Introduction Adult granulosa cell tumors (AGCT) are the most common type of malignant ovarian sex chord stromal tumors but only comprise 2 to 5 percent of all malignant ovarian neoplasms. Most have an indolent growth pattern, but their tendency for late relapses is well documented. Despite the lack of supporting data, NCCN recommends platinum-based adjuvant chemotherapy (AC) for Stage I with intermediate and high-risk features. Therefore, we conducted this meta-analysis to evaluate the impact of AC on disease recurrence in a stage I enriched AGCT.

Methods A review of the medical literature was conducted using online databases. Inclusion criteria consisted of English language, diagnosis of AGCT, studies with a preponderance of stage I, comparative studies of AC versus none, and studies that reported recurrence rates. Studies that had a preponderance of advanced stages or juvenile variants were excluded. A meta-analysis using the fixed effects and random effects models was conducted.

Results Seven retrospective comparative studies with 500 patients were included. The average median age was 47, and the average median follow-up was 58 months. Around 79% were stage I, and 79% of stage I were IC. Most AC were BEP and EP. Platinum-based AC in early-stage AGCT didn’t impact recurrence rates (HR=1.39, 95%CI 0.86–2.25, I²=48%, p=0.18).

Conclusion/Implications This is the first meta-analysis to show platinum-based AC does not improve the recurrence rate in early AGCT. In the absence of evidence supporting any benefit, recommendations to use platinum-based AC with or without Bleomycin should be re-evaluated since its risk is well-documented and carry potentially serious side effects.