ObjectiveTo evaluate the clinicopathologic characteristics and prognostic factors of ovarian granulosa cell tumors.MethodsMedical records of 113 patients presenting between January 1995 and December 2007 were retrospectively reviewed.ResultsOne-hundred two patients had adult type disease, with a mean age of 46.2 years (range, 18 to 83 years) and a mean follow-up period of 54.7 months (range, 1 to 155 months). The distribution of FIGO stages was 86 patients at stage I, 11 at stage II, and 5 at stage III. During follow-up, ten patients recurred at a mean time of 48 months (range, 4 to 109 months). Among them, three patients died after a mean of 57 months (range, 25 to 103 months). In recurrence analysis, advanced stage (p=0.032) and presence of residual disease (p=0.012) were statistically significant, and age<40 years, premenopause and positive washing cytology were marginally significant (p<0.1). In multivariate analysis, stage was the only factor associated with recurrence; adjuvant chemotherapy and fertility-sparing surgery were not statistically significant. Among 36 patients with fertility-sparing operations, eight patients had nine pregnancies and delivered seven babies. Eleven patients had juvenile type tumors; the mean age was 20.0 years (range, 8 to 45 years) and the mean follow-up period was 69.8 months (range, 20 to 156 months). The distribution of FIGO stage was nine patients at stage I and two at stage III. There were no recurrences or deaths reported. Four patients had seven pregnancies and delivered six babies.ConclusionStage is the only factor associated with disease-free survival, and fertility-sparing surgery may be a treatment option for women with early-stage disease who want to retain fertility.

Laparoscopic radical hysterectomy is a feasible and safe treatment modality in early and even locally advanced cervical cancer without decreasing survival. Surgical outcome was improved with experience, and the complication rate related to operation of group 1 was higher than that of group 2. There was no significant difference in survival between the 2 groups.

A laparoscopic NSRH for FIGO stage IB cervical cancer was comparable to open NSRH in terms of early recovery of bladder function. It did not compromise surgical radicality, but revealed high urological complications, long operating time, and much blood loss, compared with conventional radical hysterectomy. However, these surgical morbidities were corrected with increase in experiences.

Serum albumin level in pregnancy-related hypertension is a significant determinant of disease severity and may be considered as a useful marker for predicting time to delivery, severe proteinuria, and pregnancy outcomes.

A total laparoscopic nerve-sparing radical trachelectomy is feasible and without any increase of morbidity, and has the potential to improve surgical outcomes, compared with a conventional radical trachelectomy.