This study aims to determine ovarian cancer (OC) patients with platinum resistance for alternative treatment protocols by using metabolomic methodologies. Urine and serum samples of platinum-resistant and platinum-sensitive OC were analyzed using GC-MS. After data processing of GC-MS raw data, multivariate analyses were performed to interpret complex data for biologically meaningful information and to identify the biomarkers that cause differences between two groups. The biomarkers were verified after univariate, multivariate, and ROC analysis. Finally, metabolomic pathways related to group separations were specified. The results of biomarker analysis showed that 3,4-dihydroxyphenylacetic acid, 4-hydroxybutyric acid, L-threonine, D- mannose, and sorbitol metabolites were potential biomarkers in urine samples. In serum samples, L-arginine, linoleic acid, L-glutamine, and hypoxanthine were identified as important biomarkers. R2Y, Q2, AUC, sensitivity and specificity values of platinum-resistant and sensitive OC patients’ urine and serum samples were 0.85, 0.545, 0.844, 91.30%, 81.08 and 0.570, 0.206, 0.743, 77.78%, 74.28%, respectively. In metabolic pathway analysis of urine samples, tyrosine metabolism and fructose and mannose metabolism were found to be statistically significant (p < 0.05) for the discrimination of the two groups. While 3,4-dihydroxyphenylacetic acid, L-tyrosine, and fumaric acid metabolites were effective in tyrosine metabolism. D-sorbitol and D-mannose metabolites were significantly important in fructose and mannose metabolism. However, seven metabolomic pathways were significant (p < 0.05) in serum samples. In terms of p-value, L-glutamine in the nitrogen metabolic pathway from the first three pathways; L-glutamine and pyroglutamic acid metabolites in D-glutamine and D-glutamate metabolism. In the arginine and proline metabolic pathway, L-arginine, L-proline, and L-ornithine metabolites differed significantly between the two groups.

patients, whereas, 3 (2.2%) patients underwent pelvic and para-aortic lymph node dissection. Median number of dissected lymph nodes was 11 (interquartile range: 5.7-21.2). Among patients who underwent lymph node dissection, 14 (16.3%) patients showed lymph node involvement. Stage I, II and III were recorded in 97(71.9%), 13 (9.6%), and 25 (18.5%) patients respectively. We did not observe lymphedema in our study participants. Other complications related to lymph node dissection were low grade and were not associated with age, BMI, extent of lymph node dissection, total number of dissected lymph nodes, lymph node involvement and disease stage. Conclusion Complications related to lymph node dissection including lymphedema are rare after TAH+BSO for endometrial cancer and the extent of lymph node dissection or disease stage is not associated with higher risk of such complications.

Tuba Uterinanın ampuller bölgesinde gerçekleşen fertilizasyon sonrasında oluşan blastokistin endometrium dışında başka bir dokuya tutunarak gelişmesi sonucu devam eden gebeliklere dış gebelik denilmektedir. Tüm ilk üçay gebelikleri içinde %1-2 oranında dış gebelik ile karşılaşılmaktadır. Oran tüm gebelikler içinde küçük bir rakam olarak karşımıza çıkmasına rağmen gebelik ile ilişkili anne ölümleri sebepleri arasında önemli bir hastalıktır. Ancak ßHcg ölçümleri ve transvaginal ultrasonografi kullanımı ile erken tanı olasılığı artmaktadır. Erken tanı ile maternal sağ kalım ve maternal üreme organlarının kaybının azaltılması mümkün hale gelmiştir.

The aim of this study was to evaluate the clinical and pathological characteristics of mixed endometrial carcinoma (MEC). Materials and Methods: The clinical and pathological records of the 29 MEC patients, who were operated on and regularly followed up in the clinic between January 2000 and December 2019, were reviewed. Clinicpathologic features and survival in the MEC group (n=29) were compared to pure serous (n=42) and pure clear cell adenocarcinomas (n=13). Clinical features, operation characteristics, pathological findings, myometrial invasion degree (MI), lymph node involvement (LNI), lymphovascular space invasion (LVSI), adjuvant therapies, and follow-up data of the patients and their effects on survival were investigated. Results: Eighteen of the cases had endometrioid + serous, 7 had endometrioid + clear, 3 had endometrioid + serous, and 1 had clear + serous histopathology. Laparoscopic surgery was performed in 8 of the cases (27.6%) in the mixed group. Stage, the rate of LVSI, LNI, MI ≥50%, and omental metastasis were similar among the groups. There were no significant differences in the rates of receiving adjuvant therapy among the groups. Overall survive (OS) was similar among the groups. Conclusion: MECs are tumors that can be difficult to diagnose and manage. There was no difference between MEC and pure serous carcinoma (SC) and pure clear cell carcinoma (CC) in terms of clinicopathological features and prognosis. In addition to histopathological features, revealing and evaluating their molecular properties will help us to better understand this group of tumors.