Objective: To study the effect of clinical and pathologic factors on prognosis for granulosa cell tumor of the ovary.
Methods: The clinical records and tumor sections of 100 patients with granulosa cell tumors of the ovary between 1958 and 1995 were reviewed. The relationship between age, stage, mitosis and the adjuvant therapy for early stage (stage I) were analyzed retrospectively. Patients with recurrent tumors were compared with patients who remained without disease, patients with early recurring tumors were compared with late recurring tumors.
Results: The overall 5 and 10 year survival rates were 80% and 72%. There were no significant difference between ages and survival (P > 0.05). The survival rates in stage I were 98% and 96% after 5 and 10 years, respectively, and in stages II were 70% and 60%, after 5 and 10 years, all of 4 patients with stage III-IV were dead of recurrent disease in 1 year. The frequency of observed mitosis influenced the survival rate: with less 5/10 high-power fields (HPF) the survival were 96% both at 5 and 10 years, with more or equal 5/10 HPF the 5 and 10 year survival rates were 58% and 36%, respectively (P < 0.01). No significant correlation could be established between the adjuvant therapy and 5 and 10 years survival in 56 stage I patients. There were 44 patients with recurrent disease in this group, median time to recurrence was 53 months. Late recurrence appeared in 8 cases. The significant differences in stage and abdominal mass were noted between the recurrent tumors and the group without disease (P < 0.05). When early and late recurring tumors were compared, statistically significant differences were again noted: early recurring tumors had higher mitotic rates and late stage, and late recurring tumors had lower mitotic rages and early stage. Patients without recurrent tumors were similar to the patients with early recurring tumors.
Conclusions: Tumor stage and mitotic rate are the clinical and pathologic prognosticators in granulosa cell tumor. It is difficult to predict late recurrences using these clinical and pathologic parameters.