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Aim: To compare postoperative pain and recovery in patients undergoing oophorectomy with single‐port laparoscopic surgery (SPLS) versus vaginal natural orifice transluminal endoscopic surgery (vNOTES). Method: Patients who underwent salpingo‐oophorectomy with SPLS or vNOTES between 2016 and 2023 were analyzed retrospectively. Oophorectomy was performed based on the presence of an adnexal mass or breast cancer susceptibility gene mutation. Results: Fifty‐two patients underwent oophorectomy with SPLS and 35 underwent vNOTES. Although the mean mass size was slightly larger in the SPLS group than in the vNOTES group (8.0 ± 4.1 vs. 6.8 ± 3.3 cm), the difference was not significant. There was no difference in operating times between SPLS and vNOTES. The mean visual analog scale and faces pain scale scores 2 and 6 h postoperatively were lower in the vNOTES group. The mean quality of recovery‐40 (QoR‐40) score was higher in the vNOTES group (156 ± 14 vs. 148 ± 11; p = 0.009). This analysis identified vNOTES as an independent predictor of a high QoR‐40 score. Conclusion: The vNOTES group experienced less pain during the early postoperative period than the SPLS group. Although the operating and removal times were similar, the port setup time was longer for the vNOTES group. [ABSTRACT FROM AUTHOR]

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Aim: We planned this study to assess endometrial cancer (EC) patients who had late metastasis. Materials and Methods: This retrospective study constituted a review of the records of patients who were diagnosed with EC and underwent hysterectomy at the Gynecologic Oncology Clinic between 1996 and 2018. Relapses occurring after the first three years following primary treatment of EC are considered late recurrences. Post-relapse survival (PRS) refers to the time to the last follow-up or the patient's death after relapse. Results: Late metastases were identified in 42 patients, 20 (47.6%) of whom had locoregional recurrence and 22 of whom (52.4%) had extrapelvic recurrence. Median disease-free survival (DFS) times were 61 (range: 43-78) and 65 (range: 48-81) months for the groups with locoregional and extrapelvic recurrences, respectively (P = 0.462). The 5-year PRS rate for the patients was 61.1%, with 63.8% having locoregional and 59.4% having extrapelvic late metastasis (P = 0.969). Conclusion: Among the patients with late metastases, those with endometrioid type EC were found to have a better prognosis. It has been shown that locoregional or extrapelvic organ recurrence does not significantly affect survival in patients with late relapse. Although our results are not statistically significant for cases of locoregional late metastases, surgical resection increases survival rates. [ABSTRACT FROM AUTHOR]

Aim: We aimed to clarify the clinical value of P53 index in patients with early low‐risk endometrial cancer (EC) and find an optimal cut‐off value of P53 index for predicting the recurrence of these patients. Methods: The clinicopathological data of 157 patients with early low‐risk EC (stage 1A with grade 1 or 2 endometrioid EC) were analyzed. The optimal cut‐off value of the P53 index was calculated by the receiver operating characteristic curve analysis and Youden index. Cox regression model was used to evaluate the independent prognostic predictors of recurrence of EC. Then all patients were divided into two groups according to the optimal cut‐off value of the P53 index. Differences of the clinicopathological parameters between the two groups were compared. Results: Multivariate analysis showed age PR (p = 0.020) and P53 (p = 0.001) were independent prognostic factors for the recurrence of EC. The value of P53 index was found to be the optimal cut‐off point of 17.5% in estimating the recurrence of EC. The 5‐year recurrence‐free survival rates of patients in the low P53 index group (<17.5%) and the high P53 index group (≥17.5%) were 94.6% and 65.4% (p < 0.001). Conclusion: It has been revealed that the P53 index is a prognostic factor for recurrence in early low‐risk EC. The optimal cut‐off value of P53 index may contribute to the postoperative individualized treatment options for early low‐risk EC patients. [ABSTRACT FROM AUTHOR]

Objectives: Treating gynecological cancer with radical surgery, pelvic radiotherapy, and systemic chemotherapy may lead to pelvic floor dysfunction. Materials and Methods: Lower urinary tract symptoms are common after surgery for gynecological cancer. We used the Urogenital Distress Inventory (UDI)-6, Incontinence Impact Questionnaire (IIQ)-7, and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) to compare the severity of urinary incontinence and quality of life between patients who underwent staging surgery for gynecological caner and those who underwent hysterectomy for benign disease. In total, 50 patients with cancer and 50 patients with benign disease were included in the patient and control groups, respectively. Results: There were no significant differences between the groups in terms of preoperative IIQ-7, UDI-6, and ICIQ-SF scores. There was a significant difference between the groups in scores 1 and 12 months after surgery. Postoperative IIQ-7, UDI-6, and ICIQ-SF scores were significantly increased compared to preoperative scores, although there were no significant differences between preoperative and postoperative scores in the control group. Incontinence was present after surgery in 15 (43.2%) and 4 (21.1%) patients in the test and control groups, respectively. In multivariate analyses of variance, surgery for cancer was an independent risk factor for urinary incontinence. Conclusion: Genitourinary symptoms should be evaluated in cancer patients undergoing staging procedure. The quality of life of patients should be assessed in terms of incontinence in the postoperative period. [ABSTRACT FROM AUTHOR]

The purpose of this study was to develop and validate a nomogram for individual prediction of recurrence and disease-free survival (DFS) among lymph node (LN)-negative early-stage (I-IIA) cervical cancer (CC) patients treated with Type B or Type C2 hysterectomy. Data were collected from patients diagnosed with CC between 1995 and 2017 at the Gynecological Oncology Department, Tepecik Training and Research Hospital. A total of 194 cases with stage IA2-IIA CC were evaluated retrospectively. Patients with stage IA2-IIA CC who underwent radical (Type C2) or modified radical (Type B) hysterectomy and pelvic ± paraaortic LN dissection with LN negativity were included in the study. The relationships between prognostic factors such as stage, tumour size, parametrial involvement, vaginal cuff margin, endomyometrial infiltration, and lymphovascular space invasion status and DFS were compared using a univariable Cox regression model. When the nomogram was prepared, the scores of the risk factors were collected, and we observed that scores were at least 0 to a maximum of 414 points. The concordance-index for the nomogram was 0.895 (95% confidence interval, 0.79-0.99). The nomogram based on the indicated prognostic factors yielded excellent results in predicting recurrence in early-stage CC patients without LN metastasis who underwent radical hysterectomy.Impact statementWhat is already known on this subject? Pathology of radical hysterectomy specimens in patients with early-stage cervical cancer provides information that has predictive prognostic potential. In addition to FIGO stage, other important prognostic factors are lymph node status, tumour size, parametrial involvement, vaginal cuff margin status, endomyometrial infiltration, histological type, patient age, lymphovascular space invasion, histological grade, and depth of cervical stromal invasion.What do the results of this study add? In this study, patients with early-stage cervical cancer who underwent radical and modified radical hysterectomy without retroperitoneal lymph node involvement were evaluated, and recurrence development and factors affecting disease-free survival were investigated. A nomogram consisting of factors influencing disease-free survival was constructed. The total score was determined according to the status of all risk factors. This allowed clear definition of the risk for each patient. A nomogram predicting recurrence in patients with stages IA2-IIA cervical cancer with radical hysterectomy without lymph node involvement has not previously been published.What are the implications of these findings for clinical practice and/or further research? Our study investigated early-stage cervical cancer (CC) patients without lymph node (LN) metastasis. Cox regression analysis was performed with six prognostic factors: FIGO stage, tumour size, parametrial margin infiltration, vaginal cuff margin involvement, endomyometrial infiltration, and LVSI positivity. The nomogram was constructed based on the results of Cox regression. The C-index for the nomogram was 0.895 (95% CI, 0.79-0.99). These results can be considered excellent. The higher concordance index in our study indicates that these six factors may be more valuable in predicting recurrence development in CC patients. [ABSTRACT FROM AUTHOR]

We compared two transumbilical (TU) routes of surgical specimen retrieval in women with ovarian masses treated via laparoscopy: a bag made from a surgical glove and lateral transabdominal (LTA) retrieval employing a standard endobag. A total of 109 women undergoing laparoscopic surgery to treat benign adnexal masses were retrospectively evaluated between 2014 and 2017. In total, 57 masses were removed via the TU route and 52 via the LTA route. We recorded the ovarian mass size; additional postoperative analgesic drug requirements. Postoperative incisional pain scores were assessed using a 10-cm visual analogue scale (VAS), time to discharge and procedure type. The mean VAS scores at 1 h (5.0 ± 1.7 vs. 6.3 ± 1.3; p < .001); 12 h (0.7 ± 0.8 vs. 1.2 ± 1.1; p = .004); and 24 h (0.1 ± 0.3 vs. 0.7 ± 0.6; p < .001) were lower in the TU-removal group. Furthermore, additional postoperative analgesic drug requirements were significantly higher in the LTA-removal group (10 (19.2%) vs. 3 (5.3%); p = .03). During laparoscopic surgery, removal of an ovarian mass via an umbilical port (compared to a lateral port) causes less postoperative pain and does not increase the risk of wound complications such as infection or hernia.Impact statementWhat is already known on this subject? Laparoscopy has been used for the last 30 years. Constant improvement in the technique and equipment has allowed extensive, laparoscopic pelvic and abdominal surgery affording better outcomes than open surgery, an improved recovery, less pain, and fewer postoperative complications. However, mass removal remains a concern. Most laparoscopic specimens are larger than the initial trocar incision. Minimally invasive, adnexal mass surgery usually requires a trocar at least 10 mm wide to remove the mass. Alternatively, adnexal mass extraction from the abdominal cavity can proceed via a suprapubic, umbilical, or vaginal route.What do the results of this study add? During laparoscopic surgery, ovarian mass removal through an umbilical port using an endobag made from a surgical glove is useful due to the method requiring little funds, is easy to do, and results in a lower amount of postoperative pain than a removal via a lateral port using a standard endobag.What are the implications of these findings for clinical practice and/or further research? A transumbilical route using a bag made from a surgical glove is easy, economical, and causes less postoperative pain to the patient than removal via a lateral port employing a standard endobag. [ABSTRACT FROM AUTHOR]

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