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

Abstract

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.

Impact of Different Prognostic Factors on the Survival of Patients with Malignant Granulosa Cell Tumors of the Ovary: An Institutional Based Study at the Egyptian National Cancer Institute

“…Nasioudis et al[26] concluded that chemotherapy does not affect survival after controlling several factors; similarly our study did not prove any significance between administration of adjuvant chemotherapy and DFS (p=0.0986) nor OS (p=0.2848).Lee et al[27] stated that several factors including capsule invasion, had no significant relation with recurrence, however, our study revealed the significant contribution of capsule invasion in the development of recurrence in such tumors, in agreement with a recent pathological study in Croatia emphasizing several other pathological prognostic factors such as LVSI, presence of necrosis and hemorrhage, diffuse growth pattern, and nuclear atypia[28].…”

Secondary Amenorrhea and Infertility Due to an Inhibin B Producing Granulosa Cell Tumor of the Ovary. A Rare Case Report and Literature Review

“…Lee et al reported endometrial abnormalities (hyperplasia or cancer) associated with GCT in 18 cases out of 69 cases [ 5 ]. Additionally, Babarovic et al described endometrial disorders at 17 patients out of 33 evaluated patients [ 23 ].…”

Tumor ovárico de células esteroideas sin otra especificación, durante el embarazo

“…En los casos con tumores confinados al ovario es posible realizar ooforosalpingectomía unilateral (5) . Para las mujeres que han completado su descendencia o presentan estadios neoplásicos avanzados, está indicada la histerectomía abdominal total con ooforosalpingectomía bilateral y estadificación quirúrgica completa (14) . Aproximadamente 25% a 43% de los TCEOE son malignos y las metástasis suelen estar en la cavidad peritoneal y rara vez en sitios distantes.…”