Introduction Objectives: Ovarian granulosa cell tumors (OGCT) are rare, and Eurasian data have not been published. This study objective was to describe OGCT among the 19 million residents of Kazakhstan.

Methods The Kazakhstan Cancer Registry Database was queried for descriptive and outcomes data of all consecutive patients with histologically verified OGCT from 2014–2020. Descriptive statistics and log likelihood ratios were performed using JMP Version 14.0.

Results 240 patients with OGCT were included, representing 3.9% of ovarian cancer in Kazakhstan. The median age was 52 years (range, 15–87 years). Nationality of origin was 55% Kazakh, 30.8% Russian, 3.8% Ukrainian, and 11% other. Stage distribution was 53.7% Stage I, 20.4% Stage II, 22% Stage III, 2.5% Stage IV, and 1% unknown. In total, 89 patients (37.6%) received chemotherapy; this did not correlate with stage. Common regimens included paclitaxel/carboplatin; bleomycin, etoposide, and cisplatin (BEP); and EP. Of the 240 patients, 67 patients (28%) recurred; recurrence correlated with stage (p<0.001). Treatment for recurrent disease included surgery, chemotherapy, and radiation therapy. After 16-month median follow up (range, 0–90 months), 186 patients (77.5%) were without evidence of disease, 12 patients (5%) were alive with disease, and 42 patients (17.5%) had died. Risk of death increased with advancing stage (p<0.001). Stage I OGCT patients who received adjuvant chemotherapy were significantly less likely to die than those who had not (p=0.003).

Conclusion/Implications This is the first description of OGCT in Kazakhstan. There is a survival advantage to chemotherapy administration in early-stage patients, supporting the importance of access to chemotherapy.