Is adjuvant chemotherapy beneficial for patients with FIGO stage IC adult granulosa cell tumor of the ovary?

Wang, Dan; Xiang, Yang; Wu, Ming; Shen, Keng; Yang, Jiaxin; Huang, Huifang; Ren, Tong

doi:10.1186/s13048-018-0396-x

Cited by 24 publications

(40 citation statements)

References 24 publications

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“…For AGCOT patients with initial treatment, patients receiving chemotherapy are mostly patients with stage Ic or above. Studies have shown that postoperative adjuvant chemotherapy does not improve the prognosis and does not prolong the PFS or OS of the patients [24,25]. A retrospective study by Mangili et al in 35 cases of recurrent AGCOT showed chemotherapy did not improve the prognosis of the patients with recurrence who underwent secondary cytoreductive surgery, and the author recommended the patients who had no residual tumor in the secondary cytoreductive surgery may omit adjuvant chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

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

Zhao

Zhang

et al. 2020

J Ovarian Res

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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.

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Section: Discussionmentioning

confidence: 99%

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

Zhao

Zhang

et al. 2020

J Ovarian Res

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“…Current National Comprehensive Cancer Network (NCCN) guidelines recommend adjuvant chemotherapy for advanced-stage patients and stage I disease with high risk factors, but clear definition of what constitutes a high risk factor remains controversial. Two recent studies by Mangili et al [ 36 ] and Wang et al [ 37 ] that analyzed AGCT patients in FIGO substage IC failed to demonstrate the benefit of adjuvant chemotherapy. The results of their studies have shown that adjuvant chemotherapy was not associated with improved DFS and did not protect patients against recurrence of the disease.…”

Section: Discussionmentioning

confidence: 99%

Adult Granulosa Cell Tumors of the Ovary: A Retrospective Study of 36 FIGO Stage I Cases with Emphasis on Prognostic Pathohistological Features

Babarović

Franin

Klarić

et al. 2018

Analytical Cellular Pathology

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Objective Adult granulosa cell tumors (AGCTs) represent 2%–5% of all ovarian malignancies. The aim of this study was to analyze clinical and pathohistological parameters and their impact on recurrence, overall, and disease-free survival in FIGO stage I AGCT patients. Methods The tumor specimens analyzed in this retrospective study were obtained from a total of 36 patients with diagnosis of ovarian AGCT surgically treated at the Department of Gynecology, Rijeka University Hospital Centre, between 1994 and 2012. Clinical, pathological, and follow-up data were collected. Results The mean age at diagnosis was 54.5 years with a range of 24–84. The majority of the patients, 30 (83%), were in FIGO stage IA, 3 (8%) in stage IC1, 1 (3%) in stage IC2, and 2 (6%) in stage IC3. During follow-up period (median 117.5 months, range 26–276), recurrence occurred in 4 patients (12%) with 2 deaths of the disease recorded. In univariate analysis, the 5-year survival rates were significantly shorter in patients with FIGO substage IC (p = 0.019), with positive LVSI (p = 0.022), with presence of necrosis (p = 0.040), and with hemorrhage (p = 0.017). In univariate analysis, the 5-year disease-free survival rates were significantly shorter in patients treated with fertility surgery (p = 0.004), with diffuse growth pattern (p = 0.012), with moderate and severe nuclear atypia (p = 0.032), and with presence of hemorrhage (p = 0.022). FIGO substage IC proved to be independent predictor for recurrence (OR = 16.87, p = 0.015, and OR = 23.49, p = 0.023, resp.) and disease-free survival (p = 0.0002; HR 20.84, p = 0.02) at the uni- and multivariate analyses. Conclusions FIGO substage IC is predictive of recurrence and disease-free survival in patients with early-stage AGCTs. LVSI, presence of necrosis and hemorrhage, diffuse growth pattern, and nuclear atypia in AGCTs seem to be associated with overall and disease-free survival, so these pathological features should be taken into consideration when managing patients with AGCT.

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“…In large cohort of 160 patients with stage I granulosa cell tumors, a higher relapse rate was observed for patients with stage IC (43%) compared to those with stage IA disease (24%) ( p = 0.02) (Wilson et al, 2015). To date, only two studies (Mangili et al, 2016; Wang et al, 2018) have investigated the role of adjuvant chemotherapy for patients with stage IC disease and both reported on disease-free survival (DFS). Similar to our results, an analysis of the Italian MITO-9 network failed to demonstrate an improvement in disease-free survival (DFS) for patients with stage IC granulosa cell tumors who received adjuvant chemotherapy (Mangili et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

“…After a median follow-up of 96 months, there was no difference in DFS between the observation and CT groups with a 5-yr DFS rates of 50% and 27% respectively ( p = 0.4) (Mangili et al, 2016). In another retrospective study, Wang et al (2018), analyzed 60 patients with stage IC granulosa cell tumors. In that study rate of adjuvant chemotherapy administration was 53.3%.…”

Section: Discussionmentioning

confidence: 99%

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Role of adjuvant chemotherapy in the management of stage IC ovarian granulosa cell tumors

Nasioudis

Haggerty

et al. 2019

Gynecologic Oncology Reports

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Objective The aim of the present study was to investigate the patterns of use and prognostic significance of adjuvant chemotherapy (CT) for patients with stage IC ovarian granulosa cell tumors (GCTs). Methods We identified patients with stage IC GCTs diagnosed between 2004 and 2015 in the National Cancer Data Base (NCDB). Logistic regression was performed to identify variables independently associated with chemotherapy administration. Overall survival (OS) was evaluated for patients diagnosed between 2004 and 2014 following generation of Kaplan-Meier curves and compared with the log-rank test. A Cox model was constructed to control for known confounders. Results A total of 492 patients with stage IC GCTs were identified, of which 166 (33.7%) received CT. Tumor size > = 10 cm (OR: 1.85, 95% CI: 1.21, 2.82) was independently associated with the administration of CT. There was no difference in OS between patients who did ( n = 145) and did not ( n = 282) receive CT, p = 0.52; 5-yr OS rates were 93.7% and 91.6% respectively. After controlling for patient age (<50 vs ≥50 years), tumor size and performance of lymphadenectomy (LND), the administration of CT was not associated with a survival benefit (HR: 1.07, 95% CI: 0.52, 2.21). Conclusions Approximately one in three patients with stage IC GCTs received CT in the NCDB, however CT was not associated with a survival benefit.

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Is adjuvant chemotherapy beneficial for patients with FIGO stage IC adult granulosa cell tumor of the ovary?

Cited by 24 publications

References 24 publications

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

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

Adult Granulosa Cell Tumors of the Ovary: A Retrospective Study of 36 FIGO Stage I Cases with Emphasis on Prognostic Pathohistological Features

Role of adjuvant chemotherapy in the management of stage IC ovarian granulosa cell tumors

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