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dc.contributor.authorNosov, Vladimir
dc.contributor.authorSilva, Ivaldo [UNIFESP]
dc.contributor.authorTavassoli, Fattaneh
dc.contributor.authorAdamyan, Leiva
dc.contributor.authorFarias-Eisner, Robin
dc.contributor.authorSchwartz, Peter E.
dc.identifier.citationInternational Journal of Gynecological Cancer. Philadelphia: Lippincott Williams & Wilkins, v. 19, n. 4, p. 628-633, 2009.
dc.description.abstractObjective: 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.en
dc.publisherLippincott Williams & Wilkins
dc.relation.ispartofInternational Journal of Gynecological Cancer
dc.rightsAcesso aberto
dc.subjectGranulosa cellen
dc.titlePredictors of Recurrence of Ovarian Granulosa Cell Tumorsen
dc.contributor.institutionUniv Calif Los Angeles
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionYale New Haven Med Ctr
dc.contributor.institutionKulakov Sci Ctr Obstet Gynecol & Perinatol
dc.description.affiliationUniv Calif Los Angeles, David Geffen Sch Med, Dept Obstet & Gynecol, Los Angeles, CA 90046 USA
dc.description.affiliationUniversidade Federal de São Paulo, Dept Gynecol, São Paulo, Brazil
dc.description.affiliationYale New Haven Med Ctr, Dept Pathol, New Haven, CT USA
dc.description.affiliationKulakov Sci Ctr Obstet Gynecol & Perinatol, Dept Operat Gynecol, Moscow, Russia
dc.description.affiliationYale New Haven Med Ctr, Dept Obstet Gynecol & Reprod Sci, New Haven, CT USA
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Dept Gynecol, São Paulo, Brazil
dc.description.sourceWeb of Science

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