Pectasides D, Papaxoinis G, Fountzilas G, Aravantinos G, Pectasides E, Mouratidou D, Economopoulos T, Andreadis Ch
Second Department of Internal Medicine, Propaeduetic, Oncology Section, University of Athens, Attikon University Hospital, Haidari, Athens, Greece.
Anticancer Res. 2008 Mar-Apr;28(2B):1421-7.
Granulosa cell tumors (GCT) are rare malignant neoplasms of the ovaries with, usually, indolent biological behavior.
The epidemiological, clinical and pathological features of 34 patients with adult GCT, from the registry of the HeCOG, were analyzed retrospectively for their prognostic significance.
The median age was 51 years with post- to premenopausal ratio=l.8 and median size of the tumor 10 cm. Forty-seven % had a low mitotic index (1-3 mitoses/10 high-power fields, HPFs) and 48% had International Federation of Obstetrics and Gynecology (FIGO) stage IA. After 34.5 months of median follow-up, the estimated 5-year and 10-year progression-free survival (PFS) was 78% and 65%, respectively, while both the 5- and 10-year overall survival (OS) was 89%. The stage and the presence of residual disease after surgery had prognostic significance for OS in the univariate analysis. Out of 19 patients whose disease was completely resected, the median disease-free survival (DFS) was 11 months. Only rupture of the tumor during surgery had prognostic significance for DFS in the univariate analysis. Seven out of 13 evaluable patients with unresectable disease responded to first-line chemotherapy (CT), 6 of them completely, while three patients responded to second-line chemotherapy. All the responders were retreated with platinum-based CT and one of them was platinum-insensitive. All the patients receiving second-line non-platinum CT developed progressive disease (PD).
The only curative treatment of GCT is complete surgical resection of all visible disease, while platinum-based CT is the most effective first-line, as well as second-line treatment.
颗粒细胞瘤（GCT）是卵巢罕见的恶性肿瘤，通常具有惰性生物学行为。
回顾性分析了HeCOG登记处34例成年GCT患者的流行病学、临床和病理特征，以评估其预后意义。
中位年龄为51岁，绝经后与绝经前比例为1.8，肿瘤中位大小为10 cm。47%的患者有低有丝分裂指数（1 - 3个有丝分裂/10个高倍视野，HPFs），48%的患者为国际妇产科联盟（FIGO）IA期。中位随访34.5个月后，估计5年和10年无进展生存率（PFS）分别为78%和65%，而5年和10年总生存率（OS）均为89%。在单因素分析中，分期和术后残留疾病的存在对OS有预后意义。在19例疾病完全切除的患者中，无病生存期（DFS）的中位数为11个月。在单因素分析中，仅手术期间肿瘤破裂对DFS有预后意义。13例不可切除疾病的可评估患者中有7例对一线化疗（CT）有反应，其中6例完全缓解，3例对二线化疗有反应。所有有反应的患者均接受基于铂的CT再次治疗，其中1例对铂不敏感。所有接受二线非铂类CT治疗的患者均出现疾病进展（PD）。
GCT的唯一治愈性治疗方法是完全手术切除所有可见病灶，而基于铂的CT是最有效的一线及二线治疗方法。
