title: [Long-term outcome analysis in the treatment of granulosa cell tumors].
abstract: BACKGROUND
  Granulosa cell tumors of the ovary (GCT) are derived from the sex cords and the ovarian stroma. Their natural history however is indolent with a very favorable long-term prognosis. Their extreme rarity represents a limitation in our understanding of their natural history management, and prognosis.
  
  
  METHODS
  Retrospective analysis of patient documentation treated for GCT between 1988-2008 at the Maria Skłodowska-Curie Memorial Cancer Centre, Warsaw, was performed. Clinical and pathological features of the study group, as well as methods and results of the treatment were analyzed.
  
  
  RESULTS
  Medical documentation of 148 patients was analyzed. The majority of patients was classified as FIGO stage 1 (87.5%). Surgery was performed as primary treatment in all cases. Forty eight patients (32,6%) were held for observation stays, whereas 57.1% were qualified to receive adjuvant treatment: chemo- or radiotherapy. Mean progression free survival was 133.5 months (11.1 years) and was significantly longer in patients treated with the chemotherapy regimen when compared to radiotherapy (148 vs. 91 months respectively; p = 0.028). Overall survival was 173,7 months and was significantly longer in patients treated with adjuvant chemotherapy vs. RTH (165 vs. 121 months; p = 0.068). Recurrence of the disease was associated with poorer prognosis.
  
  
  CONCLUSIONS
  GCTs are potentially curable neoplasms of the ovary with low treatment failure rates. Quick diagnosis and appropriate treatment in centers experienced in ovarian cancer surgery are the necessary conditions to obtain good results. The stage of the disease remains the most important prognostic factor chemotherapy with the use of bleomycine etoposide and cisplatin should be considered in patients who require adjuvant treatment.
authors.affiliation: Katedra i Klinika Połoznictwa, Chorób Kobiecych i Ginekologii Onkologicznej II WL WUM, Warszawa, Polska. kuba.rzepka@gmail.com
authors.forename: Jakub
authors.initials: J
authors.lastname: Rzepka
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Kuc-Rajca
authors.forename: Kamil
authors.initials: K
authors.lastname: Zalewski
authors.forename: Anna
authors.initials: A
authors.lastname: Dańska-Bidzińska
authors.forename: Mariusz
authors.initials: M
authors.lastname: Bidziński
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D005260:Female; D006106:Granulosa Cell Tumor / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy*; D013509:Gynecologic Surgical Procedures / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy*; D011044:Poland / Q000453:epidemiology; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D016387:Women's Health; D055815:Young Adult