Clinicopathological Features and Outcomes of Granulosa Cell Tumor of the Ovaries - A Retrospective Study

by Selleckchem | Sep 22 2023

Background Granulosa cell tumor (GCT) is rare among all ovarian cancers. Its overall prognosis is favorable; however, the presence of extra-ovarian disease is associated with worse clinical outcomes. We report a retrospective analysis of granulosa cell tumors to evaluate the clinicopathological features and their outcomes. Methods This retrospective study included 54 adult patients aged 13 years and older. After data extraction and scrutiny, only those patients who were treated and followed up later at our institute were included in this study. Results Fifty-four patients were evaluated in this study, with a median age of 38.5 years. Most of the patients had dysfunctional uterine bleeding and abdominal pain (40.7%, n=22). The majority (n=26, 48%) underwent completion surgery as per ovarian protocol; however, 16.7% (n=09) patients underwent simple total abdominal hysterectomy with a bilateral salpingo-oophorectomy (TAH+BSO), debulking surgery in 3.7% (n=2), unilateral salpingo-oophorectomy in 20.4% (n=11) and fertility-sparing surgery in 11.1% (n=06) of the patients. Pathological stage I-A was found in 59.3%(n=32), I-C in 25.9% (n=14), II-A in 1.9% (n=1), III-A in 1.9% (n=1), III-C in 9.3% (n=5) and IV-B in 1.9% (n=1) of the population. Eleven (20.3%) patients relapsed during their course of treatment. Out of these 11 patients, three went into remission, two still have active disease, and six patients died. Conclusion Post-menopausal patients, more advanced disease at presentation, capsular rupture, presence of ascites, omental involvement, peritoneal spread, and residual disease after surgical resection were the main contributing factors towards poorer outcomes affecting disease-free survival. Overall median disease-free survival was 60 months for all the stage groups, while the overall survival was 62 months.

Comments:

The study you provided is a retrospective analysis of granulosa cell tumors (GCT) in 54 adult patients aged 13 years and older. The purpose of the study was to evaluate the clinicopathological features and outcomes of GCT.

Here are some key findings from the study:

1. Patient Characteristics: The median age of the patients in the study was 38.5 years. The most common symptoms reported were dysfunctional uterine bleeding and abdominal pain, observed in 40.7% of the patients.

2. Treatment: The majority of patients (48%) underwent completion surgery according to ovarian protocol. Other treatment approaches included simple total abdominal hysterectomy with bilateral salpingo-oophorectomy (16.7%), debulking surgery (3.7%), unilateral salpingo-oophorectomy (20.4%), and fertility-sparing surgery (11.1%).

3. Pathological Staging: The pathological stages observed in the study population were as follows: stage I-A (59.3%), stage I-C (25.9%), stage II-A (1.9%), stage III-A (1.9%), stage III-C (9.3%), and stage IV-B (1.9%).

4. Disease Outcomes: Among the patients, 20.3% experienced a relapse during their treatment. Out of these 11 patients, three achieved remission, two still have active disease, and six patients died. The factors associated with poorer outcomes included post-menopausal status, advanced disease at presentation, capsular rupture, presence of ascites, omental involvement, peritoneal spread, and residual disease after surgery.

5. Survival Rates: The median disease-free survival for all stage groups was 60 months, and the overall survival was 62 months.

It's important to note that these findings are based on a retrospective analysis of a limited number of patients. Further studies and larger sample sizes would be beneficial to validate and generalize these results.