Department of Obstetrics and Gynaecology, Freiburg Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Department of Gynaecology and Gynaecological Oncology, Ev. Kliniken Essen-Mitte, Essen, Germany.
J Surg Oncol. 2023 Jul;128(1):111-118. doi: 10.1002/jso.27248. Epub 2023 Mar 28.
Malignant sex cord-stromal cell tumours (SCST) account for only 7% of ovarian malignancies. The Arbeitsgemeinschaft fuer Gynaekologische Onkologie (AGO) study group has established a clinicopathological database to provide an overview of the current treatment strategies and survival of SCST patients and to identify research needs.
Twenty centres provided mixed retro- and prospective data of patients with tumour specimens and second-opinion pathology review treated between 2000 and 2014. Descriptive analyses of treatment strategies, Kaplan-Meier curves and cox regression analyses were conducted.
Two hundred and sixty-two SCST patients were included. One hundred and ninety-one Granulosa-cell tumour (GCT) and 17 Sertoli-Leydig cell tumour (SLCT) patients were stage I disease (>80%). Forty four GCT (18.7%) and two (8.3%) SLCT patients received adjuvant systemic treatment. After a median observation time of 78.2 months, 46% of all SCST patients experienced disease recurrence, treated predominantly with secondary debulking surgery (> 90%). Advanced FIGO stage, lymph node involvement and intra-operative capsule rupture were associated with disease recurrence on univariate analysis (all p < 0.05). Median OS time was not reached.
In this analysis of SCST patients, adjuvant chemotherapy was unable to prevent disease recurrence. Despite high recurrence rates, overall survival rates were excellent.
恶性性索-间质细胞肿瘤（SCST）仅占卵巢恶性肿瘤的 7%。德国妇科肿瘤协会（AGO）研究组建立了一个临床病理数据库，以提供 SCST 患者当前治疗策略和生存情况的概述，并确定研究需求。
20 个中心提供了 2000 年至 2014 年间接受肿瘤标本治疗且进行了二次病理复查的混合回顾性和前瞻性数据。对治疗策略进行描述性分析，绘制 Kaplan-Meier 曲线和 cox 回归分析。
共纳入 262 例 SCST 患者。191 例颗粒细胞瘤（GCT）和 17 例支持-间质细胞瘤（SLCT）患者为 I 期疾病（>80%）。44 例 GCT（18.7%）和 2 例 SLCT 患者（8.3%）接受了辅助全身治疗。在中位观察时间为 78.2 个月后，所有 SCST 患者中有 46%出现疾病复发，主要采用二次减瘤手术治疗（>90%）。FIGO 分期较晚、淋巴结受累和术中囊破裂与单因素分析中的疾病复发相关（均 p<0.05）。中位总生存时间尚未达到。
在这项 SCST 患者的分析中，辅助化疗未能预防疾病复发。尽管复发率较高，但总体生存率仍非常高。
