Article Text
Abstract
Introduction/Background Granulosa cell tumors are rare ovarian neoplasms,, with an estimated global incidence rate of 2.6/100.000 new cases per year. Typically, patients first present around the age of 50–55 years, often with postmenopausal bleeding. Given its rarity, data on adult-type GCT (aGCT) is scarce, resulting in limited knowledge about various treatment modalities and their outcomes. This study aims to provide a comprehensive overview of the disease course of aGCT with data of the first national prospective Dutch cohort study.
Methodology A national multicentre study was conducted between April 2018 and December 2023, enrolling patients with suspected or diagnosed aGCT. Data, obtained from medical records, covered patient characteristics, menopausal status, clinical complaints, FIGO stage, treatment types, imaging, operations, and pathology reports.
Results Of the 190 patients with histopathologically confirmed aGCT. median age at diagnosis was 52 years, and the most common presenting complaints included vaginal bleeding and abdominal pain.
Surgery was the primary treatment, with tumour capsule rupture in 42% of cases and adjuvant treatment in 16% of cases. Recurrences were observed in 88 patients (46%) at a median follow-up of 5 years (range 0–45), with surgery being the most frequent treatment. Recurrence-free survival intervals shortened with each successive recurrence. Significantly, a statistical association was found between the integrity of the tumour capsule at primary diagnosis and the likelihood of developing a recurrence. At the end of follow-up, 180 patients (95%) were alive, of which 48 patients (25%) alive with disease, and nine patients (5%) succumbed to aGCT-related causes.
Conclusion This study provides crucial insights into the clinical characteristics, treatment patterns, and outcomes of aGCT patients. A better understanding of the disease course and associated risk factors is vital for improving the management of recurrent disease. These results emphasize the need for personalized treatment and the consideration of extending follow-up times for aGCT patients.
Disclosures The authors have nothing to disclose.