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Adjuvant chemotherapy does not improve disease-free survival in FIGO stage IC ovarian granulosa cell tumors: The MITO-9 study.
Gynecol Oncol 2016; 143(2):276-280GO

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.

Authors+Show Affiliations

Gynecology Department, San Raffaele Scientific Institute, Milan, Italy. Electronic address: mangili.giorgia@hsr.it.Gynecology Department, San Raffaele Scientific Institute, Milan, Italy.Department of Obstetrics and Gynecology, University of Bari, Bari, Italy.Department of Obstetrics and Gynecology, University of Bari, Bari, Italy.Department of Gynecologic Oncology, S. Orsola-Malpighi University Hospital, Bologna, Italy.Medical Oncology Division, National Cancer Institute Regina Elena, Rome, Italy.Gynecology Department, San Raffaele Scientific Institute, Milan, Italy.Gynecologic Oncology Department, Centro di riferimento Oncologico (CRO) National Cancer Institute, Aviano, Italy.Obstetrics and Gynecology Department, IRCCS Foundation Policlinico Mangiagalli Regina Elena Hospital, Milan, Italy.Uro-Gynecological Oncology, National Cancer Institute "Fondazione Giovanni Pascale", Naples, Italy.Gynecology Department, Riuniti di Bergamo Hospital, Bergamo, Italy.Division of Gynecology and Obstetrics, Department of Clinical and Experimental Medicine, Pisa University, Pisa, Italy.Department of Gynecology, Obstetrics and Urology, Umberto I, "Sapienza" University of Rome, Rome, Italy.Department of Health Sciences and Medicine, University of Molise, Campobasso/Gynecologic Oncology Unit, Policlinico Universitario "Agostino Gemelli", Rome, Italy.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

27597380

Citation

Mangili, G, et al. "Adjuvant Chemotherapy Does Not Improve Disease-free Survival in FIGO Stage IC Ovarian Granulosa Cell Tumors: the MITO-9 Study." Gynecologic Oncology, vol. 143, no. 2, 2016, pp. 276-280.
Mangili G, Ottolina J, Cormio G, et al. Adjuvant chemotherapy does not improve disease-free survival in FIGO stage IC ovarian granulosa cell tumors: The MITO-9 study. Gynecol Oncol. 2016;143(2):276-280.
Mangili, G., Ottolina, J., Cormio, G., Loizzi, V., De Iaco, P., Pellegrini, D. A., ... Ferrandina, G. (2016). Adjuvant chemotherapy does not improve disease-free survival in FIGO stage IC ovarian granulosa cell tumors: The MITO-9 study. Gynecologic Oncology, 143(2), pp. 276-280. doi:10.1016/j.ygyno.2016.08.316.
Mangili G, et al. Adjuvant Chemotherapy Does Not Improve Disease-free Survival in FIGO Stage IC Ovarian Granulosa Cell Tumors: the MITO-9 Study. Gynecol Oncol. 2016;143(2):276-280. PubMed PMID: 27597380.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Adjuvant chemotherapy does not improve disease-free survival in FIGO stage IC ovarian granulosa cell tumors: The MITO-9 study. AU - Mangili,G, AU - Ottolina,J, AU - Cormio,G, AU - Loizzi,Vera, AU - De Iaco,P, AU - Pellegrini,D A, AU - Candiani,M, AU - Giorda,G, AU - Scarfone,G, AU - Cecere,S C, AU - Frigerio,L, AU - Gadducci,A, AU - Marchetti,C, AU - Ferrandina,G, Y1 - 2016/09/03/ PY - 2016/06/06/received PY - 2016/08/10/revised PY - 2016/08/13/accepted PY - 2016/10/25/pubmed PY - 2017/5/13/medline PY - 2016/9/7/entrez KW - Adjuvant chemotherapy KW - Granulosa cell tumors of the ovary KW - MITO KW - Prognostic factors KW - Relapse KW - Stage IC SP - 276 EP - 280 JF - Gynecologic oncology JO - Gynecol. Oncol. VL - 143 IS - 2 N2 - 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. SN - 1095-6859 UR - https://www.unboundmedicine.com/medline/citation/27597380/Adjuvant_chemotherapy_does_not_improve_disease_free_survival_in_FIGO_stage_IC_ovarian_granulosa_cell_tumors:_The_MITO_9_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-8258(16)31342-7 DB - PRIME DP - Unbound Medicine ER -