Prognostic factors in adult granulosa cell tumor of the ovary

OBJECTIVE: To determine the clinicopathologic prognostic factors in adult granulosa cell tumors (GCTs) of the ovary.

METHODS: This retrospective study was carried out over a period of 10 years (1995-2005) in the Gynecology Department of Shengjing Hospital, China Medical University, Shenyang, China. Forty-six patients with GCT were enrolled in this study. Demographic data, pathologic findings, treatments, and survival time were reviewed and analyzed for prognostic significance.

RESULTS: It was found that International Federation of Gynecology and Obstetrics (FIGO) stage (p=0.0003), presence of nuclear atypia (p=0.036), and increased mitoses (p=0.002) were the 3 factors that impacted significantly on survival. Age, residual tumor disease, parity, and size of the tumor had no significant effect on survival. The only factor associated with risk of recurrence was rupture of the tumor (p=0.038). Patients who received chemotherapy had a better median disease-free survival than those who did not (105 versus 78 months), however, this did not reach statistical significance (p=0.080).

CONCLUSION: The FIGO stage, nuclear atypia, and increased mitoses are the statistically significant prognostic factors, and may be used for selecting patients for adjuvant therapy. A prolonged follow-up is necessary due to risk of recurrences, late, and exceptional for the adult ovarian GCT, especially when the tumor ruptured before, or at operation.