Granulosa cell tumor of the ovary: 10 years follow-up data of 65 patients.
BACKGROUND
Granulosa cell tumor of the ovary is an uncommon neoplasm. The majority of patients are diagnosed in early stages of disease and overall prognosis is favorable. The stage at time of diagnosis is the only prognostic factor that is unequivocally related to survival. Other prognostic factors have not been well defined and are discussed in the literature controversially.


METHODS
In a multi-institutional retrospective study we analyzed all relevant clinical data of patients with histologically proven granulosa cell tumor of the ovary. We applied the Kaplan-Meier method in order to estimate overall survival rates and evaluate prognostic factors.


RESULTS
The median follow-up was 75 months (range, 6-315 months). Overall survival was 87% and 76% after 5 and 10 years, respectively. Eighty percent of granulosa cell tumors were diagnosed stage I (FIGO). The survival rate after recurrence was 56.8% after 10 years. Mitotic rate (p=0.003), tumor stage (p<0.001) and residual tumor disease (p<0.001) were associated with a poor prognosis (p<0.001). Age and rupture of the tumor could not be confirmed to be of prognostic value.


CONCLUSIONS
The results of our study showed that the mitotic index may be a valuable prognostic factor. Complete tumor resection should always be attempted, since residual tumor disease is associated with a poor prognosis. Prospective studies are needed in order to confirm our findings.
Sehouli
Jalid
J
Department of Obstetrics and Gynecology, Charité, Berlin, Germany. sehouli@aol.com
Drescher
Frank S
FS
Mustea
Alexander
A
Elling
Dirk
D
Friedmann
Wolfgang
W
Kühn
Wolfgang
W
Nehmzow
Margit
M
Opri
Firu
F
Klare
Peter
P
Dietel
Mantred
M
Lichtenegger
Werner
W
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006106:Granulosa Cell Tumor / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D008938:Mitosis / Q000502:physiology; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D015996:Survival Rate