title: Role of adjuvant radiotherapy in granulosa cell tumors of the ovary.
abstract: OBJECTIVE
  To review the role of adjuvant radiotherapy (RT) in the outcome and recurrence patterns of granulosa cell tumors (GCTs) of the ovary.
  
  
  METHODS
  The records of all patients with GCTs referred to the Princess Margaret Hospital University Health Network between 1961 and 2006 were retrospectively reviewed. The patient, tumor, and treatment factors were assessed by univariate and multivariate analyses using disease-free survival (DFS) as the endpoint.
  
  
  RESULTS
  A total of 103 patients with histologically confirmed GCTs were included in the present study. The mean duration of follow-up was 100 months (range, 1-399). Of the 103 patients, 31 received adjuvant RT. A total of 39 patients developed tumor recurrence. The tumor size, incidence of intraoperative rupture, and presence of concurrent endometrial cancer were not significant risk factors for DFS. The median DFS was 251 months for patients who underwent adjuvant RT compared with 112 months for patients who did not (p=.02). On multivariate analysis, adjuvant RT remained a significant prognostic factor for DFS (p=.004). Of the 103 patients, 12 had died and 44 were lost to follow-up.
  
  
  CONCLUSIONS
  Ovarian GCTs can be indolent, with patients achieving long-term survival. In our series, adjuvant RT resulted in a significantly longer DFS. Ideally, randomized trials with long-term follow-up are needed to define the role of adjuvant RT for ovarian GCTs.
authors.affiliation: Juravinski Cancer Centre, Department of Gynecologic Oncology, Hamilton Health Sciences Centre and McMaster University, Hamilton, ON, Canada.
authors.forename: Jan
authors.initials: J
authors.lastname: Hauspy
authors.forename: Mario E
authors.initials: ME
authors.lastname: Beiner
authors.forename: Ian
authors.initials: I
authors.lastname: Harley
authors.forename: Barry
authors.initials: B
authors.lastname: Rosen
authors.forename: Joan
authors.initials: J
authors.lastname: Murphy
authors.forename: William
authors.initials: W
authors.lastname: Chapman
authors.forename: Lisa W
authors.initials: LW
authors.lastname: Le
authors.forename: Anthony
authors.initials: A
authors.lastname: Fyles
authors.forename: Wilfred
authors.initials: W
authors.lastname: Levin
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000401:mortality / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006106:Granulosa Cell Tumor / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D047368:Tumor Burden; D055815:Young Adult