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Authors Wang D, Xiang Y, Wu M, Shen K, Yang J, Huang H, Ren T
Received 29 October 2017
Accepted for publication 25 January 2018
Published 7 March 2018 Volume 2018:11 Pages 1315—1322
DOI https://doi.org/10.2147/OTT.S155473
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Justinn Cochran
Peer reviewer comments 2
Editor who approved publication: Dr Carlos Vigil Gonzales
Objectives: We aimed to demonstrate the clinical characteristics and risk factors
associated with recurrence of adult granulosa cell tumor (AGCT), as well as the
pregnancy and long-term outcomes among patients in a single institution in
China.
Patients and methods: We reviewed 141 patients with AGCT in Peking
Union Medical College Hospital between January 1983 and September 2015.
Results: The
mean patient age was 45.1 years (16–78 years), and the mean tumor size was 8.8
cm (1–40 cm). The most common symptom was irregular menstruation (31.9%, n=45). The
disease distribution was stage I in 136 patients, stage II in three patients,
and stage III in two patients. Eighty-seven patients (61.7%) underwent radical
surgery, while 54 (38.3%) underwent fertility-sparing surgery, of whom five
subsequently had a total of five pregnancies. Fifty-two patients underwent
pelvic and/or para-aortic lymphadenectomy, and none of them showed lymph node
metastasis. The median follow-up period was 72.7 months (8.9–344 months).
Twenty-six patients (18.4%) developed recurrence during the study period, with
a median time to recurrence of 68 months (7–312 months). Initial stage (stage
IC vs IA) and nonstaging surgery were independent risk factors for recurrence
in both univariate and multivariate analyses for stage I AGCT patients.
Conclusion: Tumor stage is an independent risk factor for
recurrence in patients with AGCT. Staging surgery is recommended for patients
with AGCT, though lymphadenectomy may be omitted. Complete tumor resection is
important for patient survival in patients with AGCT recurrence. Long-term
follow-up is required, even in early-stage AGCT patients.
Keywords: granulosa cell
tumor, ovary, recurrence, pregnancy