Introduction/Background*Adult granulosa cell tumors (aGCT) represent less than 5% of all ovarian malignancies. The aim of this study was to analyze clinical and histopathological parameters and their impact on recurrence, progression-free- (PFS) and overall survival (OS).
Methodology Patients diagnosed with primary aGCT and treated in three international referral centers were included in the study. The following variables were anonymously exported from the prospective database of each clinic for further analysis: patient’s age at diagnosis, stage, chemo-, radiation, or hormonal therapy, surgery for primary site, type of restaging surgery, lymph nodes dissected, follow-up months, PFS, and OS. Descriptive statistical analysis regarding tumor and treatment characteristics was performed. Survival analyses included Kaplan-Meier functions and Cox proportional hazard ratios (HR).
Result(s)*The total study cohort included 168 patients with primary aGCT, which were treated surgically. Median age was 50 years (range 13-82). 54.2% (n=91) of patients had FIGO stage IA, 26.8% (n=45) were stage IC, and 17.8% (n=32) had FIGO stage II-IV. In total 66.7% (n=112) of patients underwent surgical restaging procedure of whom 11.9% (n=20) were up-staged. A median laparotomy was performed in 70.8% (n=119) of patients. Adjuvant chemotherapy was administered to 11.3% of patients (n=19) and one patient received endocrine therapy. After a median follow-up of 61 months, 10.7% (n=18) had recurrent disease and 4.8% (n=8) of patients died from the disease. Overall five-year PFS was 86.1% and estimated OS was 95.7%. Survival was worse for patients with advanced stages (FIGO IA/B vs. IC, HR = 5.09; 95% confidence interval [CI]: 1.53-16.9; FIGO IA/B vs. II-IV, HR=5.62; 95% CI: 1.58-19.9) and for patients who underwent adjuvant chemotherapy (HR=9.15; 95% CI: 3.62-23.1).
Conclusion*Prognosis of patients with primary aGCT is mainly determined by FIGO-Stage. The outcome of FIGO stage IC is comparable to advanced stages and a significant number of patients were up-staged. The role of adjuvant chemotherapy remains unclear and should be investigated in future studies.
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