Predictors of Recurrence of Ovarian Granulosa Cell Tumors

Predictors of Recurrence of Ovarian Granulosa Cell Tumors

Author Nosov, Vladimir Google Scholar
Silva, Ivaldo Autor UNIFESP Google Scholar
Tavassoli, Fattaneh Google Scholar
Adamyan, Leiva Google Scholar
Farias-Eisner, Robin Google Scholar
Schwartz, Peter E. Google Scholar
Institution Univ Calif Los Angeles
Universidade Federal de São Paulo (UNIFESP)
Yale New Haven Med Ctr
Kulakov Sci Ctr Obstet Gynecol & Perinatol
Abstract Objective: the prognosis of granulosa cell tumors (GCTs) is overall favorable, but a proportion of patients will experience recurrence. We report one of the largest series of patients with GCT for whom clinical, morphologic, and immunohistochemical markers have been assessed for their roles as predictors of recurrence.Methods: Patients with the diagnosis of GCT were identified at 2 hospitals from 1974 to 2004; a detailed chart analysis was performed. Tissue blocks were analyzed immunohistochemically for mitotic index, luteinization, inhibin staining, epidermal growth factor receptor, and Ki67 expression. Univariate and multivariate analyses were performed.Results: Sixty-seven patients were identified. Follow-up data up to 30 years were available. the mean age at diagnosis was 48.1 years. Twenty-five patients experienced recurrence. A statistically significant correlation (P < 0.05) was observed for age at diagnosis, with earlier age being an adverse factor (43.6 vs 50.9, P < 0.01), and use of adjuvant chemotherapy postoperatively (24% vs 40% in the nonrecurrence group). Luteinization and the immunohistochemical markers, such as inhibin, Ki67, and epidermal growth factor receptor, seemed to significantly increase the risk of recurrence if expressed. A multivariate analysis model confirmed that younger age at diagnosis and higher expression of inhibin and Ki67 are significant risk factors of GCT recurrence.Conclusions: Identification of patients who are at a high risk for recurrence of GCT is critical. Routine treatment for all patients with cytotoxic chemotherapy is not justified. We report a set of predictors of recurrence for GCT that identified subsets of patients who may benefit from prolonged surveillance and/or adjuvant systemic chemotherapy.
Keywords Granulosa cell
Language English
Date 2009-05-01
Published in International Journal of Gynecological Cancer. Philadelphia: Lippincott Williams & Wilkins, v. 19, n. 4, p. 628-633, 2009.
ISSN 1048-891X (Sherpa/Romeo, impact factor)
Publisher Lippincott Williams & Wilkins
Extent 628-633
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000266976800022

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