PROGNOSTIC FACTORS IN ADULT GRANULOSA-CELL TUMOR OF THE OVARY

BACKGROUND. The clinical course of adult granulosa cell tumor of the o vary is characterized by indolent growth tending toward late recurrenc e. A variety of clinical and pathologic parameters have previously bee n evaluated for prognostication with inconclusive results. METHODS. Th e clinical records and tumor sections of 70 patients with adult granul osa cell tumors of the ovary were reviewed. Patients with recurrent tu mors (REC) (n = 19) were compared with patients who remained without d isease (NED) (n = 51). RESULTS. Significant differences in stage and t umor size were noted between the two groups; however, after logistic r egression analysis, only stage remained statistically significant. Pat hologic evaluation revealed that Call-Exner bodies occurred more frequ ently in tumors of the NED patients. Cellular atypia and high mitotic rates were more frequent in the REC group; however, after logistic reg ression analysis, only atypia remained statistically significant. When early (<10 years) and late recurring tumors (>10 years) were compared , statistically significant differences were again noted: early recurr ing tumors had fewer Call-Exner bodies, higher mitotic rates, and high er degrees of atypia; late recurring tumors were similar to tumors in the NED patients. CONCLUSIONS. Tumor stage and, to a lesser extent, tu mor size are the only clinical parameters of prognostic importance in adult granulosa cell tumors. Cellular atypia and, to lesser extents, m itotic rate and the absence of Call-Exner bodies are the only signific ant pathologic prognosticators. It is difficult to predict early recur rences and impossible to predict late recurrences using these clinical and pathologic parameters. (C) 1997 American Cancer Society.