OBJECTIVE: Ovarian granulosa cell tumors are rare malignancies with a relatively favorable prognosis. However, patients still suffer from disease-related mortality. Therefore, the prognostic factors should be clarified. The purpose of this study was to investigate the clinical and pathologic characteristics related with disease recurrence and mortality in adult type ovarian granulosa cell tumors. METHODS: Eighty surgically staged patients with granulosa cell ovarian tumor treated at the Hacettepe University Hospital between 1982 and 2006 were retrospectively reviewed. Clinical and pathological characteristics were analyzed. RESULTS: Granulosa cell ovarian tumors accounted for 4.3% of malignant ovarian neoplasms. Mean age was 47.6 years. The most common presenting symptom was abnormal uterine bleeding (53.7%). Endometrial pathology was detected in 51.2% of patients preoperatively. Seventy percent of patients were diagnosed at stage I, and 53.8% of patients received adjuvant treatment. Mean follow-up was 67.5 months. Overall 5-year and 10-year survival was 91% and 86%, respectively. Mean survival was 147.1 months. Recurrence rate was 11.2%. In univariate analysis, advanced stage, advanced age, residual disease after surgery, and need for adjuvant treatment were associated with disease-related mortality and advanced stage disease and absence of initial staging surgery were associated with disease recurrence. However, in multivariate analysis, only initial stage was found to be a significant prognostic factor. CONCLUSION: Initial stage seems to be the single most important prognostic factor in ovarian granulosa cell tumors. Therefore, a comprehensive staging surgery should be attempted to document the real extent of disease and to estimate the oncologic outcome more accurately.
Adult ; Female ; Follow-Up Studies ; Granulosa Cell Tumor ; Granulosa Cells ; Humans ; Multivariate Analysis ; Ovarian Neoplasms ; Prognosis ; Recurrence ; Retrospective Studies ; Uterine Hemorrhage

Nonvisualized, dilated or even a small fetal stomach can be associated with a variety of anomalies and poor fetal outcome. Therefore, we attempted to evaluate the stomach circumference (SC)/abdominal circumference (AC) ratio to assess normal limits of fetal stomach size. A total of 363 fetuses ranging from 15 to 39 weeks' gestation were prospectively evaluated with ultrasonography. The SC was measured from a plane that is perpendicular to the fetal longitudinal axis at the level where the largest axial circumference of the stomach was obtained using a digitizer. The AC was also measured at the same section and the ratio was calculated by dividing the SC by the AC and multiplying by 100. The SC increased linearly from 15 to 24 weeks and showed fluctuations in size thereafter to 39 weeks. A strong correlation was noted between gestational age and both SC (r: 0.842, P <0.0001) and AC (r: 0.975, P <0.0001). The SC/AC ratio was normally distributed with a mean of 20.4 +/- 3.9% and ranged between 14.8% and 27.03% throughout pregnancy (r: 0.021, P > 0.05). Although the fetal stomach is a dynamically changing organ, the SC/AC ratio can be considered as a potentially useful parameter in assessing fetal stomach size.
Abdomen/embryology* ; Cross-Sectional Studies ; Fetal Development/physiology ; Fetus/anatomy & histology* ; Gestational Age ; Human ; Prospective Studies ; Stomach/embryology* ; Ultrasonography, Prenatal