Prognostic factors responsible for survival in sex cord stromal tumors of the ovary--an analysis of 376 women.
OBJECTIVE
To evaluate prognostic factors that impact on the survival of women with ovarian sex cord stromal tumors (SCST).


METHODS
Data including age at diagnosis, stage, histology, grade, treatment, and survival were extracted from the 1988-2001 Surveillance, Epidemiology, and End Results Program. Kaplan-Meier and Cox proportional hazards analyses were used to determine the predictors for survival.


RESULTS
376 women (median age: 51) with ovarian sex cord stromal cell tumors were identified, including 339 with granulosa cell and 37 with Sertoli-Leydig cell tumors. 265 (71%) patients had stage I, 39 (10%) stage II, 40 (11%) stage III, and 32 (8%) had stage IV disease. Women with stage I-II disease had a 5-year disease-specific survival of 95% compared to 59% in those with stage III-IV cancers (p<0.001). Patients<or=50 years had a survival advantage over those>50 years (93% vs. 84%, p<0.001). This age-associated survival advantage was observed for early (97% vs. 92%, p=0.003), but not for advanced-staged (68% vs. 53%, p=0.09) patients. 110 patients with stage I-II disease underwent conservative surgery without hysterectomy. The survival for this group was similar to patients who underwent a standard surgery including a hysterectomy (94.8% and 94.9%, p=0.38). On multivariate analysis, age<or=50 (p=0.001) and early-stage disease (p<0.001) remained significant prognostic factor for improved survival.


CONCLUSIONS
Younger age and early-stage disease are important predictors for improved survival in patients with ovarian sex cord stromal tumors. Conservative surgical treatment for early-staged patients wishing to retain fertility appears to be a safe alternative.
Zhang
Mallory
M
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford Cancer Center, 875 Blake Wilbur Drive, MC 5827, Stanford, CA 94305, USA.
Cheung
Michael K
MK
Shin
Jacob Y
JY
Kapp
Daniel S
DS
Husain
Amreen
A
Teng
Nelson N
NN
Berek
Jonathan S
JS
Osann
Kathryn
K
Chan
John K
JK
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D018312:Sex Cord-Gonadal Stromal Tumors / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome