Clinical and Pathological Predictive Factors in Women with Adult-type Granulosa Cell Tumor of the Ovary

Abstract

Granulosa cell tumor (GCT) is a rare neoplasm hallmarked by a very indolent course and late recurrences. Although numerous clinical and pathological parameters have been implicated as prognostic factors for GCT, their role remains controversial. We performed a retrospective study at our institution where we identified 48 patients with GCT from our tumor registry. Demographic and clinical course information was recorded from the medical record. Twenty of 48 formalin-fixed, paraffin-embedded blocks were retrieved from archived specimens. Pathological parameters such as nuclear atypia, mitotic count, Ki-67 index using immunohistochemistry, and quantitative DNA ploidy were performed. DNA aneuploidy by quantitative method was associated with patients' overall survival. The degree of nuclear atypia, mitotic count, Ki-67 index, and DNA aneuploidy was not predictive of tumor recurrence. Multi-institutional collaboration is imperative to create a comprehensive national database for investigation into ways that may better indicate prognosis in these patients.

Prognostic factors in ovarian adult granulosa cell tumour

“…However, other studies have not supported such an association 9 – 11. Therefore we consider, as we would expect, that patient age is not a reliable factor in predicting behaviour or outcome in AGCT.…”

“…However, it should be noted that even very small neoplasms may recur, as demonstrated by a report of a microscopic tumour recurring after 6 years 19. Other studies have shown no correlation between tumour size and behaviour,5 11 20 – 22 and we conclude that there is no consistent association between tumour size and recurrence; moreover, since the critical size varies in those studies that do suggest a relationship, it is clear that there is no consensus as to what size is important in predicting adverse behaviour.…”

Prognostic value of mitotic counts and Ki-67 immunoreactivity in adult-type granulosa cell tumour of the ovary

“…Additional factors such as tumour fixation can influence the results and these may be impossible to control in retrospective studies. Therefore it is not surprising that some reports have failed to show a correlation between mitotic activity and prognosis in patients with GCT,16 – 23 and even those studies reporting such a correlation do not agree on the cut-off value for poor outcomes. More recent immunohistochemical investigations evaluating the expression of proliferation-associated markers such as proliferating cell nuclear antigen and Ki-67/MIB-1 have also failed to show consistent results 8 10 16 17 19 22 – 25…”

Comparison of Proliferation Indices in Primary Adult-type Granulosa Cell Tumors of the Ovary and Their Corresponding Metastases: An Analysis of 14 Cases

“…determine their potential prognostic significance in patients with stage 1 disease (10,11,16,(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37). As such, almost all studies have been restricted to the examination of the primary ovarian tumors.…”