Clinical parameters and treatment results in recurrent granulosa cell tumor of the ovary

Uygun, Kazım; Aydıner, Adnan; Saip, Pınar; Koçak, Zafer; Başaran, Mert; Dincer, Maktav; Topuz, Erkan

doi:10.1016/s0090-8258(02)00141-5

Cited by 47 publications

(36 citation statements)

References 19 publications

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“…7 The importance of stage was also confirmed in the current study. Mean survival was significantly longer in patients with stage I disease, and mortality was significantly higher in patients with advanced stage disease.…”

Section: Discussionsupporting

confidence: 82%

Prognostic factors in adult granulosa cell tumors of the ovary: a retrospective analysis of 80 cases

et al. 2009

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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.

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Section: Discussionsupporting

confidence: 82%

Prognostic factors in adult granulosa cell tumors of the ovary: a retrospective analysis of 80 cases

et al. 2009

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“…Although Fotopoulou's group [23] and Lee's group [26] both showed a very high rate (> 80%) of successful cytoreduction (optimally debulking surgery) in these recurrent-GCT patients with multifocal lesions, there was no doubt that surgical cytoreduction during relapse is more challenging and involves a multivisceral approach [23]. In fact, Uygun's group [27] found that only two of 11 patients could undergo surgical tumor debulking. In the current study, up to 80% of patients were initially treated with surgery for recurrent tumors, and among this group, one-quarter of the recurrent CGTs (26.5%, 9/34) were treated with surgery alone (20.5% of all recurrent patients, Table 2).…”

Section: Discussionmentioning

confidence: 99%

Outcome of patients with recurrent adult-type granulosa cell tumors – A Taiwanese Gynecologic Oncology Group study

Wang

Sun

Lin

et al. 2015

Taiwanese Journal of Obstetrics and Gynecology

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“…Platinum based chemotherapy is often considered for GCT either alone or in combination with doxorubicin and cyclophosphamide (CAP) [45][46][47], vinblastine and bleomycin (PVB) [48][49][50], etoposide or etoposide and bleomycin (BEP) [51][52][53]. The response rates (RR) have varied from 60 to 93 % and duration of response 5-58 months (Table 3).…”

Section: Chemotherapymentioning

confidence: 99%

Recent Advances in Granulosa Cell Tumor Ovary: A Review

Kottarathil

Antony

Nair

et al. 2012

Indian J Surg Oncol

107

108

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Granulosa cell tumors constitute less than 5 % of all ovarian tumors. Unlike epithelial ovarian tumors, they occur in a younger age group, are usually detected in an early stage and often have features of hyperestrogenism. The presenting symptoms are usually nonspecific with abdominal pain or distension. They follow an indolent course and are characterized by a long natural history. Mutation of FOXL2 (402C->G) seen in 97 % of adult GCT may be pathognomonic for adult GCT. Only stage of the disease has been consistently shown in various studies to affect survival of patients with GCT. The initial management of patients, for whom fertility is not an issue, is total abdominal hysterectomy, bilateral salpingo-oophorectomy and removal of all gross disease. Nodal dissection is not a significant factor for survival and is not recommended in surgical staging of GCT. Fertility preserving surgery with unilateral salpingooophorectomy is feasible in young patients with stage Ia GCT. Patients with early stage disease (stage I and II) have a very good prognosis with 5 year DFS and OS of 89 % and 99 % respectively and these groups of patients usually don't require any postoperative treatment. Patients with stage Ic disease associated with poor prognostic factors like large tumor size or high mitotic index and stage II, have a higher chance of relapse, and may benefit with postoperative treatment but role of chemotherapy is still debatable. In advanced stage disease (stage III and IV) the 5 year DFS and OS disease was 72 % and 80 % respectively hence the option of postoperative treatment with 6 cycles of BEP should be considered in this group. Recently paclitaxel is being investigated as an effective tool in GCT. The efficacy of radiation in GCT is not well defined but in optimally debulked cases postoperative radiation is a viable option. Due to high chance of recurrence even years after apparent clinical cure of the primary tumor, lifelong follow up with clinical examination and tumor markers like inhibin B is recommended. About 25 % GCT develop recurrence and the median time to recur is usually 4-5 years. Most recurrences are intraperitoneal and usually a complete debulking of the disease is feasible even in the recurrent setting. Postoperative chemotherapy (platinum based) is usually given after surgery more so in cases with widespread disease or after suboptimal cytoreduction. Recurrent chemoresistant, progressive non-responding GCT or patients with high surgical risk are ideal candidates for targeted therapy.

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Clinical parameters and treatment results in recurrent granulosa cell tumor of the ovary

Cited by 47 publications

References 19 publications

Prognostic factors in adult granulosa cell tumors of the ovary: a retrospective analysis of 80 cases

Prognostic factors in adult granulosa cell tumors of the ovary: a retrospective analysis of 80 cases

Outcome of patients with recurrent adult-type granulosa cell tumors – A Taiwanese Gynecologic Oncology Group study

Recent Advances in Granulosa Cell Tumor Ovary: A Review

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