Recurrent granulosa cell tumor of the ovary: Retrospective analysis

Uygun, Kazım; Koçak, Zafer; Saip, Pınar; Başaran, Mustafa; Aydıner, Adnan; Dinçer, Murat; Taş, Faruk; Topuz, Erkan

doi:10.1016/s0959-8049(01)81681-6

Cited by 11 publications

(22 citation statements)

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“…Recurrence rates are also closely related with stage. 8 In stage I disease, only 5% of patients recurred whereas this rate was 33% in more advanced stages. 9 In our study group, recurrence rates were also significantly lower in stage I disease (5.4% vs. 25.0%, p=0.019).…”

Section: Discussionmentioning

confidence: 96%

“…The overall response rate to different combination chemotherapy regimens in advanced or recurrent granulosa cell tumors was reported to range from 50% to 92%. 8 The overall response rate to the BEP (bleomycin, etoposide, cisplatin) combination which is considered to be an effective regimen with tolerable toxicity as a first-line chemotherapy was reported as 83% in metastatic sex-cord stromal tumors of the ovary. 3,13 In this series, 53.8% of patients received adjuvant therapy due to advanced stage disease or high risk stage I disease.…”

Section: Discussionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

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

et al. 2009

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“…Various factors shown to have prognostic significance include age, tumor size, rupture of tumor, mitotic activity, nuclear atypia, aneuploidy (in 5-20 % GCT), p53 overexpression, high Ki-67 and stage of the disease [1][2][3][4][5][6][32][33][34][35][36][37][38].…”

Section: Prognostic Factorsmentioning

confidence: 99%

“…Few studies have shown that patients with stage Ic disease associated with poor prognostic factors like large tumor size or high mitotic index have a higher chance of relapse and may benefit with postoperative treatment [1][2][3][4][5][32][33][34][35][36][37][38]. But due to the rarity of GCT, these data have been collected from retrospective studies and case reports and it's impossible to conduct a randomized controlled trial to assess the efficacy of postoperative treatment in high risk patients.…”

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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“…Tanı anındaki hastanın yaşı önemli bir prognostik faktör olup 40 yaşından küçük olan hastaların prognozunun 40 yaşından büyük olan hastalara kıyasla daha iyi olduğu bildirilmiştir (9 takip süresinin kısa olması ve çalışmanın az hasta sayısı içermesi ile ilgili olduğu düşünülmüştür. Hastaların en sık başvuru şikayeti bazı çalışmalarda abdominal distansiyon olarak tespit edilirken, bazı çalışmalarda ise en sık anormal vajinal kanama olarak bildirilmiştir (10). Çalışmamızda en sık başvuru şikayetinin batında kitle olduğu saptanmıştır.…”

Section: Discussionunclassified

Ovarian granulosa cell tumours: A Single Center Experience

Kalkan¹,

Turgut²,

Almalı³

et al. 2017

Van Med J

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GirişTüm over malignensileri içinde seks kord stromal tümörlerin oranı %5-8'dir (1). Seks kord stromal over tümörlerinin yaklaşık %70'ni oluşturan granüloza hücreli tümörler her 100.000 kadının 0.4-1.7'sinde görülür (2). Granüloza hücreli over tümörleri seks kordlarından ve over stroma veya mezenkiminden köken alırlar. Tümörün başlangıç yaşı ve histolojik özelliklerine göre bu tümör adult ÖZET Amaç: Granüloza hücreli tümörler (GHT), overin epitelyal tümörlerine kıyasla nadir görülen daha iyi prognozlu düşük gradeli ve seks kord stromal kaynaklı tümörleridir. Tüm over kanserlerinin yaklaşık %5-8'ini oluştururlar. Biz bu çalışmada, kliniğimizde overin granüloza hücreli tümörü tanısıyla takip edilmiş olan hastaların klinik ve patolojik özeliklerini araştırdık. Results: FIGO staging is used for clinical staging of patients. The median age of patients was 45 (21-62). Of patients, while 14 of them were adult type subtype and the other two of them were juvenile subtype. In the macroscopic examination, the average tumor size 7 cm (2-20 cm). In all of the patients % 68 was premenopausal. The most common symptom was abdominal mass. In this study, the rate of mitosis phase, cellular atypia situations beyond surgery was evaluated in terms of other important prognostic factors. Endometrial proliferation was not detected in none of our patients. Adjuvant chemotherapy was given to 3 of them. Recurrence or metastasis was not observed during the follow-up period. Conclusion:The prognosis of ovarian granulosa cell tumors are quite good and they have very low risk of tumor recurrence. Treatment decisions should be taken by a multidisciplinary team. Patients themselves should be included in the decision-making process with regarding type of treatment

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Recurrent granulosa cell tumor of the ovary: Retrospective analysis

Cited by 11 publications

References 0 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

Recent Advances in Granulosa Cell Tumor Ovary: A Review

Ovarian granulosa cell tumours: A Single Center Experience

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