Introduction/Background*Malignant sex cord-stromal cell tumours (SCST) account for about 7% of all ovarian malignancies and higher-level evidence on these tumours is scarce. The Arbeitsgemeinschaft fuer Gynaekologische Onkologie (AGO) has established a clinico-pathological database (Current Ovarian geRm cell and SEx cord stromal Tumour Treatment strategies, CORSETT) for this rare disease.
Methodology 20 German centres entered mixed retro- and prospective data of SCST patients treated between 2000 to 2014 into the CORSETT database. Descriptive analyses of the treatment strategies, Kaplan-Meier curves and cox regression analyses for the survival analysis were conducted. Tumour reference pathology was provided.
Result(s)*235 patients with granulosa cell tumour (GCT, median age 52 years) and 24 patients with sertoli-leydig cell tumour (SLCT, median age 33.5 years) were included. Main surgical treatment strategy was laparoscopy (50.9%) and fertility-sparing surgery was performed in 105 GCT (54.9%) and in 14 (58.3%) SLCT patients. In 38 GCT (23.6%) and two (9.25%) SLCT patients, the tumour ruptured intra-operatively. 44 GCT (18.7%) and two (8.3%) SLCT patients received adjuvant systemic treatment (most common regimen: paclitaxel/carboplatinum, 52.3%). Median PFS was 80.4 months (95% CI 67.8 – 99.6) in GCT and was not reached in SLCT patients. 105 GCT patients (44.5%) experienced disease recurrence. Advanced FIGO stage (p = 0.04) and intra-operative cyst rupture (p = 0.02) was associated with disease recurrence.
Conclusion*Fertility-sparing surgery was offered in most SCST patients in Germany over the past years, and intra-operative tumour rupture occurred in almost every fourth GCT patient. The most commonly applied adjuvant chemotherapy regimen was taxane and carboplatinum, which had however no effect on disease recurrence. Despite excellent overall survival rates in GCT and SLCT patients, recurrence rate in GCT patients was high.
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