Less extensive surgery compared to extensive surgery: survival seems similar in young women with adult ovarian granulosa cell tumor.
OBJECTIVE
To describe the outcome of adult granulosa cell tumor (AGCT) with respect to initial clinical findings, methods of surgery, and perioperative treatment.


METHODS
Retrospective follow-up study.


METHODS
All hospitals in Jutland.


METHODS
163 women diagnosed with AGCT.


METHODS
Follow-up by hospital data files, general practitioner, death certificate, and autopsy report. Revision of histopathology by a single pathologist.


METHODS
Survival and relapse by clinical data, stage, and type of surgery.


RESULTS
The incidence of AGCT was 1.37 per year per 100,000 women (95% CI: 1.08, 1.68). The median follow-up time was 15 years and for the 79 surviving women 22 years. Stage I was found in 94% of cases. Relapse occurred in 24% of women in stage I and 100% of the other stages. Survival in stage I was 95%, 89% and 84% after 5, 10 and 20 years respectively. Increased survival of stage I in postmenopausal women was associated with surgery including hysterectomy and bilateral oophorectomy (p<0.001). In women younger than 40 years no difference in survival was found due to type of surgery. Endometrial carcinoma was found 138 times (95% CI: 48, 275) more prevalent than the expected rate.


CONCLUSIONS
The survival of women was better in AGCT than in epithelial ovarian tumor. Age and type of surgery, besides stage, influenced survival. Total abdominal hysterectomy and bilateral salpingo-oophorectomy is the recommended treatment with advancing age. At younger age less extensive surgery was associated with similar survival compared to extensive surgery, but with advancing age conservative surgery increased the risk of relapse and death.
Department of Gynecology and Obstetrics at Herning, Denmark; Department of Gynecology and Obstetrics at Holstebro, Denmark. Electronic address: finlau@rm.dk.
Finn F
FF
Lauszus
Department of Pathology, Aalborg University Hospital, Denmark.
Astrid C
AC
Petersen
Department of Gynecology and Obstetrics at Herning, Denmark.
Gudrun
G
Neumann
Department of Gynecology and Obstetrics at Holstebro, Denmark.
Line
L
Cleemann
Department of Gynecology and Obstetrics at Viborg, Denmark.
Anni
A
Rosgaard
Department of Gynecology and Obstetrics at Aalborg, Denmark.
Annemette
A
Jørgensen
Department of Gynecology and Obstetrics at Herning, Denmark; Department of Gynecology and Obstetrics at Holstebro, Denmark.
Mai
M
Vandborg
Department of Radiology, Vejle Hospital, Denmark.
Anders
A
Jakobsen
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006106:Granulosa Cell Tumor / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007044:Hysterectomy; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008593:Menopause; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000601:surgery*; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D010052:Ovariectomy; D012189:Retrospective Studies; D058994:Salpingectomy; D015996:Survival Rate; D055815:Young Adult
Endometrial carcinoma; Granulosa cell tumor; Incidence; Retrospective; Surgery; Survival