Conservative surgery in stage I adult type granulosa cells tumors of the ovary: Results from the MITO-9 study

Bergamini, Alice; Cormio, Gennaro; Ferrandina, Gabriella; Lorusso, Domenica; Giorda, Giorgio; Scarfone, Giovanna; Bocciolone, Luca; Raspagliesi, Francesco; Tateo, Saverio; Cassani, Chiara; Savarese, Antonella; Breda, Enrico; Giorgi, Ugo De; Mascilini, F.; Candiani, Massimo; Kardhashi, Anila; Biglia, Nicoletta; Perrone, Anna Myriam; Pignata, Sandro; Mangili, Giorgia

doi:10.1016/j.ygyno.2019.05.029

Cited by 30 publications

(31 citation statements)

References 18 publications

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“…[86][87][88][89] In retrospective studies, including multivariate analyses, fertility sparing surgery does not appear to be associated with poorer outcomes (DFS, PFS, OS) compared with more extensive surgery in patients with stage I germ cell tumors and sex-cord stromal tumors. [90][91][92][93][94][95][96][97][98][99][100][101][102][103][104][105] Fertility-sparing surgery may be considered for patients who wish to preserve fertility and have apparent early-stage disease and/or low-risk tumors, such as early-stage invasive epithelial tumors, LMP lesions, malignant germ cell tumors, or malignant sex cord stromal tumors. Even if the contralateral ovary cannot be spared, uterine preservation can be considered as it allows for potential future assisted reproductive approaches.…”

Section: Fertility Sparing Options For Stage I Diseasementioning

confidence: 99%

Ovarian Cancer, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology

Armstrong

Alvarez

Bakkum-Gamez³

et al. 2021

Journal of the National Comprehensive Cancer Network

475

356

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Epithelial ovarian cancer is the leading cause of death from gynecologic cancer in the United States and is the country’s fifth most common cause of cancer mortality in women. A major challenge in treating ovarian cancer is that most patients have advanced disease at initial diagnosis. These NCCN Guidelines discuss cancers originating in the ovary, fallopian tube, or peritoneum, as these are all managed in a similar manner. Most of the recommendations are based on data from patients with the most common subtypes─high-grade serous and grade 2/3 endometrioid. The NCCN Guidelines also include recommendations specifically for patients with less common ovarian cancers, which in the guidelines include the following: carcinosarcoma, clear cell carcinoma, mucinous carcinoma, low-grade serous, grade 1 endometrioid, borderline epithelial, malignant sex cord-stromal, and malignant germ cell tumors. This manuscript focuses on certain aspects of primary treatment, including primary surgery, adjuvant therapy, and maintenance therapy options (including PARP inhibitors) after completion of first-line chemotherapy.

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Section: Fertility Sparing Options For Stage I Diseasementioning

confidence: 99%

Ovarian Cancer, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology

Armstrong

Alvarez

Bakkum-Gamez³

et al. 2021

Journal of the National Comprehensive Cancer Network

475

356

View full text Add to dashboard Cite

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“…Based on the results of the present study, completeness of surgical staging is not a prognostic factor for DSS. However, a previous study shows that patients who underwent FSS(CYS USO) had a poor DFS than those who underwent RS (20).…”

Section: Discussionmentioning

confidence: 94%

Association between Postoperative Adjuvant Chemotherapy and Disease-Specific Survival in Women with Ovarian Sex Cord-Stromal Tumors: A SEER-based Study

Li¹,

Sun²,

Li³

et al. 2021

Preprint

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Background Ovarian sex cord-stromal tumors (SCSTs) are relatively rare tumor. The standard treatment is surgery, while adjuvant chemotherapy remains controversial. This study evaluated the effect of adjuvant chemotherapy and disease-specific survival (DSS) in patients with SCSTs.Methods 323 Patients with SCSTs were enrolled from the Surveillance, Epidemiology, and End Results (SEER) database. Demographic and clinicopathological characteristics were compared using Mann–Whitney U-test, Fisher’s exact test, and chi-square test. DSS were estimated by Kaplan–Meier and compared with the log-rank test. Cox proportional hazards model was used to control for confounders.Results A total of 323 patients were included in this study, and the mean age was 44 years (range, 10-89 years). The most common histologic subtype was granulosa cell tumor (GCT) (n=197, 61%). 60.7% were diagnosed with stage IA or IB disease and 18% with stage IC disease. Among them, 62.2% of patients (n=201) received chemotherapy. The Median follow-up time was 71 months (range,1-224 months). 12.7% (41/323) of patients experienced death. Patients who did not received chemotherapy (n=122) had better DSS compared to those who received chemotherapy, 5-year DSS rates were 93.5% VS 80.3% (P = 0.0005), 10-year DSS rates were 93.0% and 78.69% (P = 0.0002). Multiple Cox regression analysis showed that higher stage (p＜0.001), poor differentiation（P=0.24）, larger tumor size(size＞10cm) （P=0.018） were independently associated with an increased hazard of death，while histological subtype（P=0.082）,adjuvant chemotherapy(p=0.762), complete staging surgery（p=0.554）was not associated with prognosis.ConclusionChemotherapy could not improve the prognosis and may be associated with poorer DSS. Age, histopathologic subtype, complete staging surgery, lymphadenectomy are not associated with prognosis.

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“…Conservative treatment may be advisable in patients in whom the disease is detected in the early stage of FIGO IA / IC. Preservation of fertility is possible for this stage, as it has been shown that there is no difference in survival in conservative versus radical access, and a total of 5 years of survival is 97% [11].…”

Section: Discussionmentioning

confidence: 99%

Successfully completed pregnancy after conservative treatment of nonepithelial ovarian cancer

Nejković

Štulić²,

Rudić-Biljić-Erski³

et al. 2021

Srp Arh Celok Lek

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Introduction. Granulosa cell tumors are rare neoplasms of ovary with low malignancy potential and late recurrence. They originate from the granulose of the ovary stromal cells and have the ability to produce estrogens. The main treatment is surgical and implies hysterectomy with bilateral salpingo-oophorectomy, omentectomy, taking peritoneal biopsies, and cytological analysis of the peritoneal washing. When found in young women who have not given birth, a conservative approach can be considered. Fertility sparing surgery is safe only for early FIGO stages IA tumors ?? IC, where it is necessary to make unilateral salpingo-oophorectomy and complete staging. Case outline. We present a case of young woman with granulosa cell tumor who was accidentally discovered, and after an adequate surgery and chemotherapy she gave a birth to a healthy child. Conclusion. Young women who have not given birth and who have been diagnosed with granulosa cell ovarian tumor can be treated conservatively after adequate disease staging and confirmation that the disease is at an early stage.

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Conservative surgery in stage I adult type granulosa cells tumors of the ovary: Results from the MITO-9 study

Cited by 30 publications

References 18 publications

Ovarian Cancer, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology

Ovarian Cancer, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology

Association between Postoperative Adjuvant Chemotherapy and Disease-Specific Survival in Women with Ovarian Sex Cord-Stromal Tumors: A SEER-based Study

Successfully completed pregnancy after conservative treatment of nonepithelial ovarian cancer

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