Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Roma, Italy.
Department of Advanced Biomedical Sciences, Pathology Section, School of Medicine, University of Naples "Federico II", Via Sergio Pansini, 5, 80131, Naples, Italy.
Arch Gynecol Obstet. 2022 Aug;306(2):315-321. doi: 10.1007/s00404-021-06305-2. Epub 2021 Nov 19.
Ovarian adult granulosa cell tumours are low-grade malignant sex cord-stromal neoplasm with a low recurrence rate. Prognostic factors for recurrence include tumor stage, tumor rupture in Stage I neoplasms and the presence of residual tumors after surgery. However, in recurrent tumors, prognostic factors for overall survival (OS) are lacking. In the present paper, we conducted a systematic meta-analysis with the aim to assess prognostic factors for OS in patients with recurrent GCT.
Electronic databases were searched for all studies assessing prognostic factors in recurrent adult granulosa cell tumor of the ovary. Student T test, Fisher's exact test and Kaplan-Meier survival analysis with long-rank test were used to assess differences among groups; a p value < 0.05 was considered significant.
Eleven studies analyzing 102 recurrent tumors were included in the systematic review. Tumor stage and localization of recurrent tumors were significantly associated with OS on Kaplan-Meier analysis; Cox regression analysis showed a HR of 0.879 for the stage II, of 3.052 for the stage III, and of 2.734 for stage IV tumor was significantly associated with OS (p = 0.037); observed HRs for abdominal and thoracic locations were of 2.405 and of 4.024, respectively.
In conclusion, the present article emphasizes the prognostic significance of tumor stage > II and extrapelvic anatomic sites of recurrences in patients with recurrent granuolase cell tumors of the ovary.
卵巢成人颗粒细胞瘤是低度恶性性索间质肿瘤，复发率低。复发的预后因素包括肿瘤分期、I 期肿瘤破裂和手术后残留肿瘤。然而，在复发性肿瘤中，缺乏总生存（OS）的预后因素。在本研究中，我们进行了一项系统的荟萃分析，旨在评估复发性 GCT 患者 OS 的预后因素。
检索所有评估卵巢成人颗粒细胞瘤复发性肿瘤预后因素的研究。使用学生 T 检验、Fisher 确切检验和 Kaplan-Meier 生存分析结合 Long-rank 检验评估组间差异；p 值<0.05 认为有统计学意义。
11 项研究分析了 102 例复发性肿瘤，纳入了系统综述。肿瘤分期和复发性肿瘤的定位与 Kaplan-Meier 分析的 OS 显著相关；Cox 回归分析显示 II 期肿瘤的 HR 为 0.879，III 期肿瘤的 HR 为 3.052，IV 期肿瘤的 HR 为 2.734，与 OS 显著相关（p=0.037）；腹部和胸部的观察 HR 分别为 2.405 和 4.024。
总之，本研究强调了肿瘤分期>II 期和复发性颗粒细胞瘤患者的盆腔外解剖部位对预后的重要性。
