Long-term follow-up is crucial after treatment for granulosa cell tumours of the ovary

• Published in: British journal of cancer 2013-07, Vol.109 (1), p.29-34
• Main Authors: Mangili, G, Ottolina, J, Gadducci, A, Giorda, G, Breda, E, Savarese, A, Candiani, M, Frigerio, L, Scarfone, G, Pignata, S, Rossi, R, Marinaccio, M, Lorusso, D
• Format: Article
• Language: English
• Subjects: 692/699/67/1059; 692/699/67/1517/1709; 692/700/1750; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Biomarkers, Tumor; Biomedical and Life Sciences; Biomedicine; Biopsy; Cancer Research; Clinical Study; Drug Resistance; Epidemiology; Female; Fertility; Follow-Up Studies; Granulosa Cell Tumor - mortality; Granulosa Cell Tumor - surgery; Granulosa Cells - pathology; Hospitals; Humans; Hysterectomy; Medical prognosis; Medical sciences; Middle Aged; Molecular Medicine; Neoplasm Recurrence, Local; Oncology; Oophorectomy; Ovarian cancer; Ovarian Neoplasms - mortality; Ovarian Neoplasms - surgery; Ovary - pathology; Prognosis; Retrospective Studies; Surgery; Surgical outcomes; Survival analysis; Survival Rate; Treatment Outcome; Tumors; Womens health
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/bjc.2013.241

Objective: The aim of this study is to evaluate the long-term outcome of granulosa cell tumour (GCT) of the ovary in a large series of patients treated in MITO centres (Multicentre Italian Trials in Ovarian Cancer) and to define prognostic parameters for relapse and survival. Methods: A retrospective multi-institutional review of patients with GCTs of the ovary treated or referred to MITO centres was conducted. Surgical outcome, intraoperative and pathological findings and follow-up data were analysed. Kaplan–Meier and Cox proportional hazards analyses were used to determine the predictors for survival and recurrence. Results: A total of 97 patients with primary GCT of the ovary were identified. The median follow-up period was 88 months (range 6–498). Of these, 33 patients had at least one episode of disease recurrence, with a median time to recurrence of 53 months (range 9–332). Also, 47% of recurrences occurred after 5 years from initial diagnosis. At multivariate analysis, age and stage were independent poor prognostic indicators for survival; surgical treatment outside MITO centres and incomplete surgical staging retained significant predictive value for recurrence in both univariate and multivariate analyses. Conclusions: This study confirms the generally favourable prognosis of GCTs of the ovary, with 5-year overall survival approaching 97%. Nevertheless, prognosis after 20 years was significantly poorer, with 20-year survival rate of 66.8% and a global mortality of 30–35. These findings support the need for lifelong follow-up even in early-stage GCT.