Granulosa cell tumors of the ovary: The clinical value of serum inhibin A and B levels in a large single center cohort

Mom, Constantijne H.; Engelen, M.J.A.; Willemse, Phb; Gietema, Jourik A.; Hoor, Klaske A. ten; Vries, Elisabeth G.E. de; Zee, Ate G.J. van der

doi:10.1016/j.ygyno.2006.12.034

Cited by 98 publications

(71 citation statements)

References 27 publications

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“…In a study by Robertson et al, [7], total serum inhibin level was elevated in 100% GCTs, although, Inhibin A and B levels are elevated in patients with GCT, Inhibin B levels are usually elevated in higher proportion of tumours. Mom et al, [8] evaluated the use of serum inhibin levels in 30 women with granulosa cell tumours. The sensitivities and specificities for inhibin A were 67% and 100% and for inhibin B were 89% and 100%, respectively.…”

Section: References Discussionmentioning

confidence: 99%

Delayed Menopause Due to Ovarian Granulosa Cell Tumour

Vyas

Manjeera²,

Rai³

2013

JCDR

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Section: References Discussionmentioning

confidence: 99%

Delayed Menopause Due to Ovarian Granulosa Cell Tumour

Vyas

Manjeera²,

Rai³

2013

JCDR

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“…Newer studies using subunit specific ELISA showed inhibin B to be the major form secreted in GCT, and that inhibin B was more accurate than inhibin A in detecting GCT. Inhibins act as autocrine and paracrine granulosa cell growth factors and levels of inhibin reflect the tumor burden [17][18][19].…”

Section: B) Inhibinmentioning

confidence: 99%

Recent Advances in Granulosa Cell Tumor Ovary: A Review

Kottarathil

Antony

Nair

et al. 2012

Indian J Surg Oncol

106

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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“…16,17 Most common tumour markers useful in early detection of recurrence are inhibin B and Mullerian inhibiting substance/AMH. [18][19][20] …”

Section: Discussion Of Managementmentioning

confidence: 99%