Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea.
J Gynecol Oncol. 2011 Sep;22(3):188-95. doi: 10.3802/jgo.2011.22.3.188. Epub 2011 Sep 28.
To evaluate the clinicopathologic characteristics and prognostic factors of ovarian granulosa cell tumors.
Medical records of 113 patients presenting between January 1995 and December 2007 were retrospectively reviewed.
One-hundred two patients had adult type disease, with a mean age of 46.2 years (range, 18 to 83 years) and a mean follow-up period of 54.7 months (range, 1 to 155 months). The distribution of FIGO stages was 86 patients at stage I, 11 at stage II, and 5 at stage III. During follow-up, ten patients recurred at a mean time of 48 months (range, 4 to 109 months). Among them, three patients died after a mean of 57 months (range, 25 to 103 months). In recurrence analysis, advanced stage (p=0.032) and presence of residual disease (p=0.012) were statistically significant, and age<40 years, premenopause and positive washing cytology were marginally significant (p<0.1). In multivariate analysis, stage was the only factor associated with recurrence; adjuvant chemotherapy and fertility-sparing surgery were not statistically significant. Among 36 patients with fertility-sparing operations, eight patients had nine pregnancies and delivered seven babies. Eleven patients had juvenile type tumors; the mean age was 20.0 years (range, 8 to 45 years) and the mean follow-up period was 69.8 months (range, 20 to 156 months). The distribution of FIGO stage was nine patients at stage I and two at stage III. There were no recurrences or deaths reported. Four patients had seven pregnancies and delivered six babies.
Stage is the only factor associated with disease-free survival, and fertility-sparing surgery may be a treatment option for women with early-stage disease who want to retain fertility.
评估卵巢颗粒细胞瘤的临床病理特征和预后因素。
回顾性分析 1995 年 1 月至 2007 年 12 月期间就诊的 113 例患者的病历资料。
102 例患者为成人型疾病,平均年龄为 46.2 岁(范围,18 至 83 岁),平均随访时间为 54.7 个月(范围,1 至 155 个月)。FIGO 分期分布为 86 例Ⅰ期,11 例Ⅱ期,5 例Ⅲ期。随访期间,10 例患者平均复发时间为 48 个月(范围,4 至 109 个月)。其中 3 例患者在平均 57 个月(范围,25 至 103 个月)后死亡。在复发分析中,晚期(p=0.032)和存在残留病灶(p=0.012)具有统计学意义,年龄<40 岁、绝经前和阳性冲洗细胞学结果具有边缘统计学意义(p<0.1)。多因素分析表明,分期是与复发相关的唯一因素;辅助化疗和保留生育功能手术无统计学意义。在 36 例保留生育功能手术的患者中,8 例有 9 次妊娠,分娩 7 例婴儿。11 例为幼年型肿瘤;平均年龄为 20.0 岁(范围,8 至 45 岁),平均随访时间为 69.8 个月(范围,20 至 156 个月)。FIGO 分期分布为 9 例Ⅰ期和 2 例Ⅲ期。无复发或死亡病例报告。4 例有 7 次妊娠,分娩 6 例婴儿。
分期是与无病生存相关的唯一因素,保留生育功能手术可能是有生育要求的早期疾病患者的一种治疗选择。