Article Text
Abstract
Introduction/Background Adult-type Granulosa Cell Tumors (AGCT) of the ovary account for 5% of ovarian malignancies. Several issues on management remain controversial, due to limited evidence. The aim of this project was to assess the feasibility of pooling existing retrospective data within the collaborative groups of the ENGOT Rare Tumor Working Group and to analyze prognostic factors for survival.
Methodology This study included patients diagnosed with AGCT, registered within GINECO/TMRG and MITO groups databases, after anonymized data pooling. Peritoneal staging was considered done if peritoneal biopsies, omentectomy or peritonectomy were performed during first/restaging surgery. Conservative surgery comprised cystectomy or unilateral salpingo-oophorectomy.Clinicopathological variables were evaluated for association with relapse and death. Survival curves were calculated using Kaplan-Meier method and compared with log-rank test.
Results 585 patients were included; 336(57.4%) and 249(42.6%) were treated within GINECO and MITO, respectively. 220 patients(37.6%)received surgery inside a reference centre. 528 patients (90.2%) had I stage disease. Surgery was laparoscopic for 229 patients(39.1%). Conservative surgery was performed in 255 cases(43.6%).Peritoneal staging was done in 345 cases(59%). After a median follow up time of 76 months(range 1–657),5- year DFS and OS were 78% and 98%, respectively. At multivariate analysis, independent prognostic factors for improved DFS were early stage [OR 0.44–95% CI 0.29–0.66], optimal cytoreduction[OR 2.75–95% CI 1.32–5.75], radical surgery [OR 0.62–95% CI 0.43–0.87] and management in a reference centre[OR 0.75–95% CI 0.57–0.97]. For OS, only early stage retained significance[0.34–95%CI 0.15–0.78]. Surgical approach, peritoneal staging and adjuvant chemotherapy were not associated with improved survival in I stage disease.
Conclusion Anonymized data pooling from existing registries was feasible. Management in a reference centre, stage, surgical radicality and residual tumor are the only independent prognostic factors for DFS. Early stage only retains significance as prognostic factor for OS. This experience paves the way for further investigations within the ENGOT Rare Tumor Network.
Disclosures No disclosures.