title: Clinical presentation and outcome of adult-type granulosa cell tumors: a retrospective study of 30 patients in a single institute.
abstract: BACKGROUND
  Ovarian adult-type granulosa cell tumors (GCTs) are characterized as low-malignant and late-recurrent ovarian tumors. Although some clinical and pathological prognostic factors have been reported, other factors have yet to be sufficiently investigated for necessary confirmation. The aim of this study was to test the correlation between clinical factors and outcome, based on patients seen in a single institute.
  
  
  METHODS
  Thirty patients with pathologically confirmed adult-type GCTs between 1984 and 2010 were reviewed retrospectively. Among them, eight (26.7%) had recurrence, which subsequently contributed to two mortalities.
  
  
  RESULTS
  In a comparison of the clinical characteristics of the premenopausal and postmenopausal women with GCT, all of the postmenopausal women had symptoms (100% vs. 63.6%, p = 0.01). With regard to disease recurrence, only abnormal preoperative serum cancer antigen 125 level (≥ 35 U/mL) was significant (50% vs. 11%, p = 0.03), and residual tumor showed a borderline trend (100% vs. 21.4%, p = 0.06). Other factors, including International Federation of Gynecology and Obstetrics stage, tumor size, tumor rupture prior to or during operation, body mass index, parity, serum estrogen level, and adjuvant therapy, were not statistically significant.
  
  
  CONCLUSIONS
  Physicians should be alert to the difference in the symptom presentation of GCTs between pre- and postmenopausal women, giving particular attention to the usefulness of the preoperative serum level of cancer antigen 125 in patients with GCTs. More evidence is needed to confirm this observation.
authors.affiliation: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Obstetrics and Gynecology, National Yang-Ming University Hospital, Ilan, Taiwan, ROC; Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan, ROC; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
authors.forename: Ben-Shian
authors.initials: BS
authors.lastname: Huang
authors.affiliation: Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Ban Ciao, New Taipei City, Taiwan, ROC.
authors.forename: Hsu-Dong
authors.initials: HD
authors.lastname: Sun
authors.affiliation: Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors.forename: Yen-Mei
authors.initials: YM
authors.lastname: Hsu
authors.affiliation: Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Nursing, National Yang-Ming University, Taipei, Taiwan, ROC.
authors.forename: Wen-Hsun
authors.initials: WH
authors.lastname: Chang
authors.affiliation: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan, ROC.
authors.forename: Huann-Cheng
authors.initials: HC
authors.lastname: Horng
authors.affiliation: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan, ROC.
authors.forename: Ming-Shyen
authors.initials: MS
authors.lastname: Yen
authors.affiliation: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan, ROC.
authors.forename: Kuan-Chong
authors.initials: KC
authors.lastname: Chao
authors.affiliation: Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; Immunology Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Infection and Immunity Research Center, National Yang-Ming University, Taipei, Taiwan, ROC; Genomics Research Center, Academia Sinica, Taipei, Taiwan, ROC.
authors.forename: Shie-Liang
authors.initials: SL
authors.lastname: Edmond Hsieh
authors.affiliation: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Obstetrics and Gynecology, National Yang-Ming University Hospital, Ilan, Taiwan, ROC; Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan, ROC; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; Immunology Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Infection and Immunity Research Center, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, ROC. Electronic address: phwang@vghtpe.gov.tw.
authors.forename: Peng-Hui
authors.initials: PH
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D018394:CA-125 Antigen / Q000097:blood; D005260:Female; D006106:Granulosa Cell Tumor / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D008565:Membrane Proteins / Q000097:blood; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000503:physiopathology*; D017698:Postmenopause; D017697:Premenopause; D012189:Retrospective Studies
chemical_list: D018394:CA-125 Antigen; C451759:MUC16 protein, human; D008565:Membrane Proteins
keywords: adult-type granulosa cell tumor; cancer antigen 125; ovary; recurrence