38 research outputs found

    The Ki-67 proliferation index predicts recurrence-free survival in patients with dermatofibrosarcoma protuberans

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    Dermatofibrosarcoma protuberans (DFSP) is an uncommon soft tissue sarcoma that originates from the dermis or subcutaneous tissue in the skin. While its prognosis is generally favorable, disease recurrence is relatively frequent. Because morbidity after repeated surgery may be significant, an optimized prediction of recurrence-free survival (RFS) has the potential to improve current management strategies. The purpose of this study was to investigate the prognostic value of the Ki-67 proliferation index with respect to RFS in patients with DFSP. We retrospectively analyzed data from 45 patients with DFSP. We calculated the Ki-67 proliferation index as the percentage of immunostained nuclei among the total number of tumor cell nuclei regardless of the intensity of immunostaining. We constructed univariate and multivariate Cox proportional hazards regression models to identify predictors of RFS. Among the 45 patients included in the study, 8 developed local recurrences and 2 had lung metastases (median follow-up: 95.0 months; range: 5.2−412.4 months). The RFS rates at 60, 120, and 240 months of follow-up were 83.8%, 76.2%, and 65.3%, respectively. The median Ki-67 proliferation index was 14%. Notably, we identified the Ki-67 proliferation index as the only independent predictor for RFS in multivariate Cox proportional hazards regression analysis (hazard ratio = 1.106, 95% confidence interval = 1.019−1.200, p = 0.016). In summary, our results highlight the potential usefulness of the Ki-67 proliferation index for facilitating the identification of patients with DFSP at higher risk of developing disease recurrences

    Why do some patients with stage 1A and 1B endometrial endometrioid carcinoma experience recurrence? A retrospective study in search of prognostic factors

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    Objectives: Endometrial endometrioid carcinoma (EEC) is the most encountered subtype of endometrial cancer (EC). Our study aimed to investigate the factors affecting recurrence in patients with stage 1A and 1B EEC. Material and methods: Our study included 284 patients diagnosed with the International Federation of Gynecology and Obstetrics stage 1A/1B EEC in our center from 2010 to 2018. The clinicopathological characteristics of the patients were obtained retrospectively from their electronic files. Results: The median age of the patients was 60 years (range 31–89). The median follow-up time of the patients was 63.6 months (range 3.3–185.6). Twenty-two (7.74%) patients relapsed during follow-up. Among the relapsed patients, 59.1% were at stage 1A ECC, and 40.9% were at stage 1B. In our study, the one-, three-, and five-year recurrence-free survival (RFS) rates were 98.9%, 95.4%, and 92.9%, respectively. In the multivariate analysis, grade and tumor size were found to be independent parameters of RFS in all stage 1 EEC patients. Furthermore, the Ki-67 index was found to affect RFS in stage 1A EEC patients, and tumor grade affected RFS in stage 1B EEC patients. In the time-dependent receiver operating characteristic curve analysis, the statistically significant cut-off values were determined for tumor size and Ki-67 index in stage 1 EEC patients. Conclusions: Stage 1-EEC patients in the higher risk group in terms of tumor size, Ki-67, and grade should be closely monitored for recurrence. Defining the prognostic factors for recurrence in stage 1 EEC patients may lead to changes in follow-up algorithms

    The impact of Ki-67 index, squamous differentiation, and several clinicopathologic parameters on the recurrence of low and intermediate-risk endometrial cancer

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    Endometrial endometrioid carcinoma (EEC) represents approximately 75-80% of endometrial carcinoma cases. Three hundred and thirty-six patients with EEC followed-up in the authors’ medical center between 2010 and 2018 were included in our study. Two hundred and seventy-two low and intermediate EEC patients were identified using the European Society for Medical Oncology criteria and confirmed by histopathological examination. Recurrence was reported in 17 of these patients. The study group consisted of patients with relapse. A control group of 51 patients was formed at a ratio of 3:1 according to age, stage, and grade, similar to that in the study group. Of the 17 patients with recurrent disease, 13 patients (76.5%) were Stage 1A, and 4 patients (23.5%) were Stage 1B. No significant difference was found in age, stage, and grade between the case and control groups (p > 0.05). Body mass index, parity, tumor size, lower uterine segment involvement, SqD, and Ki-67 index with p<0.25 in the univariate logistic regression analysis were included in the multivariate analysis. Ki-67 was statistically significant in multivariate analysis (p = 0.018); however, there was no statistical significance in SqD and other parameters. Our data suggest that the Ki-67 index rather than SqD needs to be assessed for recurrence in patients with low- and intermediate-risk EEC

    Outlining the historical framework of the aviation sector in Turkey: A spatiotemporal approach

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    The fast-growing, capital-intensive, and fragile structure of air transport makes the aviation sector crucial for national economic growth and regional development. Over a century old, Turkey's aviation sector has undergone a remarkable transition from a state-regulated market to a liberal, competitive one. This fundamental change has created an urgent need to quantitatively outline the historical and contextual framework of Turkey's air transport network in order to grasp its structural dynamics and thus obtain insights into the drivers of regional and air transport development. This paper uses time-series analysis to outline the historical framework of the aviation sector in Turkey based on air traffic and spatiotemporal data at the national and regional levels. The aim is to detect outlier changes in the historical air transport timeframe at both the national and regional levels and to define discrete periods in the history of Turkey's aviation sector. The results, discussed through the prism of transport policy and regional economies, provide structural insights into the dynamics of the Turkish aviation market. The findings reveal that the periods derived from the time-series analyses are consistent with the major changes discussed in the literature. © 2020. Portland Press Limited. All Rights Reserved

    Mapping the topology of the air transport network in Turkey

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    Recent technological and philosophical research has revealed that almost everything around us is heavily dependent on network-based complexities. Airport network topologies are complex networks and their analyses are crucial regarding the fact that the evolution of airport network topology influences the economic growth of regions and countries. An equal population cartogram is derived displaying the distortion of the air transport network of Turkey in accordance with the uneven distribution of passengers. The regions between İstanbul, Ankara, İzmir, and Antalya are shrunk by the force of higher population concentration. The shrinkage across the eastern regions is less than that in the western regions; still, the distortion of the regions is dominated by particular regional hubs. © The Author(s) 2019
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