G Mangili1, J Ottolina2, G Cormio3, Vera Loizzi3, P De Iaco4, D A Pellegrini5, M Candiani2, G Giorda6, G Scarfone7, S C Cecere8, L Frigerio9, A Gadducci10, C Marchetti11, G Ferrandina12. 1. Gynecology Department, San Raffaele Scientific Institute, Milan, Italy. Electronic address: mangili.giorgia@hsr.it. 2. Gynecology Department, San Raffaele Scientific Institute, Milan, Italy. 3. Department of Obstetrics and Gynecology, University of Bari, Bari, Italy. 4. Department of Gynecologic Oncology, S. Orsola-Malpighi University Hospital, Bologna, Italy. 5. Medical Oncology Division, National Cancer Institute Regina Elena, Rome, Italy. 6. Gynecologic Oncology Department, Centro di riferimento Oncologico (CRO) National Cancer Institute, Aviano, Italy. 7. Obstetrics and Gynecology Department, IRCCS Foundation Policlinico Mangiagalli Regina Elena Hospital, Milan, Italy. 8. Uro-Gynecological Oncology, National Cancer Institute "Fondazione Giovanni Pascale", Naples, Italy. 9. Gynecology Department, Riuniti di Bergamo Hospital, Bergamo, Italy. 10. Division of Gynecology and Obstetrics, Department of Clinical and Experimental Medicine, Pisa University, Pisa, Italy. 11. Department of Gynecology, Obstetrics and Urology, Umberto I, "Sapienza" University of Rome, Rome, Italy. 12. Department of Health Sciences and Medicine, University of Molise, Campobasso/Gynecologic Oncology Unit, Policlinico Universitario "Agostino Gemelli", Rome, Italy.
Abstract
OBJECTIVE: Evidence-based management of granulosa cell tumors of the ovary (GCT) has been not yet standardized: surgery, including fertility-sparing procedures for young women, has been traditionally the standard treatment; on the other hand, chemotherapy has been used for treatment of advanced and/or recurrent disease. However, very limited experience, has been selectively focused on the role of adjuvant chemotherapy in stage IC patients. The objective of this retrospective study was to assess the efficacy of first line postoperative chemotherapy in patients with stage IC treated at the Italian Centers involved in the MITO (Multicenter Italian Trials in Ovarian cancer) Group. PATIENTS AND METHODS: A retrospective multi-institutional review of patients with GCT of the ovary at FIGO stage IC treated or referred to MITO centers was conducted. Surgical outcome, pathological findings and follow-up data were analysed. Kaplan-Meier and Cox proportional hazards analyses were used to determine the predictors factors for disease free survival. RESULTS: A total of 40 patients with primary GCT of the ovary at FIGO stage IC were identified. The median follow-up period was 96months (range 7-300). At multivariate analysis, surgical treatment outside MITO centers and incomplete surgical staging were independent poor prognostic indicators for recurrence; adjuvant chemotherapy did not retain significant predictive value for recurrence. CONCLUSIONS: This study raises the question about the value of adjuvant chemotherapy in stage IC GCT: a comprehensive evaluation of a larger series is urgently needed in order to characterize stage IC substages who can be spared treatment toxicity.
OBJECTIVE: Evidence-based management of granulosa cell tumors of the ovary (GCT) has been not yet standardized: surgery, including fertility-sparing procedures for young women, has been traditionally the standard treatment; on the other hand, chemotherapy has been used for treatment of advanced and/or recurrent disease. However, very limited experience, has been selectively focused on the role of adjuvant chemotherapy in stage IC patients. The objective of this retrospective study was to assess the efficacy of first line postoperative chemotherapy in patients with stage IC treated at the Italian Centers involved in the MITO (Multicenter Italian Trials in Ovarian cancer) Group. PATIENTS AND METHODS: A retrospective multi-institutional review of patients with GCT of the ovary at FIGO stage IC treated or referred to MITO centers was conducted. Surgical outcome, pathological findings and follow-up data were analysed. Kaplan-Meier and Cox proportional hazards analyses were used to determine the predictors factors for disease free survival. RESULTS: A total of 40 patients with primary GCT of the ovary at FIGO stage IC were identified. The median follow-up period was 96months (range 7-300). At multivariate analysis, surgical treatment outside MITO centers and incomplete surgical staging were independent poor prognostic indicators for recurrence; adjuvant chemotherapy did not retain significant predictive value for recurrence. CONCLUSIONS: This study raises the question about the value of adjuvant chemotherapy in stage IC GCT: a comprehensive evaluation of a larger series is urgently needed in order to characterize stage IC substages who can be spared treatment toxicity.
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