HR 2.6, 95% CI 1.215–5.591; P = 0.014) and maximal cytoreduction (HR 0.31, 95% CI 0.166–0.615; P < 0.001) were defined as independent prognostic factors for OS. Conclusion: The extent of CRS seems to be the only modifiable prognostic factor associated with stage III nonserous EOC. Complete cytoreduction to no gross residual disease should be the main goal of management in these women. [ABSTRACT FROM AUTHOR]

Abstract: Aim: The purpose of this study was to determine the prognostic factors and patterns of failure in lymphovascular space invasion (LVSI)‐positive women with stage IIIC endometrioid endometrial cancer (EC). Methods: A multicenter, retrospective, department database review was performed to identify LVSI‐positive patients with stage IIIC endometrioid EC at five gynecological oncology centers in Turkey. Demographic, clinicopathological and survival data were collected. Results: We identified 172 LVSI‐positive women with stage IIIC endometrioid EC during the study period; 75 (43.6%) were classified as Stage IIIC1 and 97 (56.4%) as Stage IIIC2. The median age at diagnosis was 59 years, and the median duration of follow up was 34.5 months. The total number of recurrences was 46 (26.7%). We observed 14 (8.1%) locoregional recurrences, 12 (7.0%) retroperitoneal failures and 20 (11.6%) distant relapses. For the entire study cohort, 5‐year progression‐free survival (PFS) was 67.4%, while the 5‐year overall survival (OS) rate was 75.1%. Grade 3 histology (hazard ratio [HR] 2.62, 95% confidence interval [CI] 1.34–5.12; P = 0.005), cervical stromal invasion (HR 2.33, 95% CI 1.09–4.99; P = 0.028) and myometrial invasion (MMI) ≥50% (HR 4.0, 95% CI 1.16–13.69; P = 0.028) were found to be independent prognostic factors for decreased OS. Conclusion: Uterine factors such as grade 3 disease, cervical stromal invasion and deep MMI seem to be independently associated with decreased OS in LVSI‐positive women with stage IIIC endometrioid EC. The high distant recurrence rate in this subgroup of patients warrants further studies in order to identify the most effective treatment strategy for those patients. [ABSTRACT FROM AUTHOR]

Ovulation-inducing drugs have been widely used for various types of infertility since the beginning of 1960s and their use increases day by day parallel to the success achieved in fertility treatment. However, the researches performed in the last two decades have begun to discuss about the safety of these drugs and the risks associated with their use. Especially, the potential neoplastic effects of these drugs are increasingly questioned. The studies have discussed whether there is an association between the exposure to ovulation-inducing drugs and the incidence of various cancers. Moreover, several studies have been performed to reveal whether there is an increased risk of childhood cancers in children conceived after fertility treatment. The point we reached through the available data is that the risk of breast, uterine and invasive ovarian cancers is not increased, but the risk of borderline ovarian tumors might increase after such a therapy. The risk of cancer has been found similar for children conceived after fertility treatment and those conceived naturally. It should also be kept in mind that cancers are overdiagnosed in infertile women population because of the close medical surveillance, which may also contribute to the early detection of cancers. Although it is still early to state the last words on this topic, the possible association should be addressed when obtaining an informed consent before starting treatment. [ABSTRACT FROM AUTHOR]

Background: Although many associations have been demonstrated between hyperhomocysteinemia and pregnancy complications, such as spontaneous abortion, preterm labor, preeclampsia and low birthweight, it is still not clear whether hyperhomocysteinemia is the cause or the consequence of these pregnancy complications. The aim of this study was to investigate the effects of homocysteine on the spontaneous contractility of isolated pregnant human myometrium.Methods: Myometrium samples obtained from women undergoing elective caesarean section were suspended in a jacketed organ bath containing Krebs' solution at 37 degrees C (pH 7.4), continuously gassed with 95% O2 and 5% CO2. After manifestation of spontaneous contractions under 2 g of resting tension, homocysteine was applied to the organ bath, and amplitude and frequency of contractions were evaluated at 20-min intervals. Statistical analysis of amplitude and frequency of the contractions was performed using the Kruskal-Wallis analysis of variance test.Results: Application of 0.1 mm homocysteine had no significant effect on either frequency (4.63 +/- 0.42 vs. 4.01 +/- 0.53 for the control period; p > 0.05) or amplitude (3.20 +/- 0.07 g vs. 3.15 +/- 0.07 g; p > 0.05) of spontaneous contractions, while 1 and 2 mm homocysteine significantly increased the frequency (8.54 +/- 0.62 vs. 3.9 +/- 0.44, p < 0.02, and 12.32 +/- 0.72 vs. 3.96 +/- 0.51, p < 0.001, respectively) of spontaneous contractions but caused only a modest change in amplitude (2.92 +/- 0.04 g vs. 2.87 +/- 0.05 g, p > 0.05, and 3.02 +/- 0.06 g vs. 2.93 +/- 0.05 g, p > 0.05, respectively).Conclusion: Results from this study indicate for the first time that homocysteine causes enhancement of spontaneous contractions of myometrium derived from pregnant women. [ABSTRACT FROM AUTHOR]

: ObjectiveThe aim of this study was to investigate the effects of erythromycin on prostaglandin F2α (PGF2α)-induced contractions of isolated myometrial strips from non-pregnant rats.: DesignIn vitro pharmacological study.: SettingFirat University Faculty of Medicine.: SampleMyometrium samples were taken from 55 adult Wistar rats.: MethodsMyometrial strips were isolated from mature, non-pregnant Wistar rats. Isometric contractions of these strips were induced with 1 μM PGF2α. Effects of 0.01, 0.1, 0.2, 0.5 and 1 mM erythromycin on the frequency and amplitude of these PGF2α-induced contractions were recorded.: Main outcome measuresThe inhibition of prostaglandin F2α-induced contractions in vitro.: ResultsApplication of 0.01 mM erythromycin had no effect on either amplitude or frequency of contractions. However, 0.1, 0.2, 0.5 and 1 mM erythromycin decreased the frequency and amplitude of PGF2α-induced contractions. The inhibitory effect of erythromycin on amplitude was 27%, 38%, 54% and 83% (P < 0.05), and that on frequency was 10%, 16%, 32% and 61% (P < 0.05) at 0.1, 0.2, 0.5 and 1 mM concentrations, respectively.: ConclusionThe results of this study demonstrate that erythromycin inhibits PGF2α-induced contractions in rat myometrium. Because PGF2α-induced contractions have been suggested to be involved in the pathogenesis of primary dysmenorrhoea, effects of erythromycin in this clinical entity may present a new approach for the treatment. [Copyright &y& Elsevier]

Background: Despite the fact that preterm labor and birth account for the vast majority of neonatal morbidity and mortality the currently available treatment options are still far from satisfactory. The aim of this study was to investigate the effects of erythromycin on stretch-induced contractions of pregnant human myometrial strips, obtained at cesarean section.Method: Myometrial strips were suspended in an organ bath under 3 g tension and the effects of erythromycin (0.1, 0.2, 0.5, 1.0 mM) on stretch-induced isometric contractions were evaluated. Results were statistically analyzed using Kruskal Wallis analysis of variance and Wilcoxon Rank tests where appropriate.Results: Erythromycin caused a significant decrease in the peak amplitude, while causing an increase in frequency of stretch-induced myometrial contractions in a dose dependent manner in vitro.Conclusions: Results from this preliminary study suggest that erythromycin may have additional beneficial effects in infection related preterm labor cases, however, further studies are needed for clarifying the usefulness of erythromycin as a tocolytic agent. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate the effects of erythromycin on prostaglandin F2alpha (PGF2alpha)-induced contractions of isolated myometrial strips from non-pregnant rats., Design: In vitro pharmacological study., Setting: Firat University Faculty of Medicine., Sample: Myometrium samples were taken from 55 adult Wistar rats., Methods: Myometrial strips were isolated from mature, non-pregnant Wistar rats. Isometric contractions of these strips were induced with 1 microM PGF2alpha. Effects of 0.01, 0.1, 0.2, 0.5 and 1 mM erythromycin on the frequency and amplitude of these PGF2alpha-induced contractions were recorded., Main Outcome Measures: The inhibition of prostaglandin F2alpha-induced contractions in vitro., Results: Application of 0.01 mM erythromycin had no effect on either amplitude or frequency of contractions. However, 0.1, 0.2, 0.5 and 1 mM erythromycin decreased the frequency and amplitude of PGF2alpha-induced contractions. The inhibitory effect of erythromycin on amplitude was 27%, 38%, 54% and 83% (P < 0.05), and that on frequency was 10%, 16%, 32% and 61% (P < 0.05) at 0.1, 0.2, 0.5 and 1 mM concentrations, respectively., Conclusion: The results of this study demonstrate that erythromycin inhibits PGF2alpha-induced contractions in rat myometrium. Because PGF2alpha-induced contractions have been suggested to be involved in the pathogenesis of primary dysmenorrhoea, effects of erythromycin in this clinical entity may present a new approach for the treatment.