| Abstract (english) | Objective
. Adult granulosa cell tumors (AGCTs) represent 2%
–
5% of all ovarian malignancies. The aim of this study was to analyze
clinical and pathohistological parameters and their impact on recurrence, overall, and disease-free survival in FIGO stage I AGCT
patients.
Methods.
The tumor specimens analyzed in this retrospective study were obtained from a total of 36 patients with
diagnosis of ovarian AGCT surgically treated at the Department of Gynecology, Rijeka University Hospital Centre, between
1994 and 2012. Clinical, pathological, and follow-up data were collected.
Results.
The mean age at diagnosis was 54.5 years with
a range of 24
–
84. The majority of the patients, 30 (83%), were in FIGO stage IA, 3 (8%) in stage IC1, 1 (3%) in stage IC2, and 2
(6%) in stage IC3. During follow-up period (median 117.5 months, range 26
–
276), recurrence occurred in 4 patients (12%) with
2 deaths of the disease recorded. In univariate analysis, the 5-year survival rates were signi
fi
cantly shorter in patients with FIGO
substage IC (
p
=0
019
), with positive LVSI (
p
=0
022
), with presence of necrosis (
p
=0
040
), and with hemorrhage (
p
=0
017
).
In univariate analysis, the 5-year disease-free survival rates were signi
fi
cantly shorter in patients treated with fertility surgery
(
p
=0
004
), with di
ff
use growth pattern (
p
=0
012
), with moderate and severe nuclear atypia (
p
=0
032
), and with presence of
hemorrhage (
p
=0
022
). FIGO substage IC proved to be independent predictor for recurrence (OR = 16.87,
p
=0
015
, and
OR = 23.49,
p
=0
023
, resp.) and disease-free survival (
p
=0
0002
; HR 20.84,
p
=0
02
) at the uni- and multivariate analyses.
Conclusions.
FIGO substage IC is predictive of recurrence and disease-free survival in patients with early-stage AGCTs. LVSI,
presence of necrosis and hemorrhage, di
ff
use growth pattern, and nuclear atypia in AGCTs seem to be associated with overall
and disease-free survival, so these pathological features should be taken into consideration when managing patients with AGCT. |
