Characteristics and treatment results of recurrence in adult-type granulosa cell tumor of ovary

Abstract

Background: The aim of this study was to explore the clinicopathological characteristics of recurrent adult-type granulosa cell tumor of the ovary (AGCOT) and evaluated the treatment results to define the prognostic parameters for survival after recurrence. Results: A retrospective review of 40 patients with recurrent AGCOT, who were treated in the Cancer Hospital at the Chinese Academy of Medical Sciences from 2000 to 2015 was conducted. The impact of clinical and pathological characteristics, progression-free survival (PFS), and post-recurrence therapeutic approaches on prognosis were analyzed. Among the 40 recurrent patients, there were 10 cases where the relapse was uncontrolled, 24 cases had second relapses, and 6 cases without further relapses at the time of our follow-up. The median PFS was 61 months (range, 7-408 months), and the median time interval between the first and the second relapses (R-PFS) was 25 months (range, 0-94 months). The median time interval between the first relapse and death (R-OS) was 90 months (range, 2-216 months). PFS ≥ 61 months (P = 0.004) and post-recurrence therapeutic approach (P < 0.001) were independent risk factors for repeated recurrences. The age at recurrence (P = 0.031) and post-recurrence therapeutic approach (P = 0.001) were independent risk factors for death after recurrence. Conclusion: Among patients with recurrent AGCOT, those with long PFS had good prognoses. Maximal cytoreductive effort should be made after recurrence. Complete resection and postoperative adjuvant chemotherapy may improve the prognosis of patients with recurrent AGCOT.

Clinical characteristics of late recurrence in granulosa cell tumor of ovary

“…It has been reported that JGCOT may have late recurrence 5 . In this study, the median interval between relapse and initial treatment of 22 patients with recurrent GCT was 87 months, which was consistent with the 5-10 years reported in the literature 6,7 . Pectasides et al considered that the risk of long-term cancer-related death could reach 50% 8 .…”

“…Pectasides et al considered that the risk of long-term cancer-related death could reach 50% 8 . There was a big difference in recurrence rates of GCT among different researches, 17% ～ 50% 7,9,10 , where the reason may be that most studies are retrospective analysis, and the recurrence rate is related to the length of follow-up.…”

“…Zhao et al reported PFS ≥ 61 months and post-recurrence therapeutic approach were independent risk factors for repeated recurrences in 40 recurrent AGCOT patients 7 . In addition, the age at recurrence(≤50y) and post-recurrence therapeutic approach were independent risk factors for death after AGCOT recurrence 7 .…”

Ovarian sex cord-stromal tumors: an update on clinical features, molecular changes, and management

“…96 Other chemotherapy regimens for recurrent adult granulosa cell tumors include bleomycin, etoposide, and cisplatin, paclitaxel plus platinum based regimens (such as paclitaxel plus cisplatin and paclitaxel plus carboplatin), and paclitaxel plus ifosfamide . 97 Several studies have shown that postoperative chemotherapy is not associated with improved prognosis and prolonged disease free survival and possibly overall survival of granulosa cell tumor patients. [97][98][99] In a study of the impact of adjuvant chemotherapy on disease specific survival in patients with granulosa cell tumors, Oseledchyk et al found that regardless of stage, there were no significant differences in 5 year disease specific survival between patients who received chemotherapy and those who did not.…”

“…97 Several studies have shown that postoperative chemotherapy is not associated with improved prognosis and prolonged disease free survival and possibly overall survival of granulosa cell tumor patients. [97][98][99] In a study of the impact of adjuvant chemotherapy on disease specific survival in patients with granulosa cell tumors, Oseledchyk et al found that regardless of stage, there were no significant differences in 5 year disease specific survival between patients who received chemotherapy and those who did not. 100 A retrospective study by Wang et al which included 60 patients with stage IC adult granulosa cell tumors (32 in the adjuvant chemotherapy group and 28 in the no adjuvant chemotherapy group), reported that adjuvant chemotherapy in stage IC adult granulosa cell tumors patients was not associated with improved disease free survival.…”