Granulosa cell tumors Archives - Revista Brasileira de Ginecologia e Obstetrícia

OBJECTIVE: to evaluate staging, surgical procedures and outcome of ovarian granulosa cell tumors (GCT), with emphasis in the possibility of conservative surgery (unilateral ooforectomy). METHODS: this is a retrospective cohort study in which 24 patients treated with GCT during the period of January 1994 to January 2004 were included. Variables of interest such as patient's age, symptoms, tumor size on physical examination, staging, treatment modalities (types of surgery and of adjuvant chemotherapy and/or radiotherapy) and prognosis have been analyzed. The chi-square test was used to check the association between variables, and the level of significance was set at p < 0.05, always describing the two-tailed Fisher exact test. RESULTS: the patients' age varied from 30 to 82 (mean 51.7) years old. The most frequently referred symptom was pelvic pain (n = 10; 41.7%). Fourteen patients (58.3%) presented clinical stage (CS) Ic, 5 (20.8%) CS IIIc and 5 (20.8%) CS Ia. More advanced clinical stages were significantly associated with palpable pelvic masses (p < 0.04). Endometrial hyperplasias were found in 3 (25%) of the 12 hysterectomy specimens. The follow-up period varied from 2 to 114 (mean 42.5) months. Among the 16 (66.7%) surviving and disease-free patients, 4 had CS Ia (25%), 11 CS Ib (68.8%) and 1 CS Ic (6.3%), whereas all patients who died had CS IIIc (p = 0.0008). All 6 patients (25%) that underwent conservative surgery were alive and without recurrence. CONCLUSION: although GCT usually present low aggressiveness, the clinical staging continues to be the main prognostic factor and hence it determines the option for conservative surgery and the use of adjuvant therapy.