Granulosa cell tumor of the ovary. A clinicopathological evaluation of 60 cases.

The patients with granulosa cell tumor of the ovary constituted 7.6% (60/780) of all ovarian malignancies treated at our Institution. The mean age of patients at diagnosis was 53.1. The most frequent symptom was abnormal vaginal bleeding. Of the 60 patients, 36 had stage I, 2 had stage II, 16 had stage III and 6 had stage IV disease. Endometrial hyperplasia and adenocarcinoma were detected in 18 and 3 patients, respectively. Lymph node metastasis was detected in only one of 18 patients subjected to lymphadenectomy. Recurrent disease was observed in 3 of 36 patients with stage I disease. The overall 5-year survival was found to be 85.0% (51/60). This figure varied from 100.0% to 63.6% according to the stage. In patients with stage I disease, surgery with and without adjuvant therapy achieved the same 5-year survival rate. In advanced stage, 5-year survival rate dropped from 90.0% with no gross residual disease to 25.0% with residual disease more than 2 cm. In patients with stage I disease, surgery only seems to be the treatment of choice. In advanced stage, since residual disease after surgery effects survival significantly, an aggressive surgical approach is advocated.