Yasuhiko Ebina1, Wataru Yamagami2, Yoichi Kobayashi3, Tsutomu Tabata4, Masanori Kaneuchi5, Satoru Nagase6, Takayuki Enomoto7, Mikio Mikami8. 1. Division of Comprehensive Development Nursing, Faculty of Health Sciences, Hokkaido University, Sapporo, Japan. Electronic address: ebiyas@hs.hokudai.ac.jp. 2. Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan. 3. Department of Obstetrics and Gynecology, Kyorin University, Faculty of Medicine, Tokyo, Japan. 4. Department of Obstetrics and Gynecology, Tokyo Women's Medical University, Tokyo, Japan. 5. Department of Obstetrics and Gynecology, Otaru General Hospital, Otaru, Japan. 6. Department of Obstetrics and Gynecology, Yamagata University Faculty of Medicine, Yamagata, Japan. 7. Department of Obstetrics and Gynecology, Niigata University School of Medicine, Niigata, Japan. 8. Department of Obstetrics and Gynecology, Tokai University School of Medicine, Kanagawa, Japan.
Abstract
OBJECTIVES: The aim of this study was to elucidate the clinicopathological features of ovarian granulosa cell tumors (GCTs) and to identify the prognostic factors. METHODS: The Japanese Society of Gynecologic Oncology (JSGO) conducted an observational retrospective cohort study of women with GCTs enrolled in the Gynecological Tumor Registry of the Japan Society of Obstetrics and Gynecology (JSOG) between 2002 and 2015. Clinicopathological features, including lymph node metastasis, were evaluated. In addition, we performed a prognostic analysis of patients between 2002 and 2011 for whom survival data were available. Kaplan-Meier and multivariate Cox proportional hazards analyses were performed. RESULTS: We identified 1426 patients with GCTs. Of the 222 patients who underwent lymph node dissection, 10 (4.5%) had lymph node metastasis. The incidence of lymph node metastasis in patients with pT1, pT2, and pT3 was 2.1%, 13.3%, and 26.7%, respectively (p < 0.001). Prognostic analysis was performed on 674 patients. In the multivariate Cox regression analysis, residual disease after initial surgery (hazard ratio (HR) = 10.39, 95% confidence interval (CI) = 3.15-34.29) and lymph node metastasis (HR = 5.58, 95% CI = 1.62-19.19) were independent risk factors for cancer-specific survival. CONCLUSIONS: In the initial surgery for GCTs, lymph node dissection can be omitted if the operative finding is pT1. In cases of pT2 or higher, lymph node dissection should be considered. Debulking is critical for achieving no gross residual tumor at the end of the surgery.
OBJECTIVES: The aim of this study was to elucidate the clinicopathological features of ovarian granulosa cell tumors (GCTs) and to identify the prognostic factors. METHODS: The Japanese Society of Gynecologic Oncology (JSGO) conducted an observational retrospective cohort study of women with GCTs enrolled in the Gynecological Tumor Registry of the Japan Society of Obstetrics and Gynecology (JSOG) between 2002 and 2015. Clinicopathological features, including lymph node metastasis, were evaluated. In addition, we performed a prognostic analysis of patients between 2002 and 2011 for whom survival data were available. Kaplan-Meier and multivariate Cox proportional hazards analyses were performed. RESULTS: We identified 1426 patients with GCTs. Of the 222 patients who underwent lymph node dissection, 10 (4.5%) had lymph node metastasis. The incidence of lymph node metastasis in patients with pT1, pT2, and pT3 was 2.1%, 13.3%, and 26.7%, respectively (p < 0.001). Prognostic analysis was performed on 674 patients. In the multivariate Cox regression analysis, residual disease after initial surgery (hazard ratio (HR) = 10.39, 95% confidence interval (CI) = 3.15-34.29) and lymph node metastasis (HR = 5.58, 95% CI = 1.62-19.19) were independent risk factors for cancer-specific survival. CONCLUSIONS: In the initial surgery for GCTs, lymph node dissection can be omitted if the operative finding is pT1. In cases of pT2 or higher, lymph node dissection should be considered. Debulking is critical for achieving no gross residual tumor at the end of the surgery.