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Surgical staging and adjuvant chemotherapy in the management of patients with adult granulosa cell tumors of the ovary.

Abstract

OBJECTIVE

To analyze the role of surgical staging and adjuvant chemotherapy in patients with adult type granulosa cell tumor (GCT) of the ovary.

METHODS

Patients were divided into those with early-stage (stages I-II, n=93) and advanced-stage (stages III-IV, n=13) GCT and analyzed separately in this retrospective study.

RESULTS

Of the 93 patients with early-stage GCT, 30 were completely staged and 25 underwent lymph node dissection. After surgery, 17 patients received adjuvant chemotherapy with bleomycin/etoposide/cisplatin (BEP). None had lymph node metastasis. Completely staged patients had no recurrence or deaths. However, recurrences were observed in 9 of 63 patients (14.3%) who did not undergo complete staging, with four (6.3%) dying due to disease. The 5-year disease-free survival (DFS) rates of groups with and without complete staging were 100% and 84%, respectively (P=0.037). Adjuvant chemotherapy was not significantly associated with DFS (P=0.193). All patients with advanced-stage GCT underwent optimal cytoreduction and received adjuvant chemotherapy with BEP. None of the 6 patients who completed 6 cycles of BEP had recurrence, whereas 5 of the 7 patients (71.4%) who received fewer than 6 cycles of BEP had recurrences and 3 (42.9%) died due to disease. The 5-year DFS rates of these two groups were 100% and 50%, respectively (P=0.022), with cycles of chemotherapy being the only significant factor for DFS in patients with advanced-stage GCT.

CONCLUSIONS

Complete surgical staging is recommended, but lymph node removal is not recommended for early-stage GCT. Optimal debulking followed by six cycles of BEP chemotherapy is recommended for advanced-stage GCT.

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  • Authors+Show Affiliations

    ,

    Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Seoul, Republic of Korea.

    , , , , , ,

    Source

    Gynecologic oncology 125:1 2012 Apr pg 80-6

    MeSH

    Adult
    Aged
    Aged, 80 and over
    Antineoplastic Agents
    Antineoplastic Combined Chemotherapy Protocols
    Bleomycin
    Chemotherapy, Adjuvant
    Cisplatin
    Drug Administration Schedule
    Etoposide
    Female
    Follow-Up Studies
    Granulosa Cell Tumor
    Gynecologic Surgical Procedures
    Humans
    Lymph Node Excision
    Middle Aged
    Neoplasm Staging
    Ovarian Neoplasms
    Pelvis
    Recurrence
    Registries
    Retrospective Studies
    Survival Analysis
    Treatment Outcome

    Pub Type(s)

    Evaluation Studies
    Journal Article

    Language

    eng

    PubMed ID

    22210469

    Citation

    Park, Jeong-Yeol, et al. "Surgical Staging and Adjuvant Chemotherapy in the Management of Patients With Adult Granulosa Cell Tumors of the Ovary." Gynecologic Oncology, vol. 125, no. 1, 2012, pp. 80-6.
    Park JY, Jin KL, Kim DY, et al. Surgical staging and adjuvant chemotherapy in the management of patients with adult granulosa cell tumors of the ovary. Gynecol Oncol. 2012;125(1):80-6.
    Park, J. Y., Jin, K. L., Kim, D. Y., Kim, J. H., Kim, Y. M., Kim, K. R., ... Nam, J. H. (2012). Surgical staging and adjuvant chemotherapy in the management of patients with adult granulosa cell tumors of the ovary. Gynecologic Oncology, 125(1), pp. 80-6. doi:10.1016/j.ygyno.2011.12.442.
    Park JY, et al. Surgical Staging and Adjuvant Chemotherapy in the Management of Patients With Adult Granulosa Cell Tumors of the Ovary. Gynecol Oncol. 2012;125(1):80-6. PubMed PMID: 22210469.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Surgical staging and adjuvant chemotherapy in the management of patients with adult granulosa cell tumors of the ovary. AU - Park,Jeong-Yeol, AU - Jin,Ke Long, AU - Kim,Dae-Yeon, AU - Kim,Jong-Hyeok, AU - Kim,Yong-Man, AU - Kim,Kyu-Rae, AU - Kim,Young-Tak, AU - Nam,Joo-Hyun, Y1 - 2011/12/28/ PY - 2011/09/09/received PY - 2011/12/16/revised PY - 2011/12/17/accepted PY - 2012/1/3/entrez PY - 2012/1/3/pubmed PY - 2012/7/14/medline SP - 80 EP - 6 JF - Gynecologic oncology JO - Gynecol. Oncol. VL - 125 IS - 1 N2 - OBJECTIVE: To analyze the role of surgical staging and adjuvant chemotherapy in patients with adult type granulosa cell tumor (GCT) of the ovary. METHODS: Patients were divided into those with early-stage (stages I-II, n=93) and advanced-stage (stages III-IV, n=13) GCT and analyzed separately in this retrospective study. RESULTS: Of the 93 patients with early-stage GCT, 30 were completely staged and 25 underwent lymph node dissection. After surgery, 17 patients received adjuvant chemotherapy with bleomycin/etoposide/cisplatin (BEP). None had lymph node metastasis. Completely staged patients had no recurrence or deaths. However, recurrences were observed in 9 of 63 patients (14.3%) who did not undergo complete staging, with four (6.3%) dying due to disease. The 5-year disease-free survival (DFS) rates of groups with and without complete staging were 100% and 84%, respectively (P=0.037). Adjuvant chemotherapy was not significantly associated with DFS (P=0.193). All patients with advanced-stage GCT underwent optimal cytoreduction and received adjuvant chemotherapy with BEP. None of the 6 patients who completed 6 cycles of BEP had recurrence, whereas 5 of the 7 patients (71.4%) who received fewer than 6 cycles of BEP had recurrences and 3 (42.9%) died due to disease. The 5-year DFS rates of these two groups were 100% and 50%, respectively (P=0.022), with cycles of chemotherapy being the only significant factor for DFS in patients with advanced-stage GCT. CONCLUSIONS: Complete surgical staging is recommended, but lymph node removal is not recommended for early-stage GCT. Optimal debulking followed by six cycles of BEP chemotherapy is recommended for advanced-stage GCT. SN - 1095-6859 UR - https://www.unboundmedicine.com/medline/citation/22210469/Surgical_staging_and_adjuvant_chemotherapy_in_the_management_of_patients_with_adult_granulosa_cell_tumors_of_the_ovary_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-8258(11)01437-5 DB - PRIME DP - Unbound Medicine ER -