Department of Obstetrics and Gynecology, IRCCS San Raffaele Hospital, Milan, Italy; Università Vita Salute San Raffaele, Milan, Italy.
Dipartimento per La Salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy; Università Cattolica del Sacro Cuore, Istituto di Ginecologia e Ostetricia, Roma, Italy.
Eur J Surg Oncol. 2021 Jul;47(7):1705-1709. doi: 10.1016/j.ejso.2021.02.003. Epub 2021 Feb 9.
Juvenile type granulosa cell tumor (JGCTs) are extremely rare, mainly diagnosed in young women and pre-pubertal girls at stage I disease. Literature is scanty and guidelines regarding the optimal management are still controversial. The aim of this study is to add on the experience of the MITO group (Multicenter Italian Trials in Ovarian Cancer).
Clinicopathological data from patients with stage I JGCTs were retrospectively collected. Descriptive statistics were used to characterize the patient population. Clinicopathological features and treatment variables were evaluated for association with relapse.
Seventeen patients were identified. Surgical approach was laparoscopic and open for 7 (41%) and 10 (59%) patients, respectively. Fertility sparing surgery (FSS) was performed in 15 patients (88%): unilateral salpingo-oophorectomy (USO) in 11 patients, cystectomy with subsequent USO in 2 patients and cystectomy alone in the remaining 2. Adjuvant chemotherapy was given in 2 cases. After a median follow up time of 80 months, no recurrences were registered.
Given the available data, minimally invasive surgery is safe in stage I JGCTs. Because of the good prognosis and of the young age of patients, FSS can be chosen in most of the cases. The role of cystectomy deserves further validation. The need of adjuvant chemotherapy in stage I disease is still unclear, even if available data does not seem to support treatment over surveillance.
青少年型颗粒细胞瘤（JGCTs）极为罕见，主要发生于 I 期疾病的年轻女性和青春期前女孩。文献资料稀缺，关于最佳管理的指南仍存在争议。本研究旨在增加 MITO 组（多中心意大利卵巢癌试验）的经验。
回顾性收集 I 期 JGCTs 患者的临床病理数据。采用描述性统计方法对患者人群进行特征描述。评估临床病理特征和治疗变量与复发的关系。
共确定了 17 名患者。手术方式分别为腹腔镜和开腹，分别为 7 例（41%）和 10 例（59%）。15 名患者（88%）进行了保留生育力手术（FSS）：11 名患者行单侧输卵管卵巢切除术（USO），2 名患者行囊肿切除术加随后的 USO，其余 2 名患者仅行囊肿切除术。2 例患者接受了辅助化疗。中位随访时间 80 个月后，未发生复发。
鉴于现有数据，微创外科在 I 期 JGCTs 中是安全的。由于预后良好且患者年龄较轻，大多数情况下可选择 FSS。囊肿切除术的作用值得进一步验证。I 期疾病是否需要辅助化疗仍不清楚，尽管现有数据似乎不支持治疗优于监测。
