Granulosa cell tumor of the ovary: A population-based study of 37 women with stage I disease

Objectives. The goal of this work was to evaluate clinical and pathological findings, surgical procedures, and postoperative treatment in women with s tage I granulosa cell tumor. Methods. Data for 49 women with granulosa cell tumor were collected retrosp ectively. All pathological sections and findings were reviewed from diagnos is until recently. Follow-up data were collected from the general practitio ner, hospital records, or death certificate. Fisher's exact test, Student's t test, Mann-Whitney test, and Kaplan-Meier survival analysis were applied , as appropriate. Results. Thirty-seven women of median age 58 years (range, 33-82) were diag nosed in stage I. Follow-up time was 8 years (range, 8 months to 26 years). The estimated survival for stage I was 93% at 5 years, 84% at 10 years, an d 62% at 20 years; the actual survival rates were 94, 82, and 62% after 5, 10, and 20 years, respectively. Primary treatment consisting of total abdom inal hysterectomy and bilateral salpingo-oophorectomy was associated with i mproved survival (P < 0.05) and tended to be associated with longer relapse -free interval (P < 0.06). The 10-year survival rate was 40% in postmenopau sal women operated conservatively and more than 90% for the extensively tre ated women (P < 0.05). Evidence of increased estrogen secretion was found m ore often in postmenopausal woman as compared with premenopausal women (P < 0.01) but did not affect survival. No pathological parameter correlated wi th prognosis. Conclusion. Granulosa cell tumor is a tumor of unquestionable malignant pot ential and has a tendency for late relapses. Longtime follow-up is recommen ded, (C) 2001 Academic Press.