Prognostic predictors in recurrent adult granulosa cell tumors of the ovary: a systematic review and meta-analysis

Inzani, Frediano; Santoro, Angela; Travaglino, Antonio; D’Alessandris, Nicoletta; Raffone, Antonio; Straccia, Patrizia; Angelico, Giuseppe; Arciuolo, Damiano; Scaglione, Giulia; Valente, Michele; Tralongo, Pietro; Gallotta, Valerio; Zannoni, Gian Franco

doi:10.1007/s00404-021-06305-2

Cited by 10 publications

(7 citation statements)

References 31 publications

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“…Consistent with the above studies, this study found that more than 75% of patients presented with pelvic and abdominal recurrence, with abdominal or pelvic mass and liver metastasis being the most common situation. Moreover, relapse pattern (distant lesion) was also considered a prognostic factor of secondary recurrence in this study, and similar results were observed in another study 17 . Therefore, recurrence during first 5‐year follow‐up and additional recurrence within 33 months since the first recurrence illustrate unfavorable prognosis in patients with AGCT.…”

Section: Discussionsupporting

confidence: 88%

“…Moreover, relapse pattern (distant lesion) was also considered a prognostic factor of secondary recurrence in this study, and similar results were observed in another study. 17 Therefore, recurrence during first 5‐year follow‐up and additional recurrence within 33 months since the first recurrence illustrate unfavorable prognosis in patients with AGCT. Hence, a long period of regular follow‐up is recommended to monitor pelvic abdominal status.…”

Section: Discussionmentioning

confidence: 99%

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Clinical characteristics and oncological outcomes of recurrent adult granulosa cell tumor of ovary: A retrospective study of seventy patients

Wang

Jia

et al. 2023

Acta Obstet Gynecol Scand

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Introduction:This study aimed to describe the clinicopathological characteristics of recurrent adult granulosa cell tumor and identify the risk factors for recurrence.Material and methods: Seventy recurrent adult granulosa cell tumor patients treated in Peking Union Medical College Hospital between 2000 and 2020 were retrospectively reviewed. The primary outcomes were progression-free survival after first recurrence (PFS-R), overall survival after first recurrence (OS-R) and recurrence frequency. The Kaplan-Meier analysis, univariate and multivariate Cox proportional hazard analysis, and the Prentice, Williams and Peterson counting process (PWP-CP) model were adopted.Results: There were 70 patients included in the study, and recurrence occurred twice in more than 71% of patients, and 49.9% of patients relapsed ≥ three times. The recurrence pattern in over half of the patients at first recurrence was multifocal and distant disease, and abdominal or pelvic mass and liver metastasis were the most common.The 5-year PFS-R was 29.3%, and the 10-year PFS-R was 11.3%; the 5-year OS-R was 94.9%, and the 10-year OS-R was 87.9%. Kaplan-Meier analysis demonstrated that patients with distant recurrence and PFS1 (PFS when first recurrence occurred) ≤60 months had worse PFS-R (p = 0.017, 0.018), and patients with PFS-R ≤ 34 months had worse OS-R (p = 0.023). It demonstrated that PFS1 ≤ 60 months (hazard ratio, HR 1.9, 95% confidence interval [CI]: 1.1-3.4, p = 0.028) was an independent risk factor for PFS-R, and local lesion at recurrence (HR 0.488, 95% CI: 0.3-0.9, p = 0.027) was an independent protective factor for PFS-R. In addition, it demonstrated that PFS-R ≤ 33 months (HR 5.5, 95% CI: 1.2-25.3, p = 0.028) was an independent risk factor for OS-R. The PWP-CP analysis showed that laparoscopic operation (at each operation) could significantly increase recurrence times (p = 0.002, HR = 3.4), and noThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and oncological outcomes of recurrent adult granulosa cell tumor of ovary: A retrospective study of seventy patients

Wang

Jia

et al. 2023

Acta Obstet Gynecol Scand

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“…From the 95% 5-year survival rate at stage I, survival drops to 55% to 75% at stage II, and further down to 22% to 50% at stage III ( 27 ). A recent study also showed that an anatomic site of recurrence outside the pelvis was associated with a worse prognosis ( 36 ).…”

Section: Granulosa Cell Tumorsmentioning

confidence: 99%

ERβ in Granulosa Cell Tumors and Its Clinical Potential

et al. 2023

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Granulosa cell tumors (GCT) are rare ovarian tumors that are comprised of an adult and a juvenile subtype. They have a generally good prognosis, but the survival rate drastically declines in patients with late-stage or recurring tumors. Due to the rarity of GCT, the tumor type is largely understudied and lacks a specific treatment strategy. Estrogen receptor beta (ERβ/ESR2) has been found to be highly expressed in GCT which could be of therapeutic importance since it can be targeted with small molecules. However, its role in GCT is not known. In this review, we summarize the current knowledge about the action of ERβ in the ovary and discuss its prospective role in GCT.

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“…7 Whether surgery is more effective than chemotherapy or radiotherapy is unknown. [8][9][10][11][12] Cytotoxic platinum-based chemotherapy (CT) is recommended for treating metastatic or recurrent AOGCT. The objective response rates (RRs) to multiple combined chemotherapy regimens have been reported to range from 50% to 92%; [13][14][15] however, durable remission is infrequent.…”

Section: Introductionmentioning

confidence: 99%

The Prognostic Significance of Adjuvant Chemotherapy in Adult Ovarian Granulosa Cell Tumors: A Systematic Review and Meta-analysis

Zhuang,

Yang

2023

Cancer Control

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Introduction This study aimed to evaluate the oncological and prognostic significance of adjuvant chemotherapy (CT) in patients with adult granulosa cell tumors of the ovary (AOGCT). Methods We searched the Chinese National Knowledge Infrastructure, Clinical Trials, Wanfang Database, Web of Science, Cochrane Library, and MEDLINE electronic databases for articles published up to May 2023. Reference lists of the enrolled studies, Google Scholar, and scientific meeting reports were also manually searched. Results We enrolled 5641 patients with AOGCT from 33 eligible studies, including 1674 (29.7%) and 3967 (70.3%) patients in the CT and non-CT groups, respectively. Based on the cumulative results, adjuvant CT did not affect the risk of recurrence or progression (R/P) (odds ratio [OR]: 1.67, 95% confidence interval [CI]: 1.01–2.78, I2 = 63%, P = .05) and 5-year overall survival (OR: .86, 95% CI: .70–1.04, I2 = 0%, P = .12) of patients with AOGCT. However, adjuvant CT might reduce the 5-year disease-free survival (OR: 2.90, 95% CI: 1.19–7.08, I2 = 55%, P = .02). Sub-group analysis revealed that adjuvant CT did not affect the risk of R/P in patients with early-stage AOGCT (OR: .78, 95% CI: .43–1.43, I2 = 2%, P = .43) and advanced or recurrent AOGCT (OR: .78, 95% CI: .43–1.43, I2 = 2%, P = .43). Conclusion This meta-analysis suggests that patients with AOGCT might not benefit from adjuvant CT, even those with advanced or recurrent disease. The results should be interpreted with caution because of the inherent limitations of retrospective studies.

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Prognostic predictors in recurrent adult granulosa cell tumors of the ovary: a systematic review and meta-analysis

Cited by 10 publications

References 31 publications

Clinical characteristics and oncological outcomes of recurrent adult granulosa cell tumor of ovary: A retrospective study of seventy patients

Clinical characteristics and oncological outcomes of recurrent adult granulosa cell tumor of ovary: A retrospective study of seventy patients

ERβ in Granulosa Cell Tumors and Its Clinical Potential

The Prognostic Significance of Adjuvant Chemotherapy in Adult Ovarian Granulosa Cell Tumors: A Systematic Review and Meta-analysis

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