| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 3945249 | Gynecologic Oncology | 2012 | 7 Pages |
ObjectiveTo analyze the role of surgical staging and adjuvant chemotherapy in patients with adult type granulosa cell tumor (GCT) of the ovary.MethodsPatients were divided into those with early-stage (stages I–II, n = 93) and advanced-stage (stages III–IV, n = 13) GCT and analyzed separately in this retrospective study.ResultsOf the 93 patients with early-stage GCT, 30 were completely staged and 25 underwent lymph node dissection. After surgery, 17 patients received adjuvant chemotherapy with bleomycin/etoposide/cisplatin (BEP). None had lymph node metastasis. Completely staged patients had no recurrence or deaths. However, recurrences were observed in 9 of 63 patients (14.3%) who did not undergo complete staging, with four (6.3%) dying due to disease. The 5-year disease-free survival (DFS) rates of groups with and without complete staging were 100% and 84%, respectively (P = 0.037). Adjuvant chemotherapy was not significantly associated with DFS (P = 0.193). All patients with advanced-stage GCT underwent optimal cytoreduction and received adjuvant chemotherapy with BEP. None of the 6 patients who completed 6 cycles of BEP had recurrence, whereas 5 of the 7 patients (71.4%) who received fewer than 6 cycles of BEP had recurrences and 3 (42.9%) died due to disease. The 5-year DFS rates of these two groups were 100% and 50%, respectively (P = 0.022), with cycles of chemotherapy being the only significant factor for DFS in patients with advanced-stage GCT.ConclusionsComplete surgical staging is recommended, but lymph node removal is not recommended for early-stage GCT. Optimal debulking followed by six cycles of BEP chemotherapy is recommended for advanced-stage GCT.
► Complete surgical staging is recommended for patients with early-stage granulosa cell tumor (GCT). ► Lymph node dissection is not recommended due to the rarity of lymph node metastasis. ► At least six cycles of adjuvant BEP chemotherapy is recommended for patients with advanced-stage GCT.
