Department of Gynecology Oncology, National Cancer Center/ National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.17, South Panjiayuan Residential, Chaoyang District, Beijing, 100021, China.
Department of Pathology, National Cancer Center/ National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.17, South Panjiayuan Residential, Chaoyang District, Beijing, 100021, China.
J Ovarian Res. 2020 Feb 14;13(1):19. doi: 10.1186/s13048-020-00619-6.
The aim of this study was to explore the clinicopathological characteristics of recurrent adult-type granulosa cell tumor of the ovary (AGCOT) and evaluated the treatment results to define the prognostic parameters for survival after recurrence.
A retrospective review of 40 patients with recurrent AGCOT, who were treated in the Cancer Hospital at the Chinese Academy of Medical Sciences from 2000 to 2015 was conducted. The impact of clinical and pathological characteristics, progression-free survival (PFS), and post-recurrence therapeutic approaches on prognosis were analyzed. Among the 40 recurrent patients, there were 10 cases where the relapse was uncontrolled, 24 cases had second relapses, and 6 cases without further relapses at the time of our follow-up. The median PFS was 61 months (range, 7-408 months), and the median time interval between the first and the second relapses (R-PFS) was 25 months (range, 0-94 months). The median time interval between the first relapse and death (R-OS) was 90 months (range, 2-216 months). PFS ≥ 61 months (P = 0.004) and post-recurrence therapeutic approach (P < 0.001) were independent risk factors for repeated recurrences. The age at recurrence (P = 0.031) and post-recurrence therapeutic approach (P = 0.001) were independent risk factors for death after recurrence.
Among patients with recurrent AGCOT, those with long PFS had good prognoses. Maximal cytoreductive effort should be made after recurrence. Complete resection and postoperative adjuvant chemotherapy may improve the prognosis of patients with recurrent AGCOT.
本研究旨在探讨复发性成人型颗粒细胞瘤（AGCOT）的临床病理特征，并评估治疗结果，以确定复发后生存的预后参数。
对 2000 年至 2015 年在中国医学科学院肿瘤医院治疗的 40 例复发性 AGCOT 患者进行回顾性分析。分析了临床病理特征、无进展生存期（PFS）、复发后治疗方法对预后的影响。在 40 例复发性患者中，有 10 例复发无法控制，24 例有第二次复发，6 例在随访时无进一步复发。中位 PFS 为 61 个月（范围为 7-408 个月），第一次和第二次复发之间的中位时间间隔（R-PFS）为 25 个月（范围为 0-94 个月）。第一次复发和死亡之间的中位时间间隔（R-OS）为 90 个月（范围为 2-216 个月）。PFS≥61 个月（P=0.004）和复发后治疗方法（P<0.001）是重复复发的独立危险因素。复发时的年龄（P=0.031）和复发后治疗方法（P=0.001）是死亡的独立危险因素。
在复发性 AGCOT 患者中，PFS 较长的患者预后较好。复发后应进行最大程度的减瘤治疗。完全切除和术后辅助化疗可能改善复发性 AGCOT 患者的预后。
