Prognostic factors of adult granulosa cell tumors of the ovary: a Turkish retrospective multicenter study
- Author:
Okan OKTAR
1
;
Vakkas KORKMAZ
;
Alp TOKALIOĞLU
;
Çağatayhan ÖZTÜRK
;
Özgür ERDOĞAN
;
Yeşim UÇAR
;
Hande Esra KOCA YILDIRIM
;
Candost HANEDAN
;
Fatih KILIÇ
;
Burak ERSAK
;
Necim YALÇIN
;
Fatma ÖZMEN
;
Alper KAHRAMAN
;
Selin Aktürk ESEN
;
Sevda BAŞ
;
Emel Doğan ÖZDAŞ
;
İlker SELÇUK
;
Gökhan UÇAR
;
Özgür KOÇAK
;
Caner ÇAKIR
;
Sevgi KOÇ
;
Çiğdem KILIÇ
;
Günsu Kimyon CÖMERT
;
Işın ÜREYEN
;
Tayfun TOPTAŞ
;
Mehmet Ali NARIN
;
Tolga TAŞÇI
;
Salih TAŞKIN
;
Nurettin BORAN
;
Muzaffer SANCI
;
Fahriye Tuğba KÖŞ
;
Özlem Moraloğlu TEKIN
;
Yaprak Engin ÜSTÜN
;
Fırat ORTAÇ
;
Taner TURAN
Author Information
- Publication Type:Original Article
- From:Journal of Gynecologic Oncology 2024;35(3):e39-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Objective:To define the clinical, histopathological features and the prognostic factors affecting survival in patients with adult granulosa cell tumors of the ovary (AGCT).
Methods:A 322 patients whose final pathologic outcome was AGCT treated at nine tertiary oncology centers between 1988 and 2021 participated in the study.
Results:The mean age of the patients was 51.3±11.8 years and ranged from 21 to 82 years.According to the International Federation of Gynecology and Obstetrics 2014, 250 (77.6%) patients were stage I, 24 (7.5%) patients were stage II, 20 (6.2%) patients were stage III, and 3 (7.8%) were stage IV. Lymphadenectomy was added to the surgical procedure in 210(65.2%) patients. Lymph node involvement was noted in seven (3.3%) patients. Peritoneal cytology was positive in 19 (5.9%) patients, and 13 (4%) had metastases in the omentum. Of 285 patients who underwent hysterectomy, 19 (6.7%) had complex hyperplasia with atypia/ endometrial intraepithelial neoplasia, and 8 (2.8%) had grade 1 endometrioid endometrial carcinoma. It was found that 93 (28.9%) patients in the study group received adjuvant treatment. Bleomycin, etoposide, cisplatin was the most commonly used chemotherapy protocol. The median follow-up time of the study group was 41 months (range, 1–276months). It was noted that 34 (10.6%) patients relapsed during this period, and 9 (2.8%)patients died because of the disease. The entire cohort had a 5-year disease-free survival (DFS) of 86% and a 5-year disease-specific survival of 98%. Recurrences were observed only in the pelvis in 13 patients and the extra-abdominal region in 7 patients. The recurrence rate increased 6.168-fold in patients with positive peritoneal cytology (95% confidence interval [CI]=1.914–19.878; p=0.002), 3.755-fold in stage II–IV (95% CI=1.275–11.063; p=0.016), and 2.517-fold in postmenopausal women (95% CI=1.017–6.233; p=0.046) increased.
Conclusion:In this study, lymph node involvement was detected in 3.3% of patients with AGCT. Therefore, it was concluded that lymphadenectomy can be avoided in primary surgical treatment. Positive peritoneal cytology, stage, and menopausal status were independent prognostic predictors of DFS.
