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Postoperative chemotherapy in advanced ovarian granulosa cell tumors.
Int J Gynecol Cancer 2002 Jan-Feb; 12(1):119-23IJ

Abstract

The objective of this research is to assess the use of first-line postoperative chemotherapy in patients with advanced ovarian granulosa cell tumor (GCT). A retrospective population-based case series identified 60 women with stage IC or greater ovarian GCT over a 25-year period. Five patients were excluded because of incomplete information. None of the patients had received chemotherapy or radiotherapy prior to the diagnosis of advanced GCT. All patients had, at a minimum, a total abdominal hysterectomy and bilateral salpingo-oophorectomy. Pathology was centrally reviewed and the diagnosis confirmed. Of the 55 eligible patients, the 21 women with stage III and IV disease were the main focus of the study. Clinical outcomes and survival were compared between 13 women who received combination chemotherapy and eight who did not. Univariate analysis was conducted to assess the impact of age at diagnosis, size of residual disease, and adjuvant use of radiation therapy on prognosis. For the 55 patients, median age at diagnosis was 54 years (range 22-79). Median length of follow-up was 4.4 years (range 0.3-23.3). Median time to progression was 2.3 years (range 0.3-5.3). Sixty percent of those with no macroscopic disease after primary surgery recurred within 4.5 years of diagnosis. All patients with gross residual disease (>2 cm) were dead within 4 years of diagnosis. Overall 5 years survival rate was 61.6% (95% CI (49.3-76.9)). Among stage III and IV patients, there were no differences with respect to age at diagnosis and use of radiation therapy between those who did and did not receive chemotherapy. The only statistically significant difference was the presence of macroscopic residual disease (82% vs. 22%). Although there was no statistical significant difference in overall survival, there was a trend toward a poorer outcome in the group that received chemotherapy. Survival of patients with macroscopic residual disease was not influenced by use of chemotherapy (P = 0.976). We conclude that the presence of macroscopic residual disease after primary surgery was the most important prognostic factor. Although these patients were more likely to receive postoperative chemotherapy, there was no evidence to document a beneficial effect of systemic therapy in this group of women.

Authors+Show Affiliations

Department of Gynecology, Tom Baker Cancer Center, 1331-29th Street NW, Calgary, Alberta T2N 4N2, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11860546

Citation

Al-Badawi, I A., et al. "Postoperative Chemotherapy in Advanced Ovarian Granulosa Cell Tumors." International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society, vol. 12, no. 1, 2002, pp. 119-23.
Al-Badawi IA, Brasher PM, Ghatage P, et al. Postoperative chemotherapy in advanced ovarian granulosa cell tumors. Int J Gynecol Cancer. 2002;12(1):119-23.
Al-Badawi, I. A., Brasher, P. M., Ghatage, P., Nation, J. G., Schepansky, A., & Stuart, G. C. (2002). Postoperative chemotherapy in advanced ovarian granulosa cell tumors. International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society, 12(1), pp. 119-23.
Al-Badawi IA, et al. Postoperative Chemotherapy in Advanced Ovarian Granulosa Cell Tumors. Int J Gynecol Cancer. 2002;12(1):119-23. PubMed PMID: 11860546.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Postoperative chemotherapy in advanced ovarian granulosa cell tumors. AU - Al-Badawi,I A, AU - Brasher,P M A, AU - Ghatage,P, AU - Nation,J G, AU - Schepansky,A, AU - Stuart,G C E, PY - 2002/2/28/pubmed PY - 2002/4/27/medline PY - 2002/2/28/entrez SP - 119 EP - 23 JF - International journal of gynecological cancer : official journal of the International Gynecological Cancer Society JO - Int. J. Gynecol. Cancer VL - 12 IS - 1 N2 - The objective of this research is to assess the use of first-line postoperative chemotherapy in patients with advanced ovarian granulosa cell tumor (GCT). A retrospective population-based case series identified 60 women with stage IC or greater ovarian GCT over a 25-year period. Five patients were excluded because of incomplete information. None of the patients had received chemotherapy or radiotherapy prior to the diagnosis of advanced GCT. All patients had, at a minimum, a total abdominal hysterectomy and bilateral salpingo-oophorectomy. Pathology was centrally reviewed and the diagnosis confirmed. Of the 55 eligible patients, the 21 women with stage III and IV disease were the main focus of the study. Clinical outcomes and survival were compared between 13 women who received combination chemotherapy and eight who did not. Univariate analysis was conducted to assess the impact of age at diagnosis, size of residual disease, and adjuvant use of radiation therapy on prognosis. For the 55 patients, median age at diagnosis was 54 years (range 22-79). Median length of follow-up was 4.4 years (range 0.3-23.3). Median time to progression was 2.3 years (range 0.3-5.3). Sixty percent of those with no macroscopic disease after primary surgery recurred within 4.5 years of diagnosis. All patients with gross residual disease (>2 cm) were dead within 4 years of diagnosis. Overall 5 years survival rate was 61.6% (95% CI (49.3-76.9)). Among stage III and IV patients, there were no differences with respect to age at diagnosis and use of radiation therapy between those who did and did not receive chemotherapy. The only statistically significant difference was the presence of macroscopic residual disease (82% vs. 22%). Although there was no statistical significant difference in overall survival, there was a trend toward a poorer outcome in the group that received chemotherapy. Survival of patients with macroscopic residual disease was not influenced by use of chemotherapy (P = 0.976). We conclude that the presence of macroscopic residual disease after primary surgery was the most important prognostic factor. Although these patients were more likely to receive postoperative chemotherapy, there was no evidence to document a beneficial effect of systemic therapy in this group of women. SN - 1048-891X UR - https://www.unboundmedicine.com/medline/citation/11860546/Postoperative_chemotherapy_in_advanced_ovarian_granulosa_cell_tumors_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=1048-891X&date=2002&volume=12&issue=1&spage=119 DB - PRIME DP - Unbound Medicine ER -