title: Prognostic Factors in Adult Granulosa Cell Tumor: A Long Follow-Up at a Single Center.
abstract: OBJECTIVE
  In this study, we aimed to demonstrate characteristics, recurrence rates, survival numbers, and factors associated with survival of patients with adult granulosa cell tumor (AGCT) from a single institution. Our secondary goal was to evaluate the necessity of staging surgery and the importance of a comprehensive lymphadenectomy in these patients.
  
  
  METHODS
  The data of 158 patients in our institution who were diagnosed with AGCT between 1988 and 2013 were evaluated. The data were obtained from the files of the patients, electronic database of the gynecologic oncology clinic, operation notes, and pathology records.
  
  
  RESULTS
  The median (range) age of the patients was 50.3 (22-82) years. The main symptom was postmenopausal bleeding (25.9%). Seventy-six percent of the patients underwent staging surgery including lymphadenectomy. Among these patients, 3 (2.5%) had lymph node metastasis. The median (range) follow-up time was 97 (1-296) months. In the follow-up period, 18 patients (12.5%) had recurrence. Menopausal status (P = 0.016), advanced age (P = 0.024), cyst rupture (P = 0.001), poorly differentiated tumor (P = 0.002), and advanced stage (P < 0.001) were associated with recurrence. Stage was the only independent prognostic factor for the development of recurrence. None of the patients had lymph node failure.
  
  
  CONCLUSIONS
  In the present study with a long follow-up period and in which most of the patients had staging surgery including lymphadenectomy (76.6%), lymph node recurrence was not observed and the total recurrence rate (12.5%) was lower than that reported in the literature. The study showed the importance of surgical staging in patients with AGCT.
authors.affiliation: Gynecologic Oncology Division, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Karalok
authors.forename: Taner
authors.initials: T
authors.lastname: Turan
authors.forename: Isin
authors.initials: I
authors.lastname: Ureyen
authors.forename: Tolga
authors.initials: T
authors.lastname: Tasci
authors.forename: Derman
authors.initials: D
authors.lastname: Basaran
authors.forename: Sevgi
authors.initials: S
authors.lastname: Koc
authors.forename: Nurettin
authors.initials: N
authors.lastname: Boran
authors.forename: M Faruk
authors.initials: MF
authors.lastname: Kose
authors.forename: Gokhan
authors.initials: G
authors.lastname: Tulunay
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006106:Granulosa Cell Tumor / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000628:therapy; D011379:Prognosis; D015996:Survival Rate; D055815:Young Adult