title: Histopathological prognostic factors of adult granulosa cell tumors of the ovary.
abstract: BACKGROUND
  The prognostic factors of adult granulosa cell tumor (AGCT) have not been well defined.
  
  
  METHODS
  In 27 AGCT patients, we examined clinical stage, microscopic patterns, mitotic index (MI), and lymph-vascular space invasion (LVSI) to determine whether these factors were related to disease-free survival (DFS) of patients with AGCT. We also performed immunohistochemical examination for p53.
  
  
  RESULTS
  Seventeen cases represented stage I tumors, four stage II, five stage III, and one stage IV. Patients with stage I disease had more favorable prognosis than those with stage II to IV disease (p=0.034). There was no relation between the microscopic patterns and the DFS. The MI, which was categorized into < or =3/10 high power field (HPF) and > or =4/10 HPF, was significantly related to patients DFS (p<0.0005). The DFS time for patients with moderate or prominent LVSI was significantly shorter than that for patients with no or minimal LVSI (p<0.0001). By multivariate analysis, MI and LVSI were shown to be independent prognostic factors. Five of seven patients with recurrent tumor had extrapelvic spread; two in the abdominal cavity and three in the liver.
  
  
  CONCLUSIONS
  The results of this study suggest that prognosis for patients with AGCT depends on the MI and LVSI. During the follow-up period of patients, they need to be examined for distant metastasis including liver.
authors.affiliation: Department of Obstetrics and Gynecology, Hokkaido University Hospital, Sapporo 060-8638, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Fujimoto
authors.forename: N
authors.initials: N
authors.lastname: Sakuragi
authors.forename: K
authors.initials: K
authors.lastname: Okuyama
authors.forename: T
authors.initials: T
authors.lastname: Fujino
authors.forename: K
authors.initials: K
authors.lastname: Yamashita
authors.forename: S
authors.initials: S
authors.lastname: Yamashiro
authors.forename: M
authors.initials: M
authors.lastname: Shimizu
authors.forename: S
authors.initials: S
authors.lastname: Fujimoto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006106:Granulosa Cell Tumor / Q000473:pathology* / Q000628:therapy; D006651:Histocytochemistry; D006801:Humans; D008875:Middle Aged; D008940:Mitotic Index; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000628:therapy; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016159:Tumor Suppressor Protein p53 / Q000032:analysis
chemical_list: D016159:Tumor Suppressor Protein p53