Granulosa cell tumors of the ovary: review of 43 cases.

PURPOSE

Granulosa cell tumors of the ovary (OGCT) are rarely seen tumors and display a quite interesting behavior profile. The purpose of this study was to evaluate the impact of stage, histological type (juvenile or adult type) and treatment on the prognosis of this disease.

METHODS

Forty-three females with OGCT operated between January 1990 and June 2007 were retrospectively evaluated. Radical surgery was performed to 37 patients (86%) without fertility desire, whereas conservative surgery was performed to 6 patients with early-stage disease and fertility desire.

RESULTS

Thirty-nine (90.6%) patients had stage I disease, whereas 4 (9.4%) had advanced-disease stage (stage II 2 and stage III 2 patients). All of the patients were surgically treated, but conservative surgery was applied to only 6 cases. Postoperative chemotherapy was administered to 18 cases and the remaining 25 cases were put under follow-up without chemotherapy. Recurrence was observed in 8 cases and 1 of these cases was of juvenile type. Mean time to recurrence was 55.14±32.18 months (range 15-122). Tumor stage was the most important prognostic factor, with 5-year overall survival of 96.77% in local disease, and 66.67% in advanced-stage disease (p<0.01).

CONCLUSION

OGCT can recur many years after primary therapy. Consequently these patients must be followed-up for long periods of time. Disease stage at diagnosis was the most important factor affecting the recurrence rate and prognosis. The evaluation of all factors affecting survival needs further studies with larger numbers of patients.