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Clinicopathological characteristics and prognosis of adult ovarian granulosa cell tumor: a single-institution experience in China

Authors Wang D, Xiang Y, Wu M, Shen K, Yang J, Huang H, Ren T

Received 29 October 2017

Accepted for publication 25 January 2018

Published 7 March 2018 Volume 2018:11 Pages 1315—1322

DOI https://doi.org/10.2147/OTT.S155473

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Justinn Cochran

Peer reviewer comments 2

Editor who approved publication: Dr Carlos E Vigil


Dan Wang, Yang Xiang, Ming Wu, Keng Shen, Jiaxin Yang, Huifang Huang, Tong Ren

Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People’s Republic of China

Objectives:
We aimed to demonstrate the clinical characteristics and risk factors associated with recurrence of adult granulosa cell tumor (AGCT), as well as the pregnancy and long-term outcomes among patients in a single institution in China.
Patients and methods: We reviewed 141 patients with AGCT in Peking Union Medical College Hospital between January 1983 and September 2015.
Results:
The mean patient age was 45.1 years (16–78 years), and the mean tumor size was 8.8 cm (1–40 cm). The most common symptom was irregular menstruation (31.9%, n=45). The disease distribution was stage I in 136 patients, stage II in three patients, and stage III in two patients. Eighty-seven patients (61.7%) underwent radical surgery, while 54 (38.3%) underwent fertility-sparing surgery, of whom five subsequently had a total of five pregnancies. Fifty-two patients underwent pelvic and/or para-aortic lymphadenectomy, and none of them showed lymph node metastasis. The median follow-up period was 72.7 months (8.9–344 months). Twenty-six patients (18.4%) developed recurrence during the study period, with a median time to recurrence of 68 months (7–312 months). Initial stage (stage IC vs IA) and nonstaging surgery were independent risk factors for recurrence in both univariate and multivariate analyses for stage I AGCT patients.
Conclusion: Tumor stage is an independent risk factor for recurrence in patients with AGCT. Staging surgery is recommended for patients with AGCT, though lymphadenectomy may be omitted. Complete tumor resection is important for patient survival in patients with AGCT recurrence. Long-term follow-up is required, even in early-stage AGCT patients.

Keywords: granulosa cell tumor, ovary, recurrence, pregnancy

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