Lee Y-K, Park N-H, Kim J W, Song Y-S, Kang S-B, Lee H-P
Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, Korea.
Int J Gynecol Cancer. 2008 Jul-Aug;18(4):642-7. doi: 10.1111/j.1525-1438.2007.01065.x. Epub 2007 Sep 14.
Granulosa cell tumor (GCT) of the ovary is a very rare neoplasm, which is characterized by an indolent clinical course. Thus, the clinical characteristics, optimal treatment, and follow-up protocols are not well established. The goal of this study is to evaluate clinical findings, prognostic factors, and recurrent features of GCT in Korean patients. Between 1987 and 2005, 42 cases of GCT were diagnosed in our institution. There were 35 cases showing adult-type GCT, which were available for evaluation. All charts were reviewed, and the clinical data along with treatment results were retrospectively studied. Statistical analyses were performed for risk factors of recurrence and disease-free survival. GCT accounted for 3% of all ovarian malignancies in our institution during the study period. The median age was 45 years (range, 24-68 years). Abdominal and hormone-related symptoms were the main causes of first presentation. There were eight cases of recurrence including two cases of disease-related deaths during the median follow-up period of 177 months (range, 8-212 months). Factors affecting the recurrence involved residual tumor and stage, but residual tumor was the only significant factor of recurrence in multivariate analysis. The median time to relapse was 75 months (range, 55-137 months), and the liver was the most common extra-pelvic metastatic site followed by the intestine. Continuous long-term follow-up with pelvic and whole-abdominal surveillance is absolutely required. Active management including complete tumorectomy is the most important treatment modality in both primary surgeries and recurrent cases.
卵巢颗粒细胞瘤（GCT）是一种非常罕见的肿瘤，其临床病程较为隐匿。因此，其临床特征、最佳治疗方法及随访方案尚未完全确立。本研究的目的是评估韩国患者GCT的临床发现、预后因素及复发特征。1987年至2005年期间，我院共诊断出42例GCT。其中35例为成人型GCT，可供评估。我们回顾了所有病历，并对临床数据及治疗结果进行了回顾性研究。对复发风险因素及无病生存期进行了统计分析。在研究期间，GCT占我院所有卵巢恶性肿瘤的3%。中位年龄为45岁（范围24 - 68岁）。腹部症状及激素相关症状是初次就诊的主要原因。在中位随访期177个月（范围8 - 212个月）内，有8例复发，包括2例与疾病相关的死亡。影响复发的因素包括残留肿瘤及分期，但在多因素分析中，残留肿瘤是唯一显著的复发因素。复发的中位时间为75个月（范围55 - 137个月），肝脏是最常见的盆腔外转移部位，其次是肠道。绝对需要对盆腔和全腹进行持续长期监测随访。积极的治疗措施包括完整的肿瘤切除术，这在初次手术及复发病例中都是最重要的治疗方式。
