Clinicopathological characteristics and prognostic factors of ovarian granulosa cell tumors: A JSGO-JSOG joint study

Objectives. The aim of this study was to elucidate the clinicopathological features of ovarian granulosa cell tu-mors (GCTs) and to identify the prognostic factors. Methods. The Japanese Society of Gynecologic Oncology (JSGO) conducted an observational retrospective co-hort study of women with GCTs enrolled in the Gynecological Tumor Registry of the Japan Society of Obstetrics and Gynecology (JSOG) between 2002 and 2015. Clinicopathological features, including lymph node metastasis, were evaluated. In addition, we performed a prognostic analysis of patients between 2002 and 2011 for whom survival data were available. Kaplan-Meier and multivariate Cox proportional hazards analyses were performed. Results. We identified 1426 patients with GCTs. Of the 222 patients who underwent lymph node dissection, 10 (4.5%) had lymph node metastasis. The incidence of lymph node metastasis in patients with pT1, pT2, and pT3 was 2.1%, 13.3%, and 26.7%, respectively (p < 0.001). Prognostic analysis was performed on 674 patients. In the multivariate Cox regression analysis, residual disease after initial surgery (hazard ratio (HR) = 10.39, 95% confidence interval (CI) = 3.15-34.29) and lymph node metastasis (HR = 5.58, 95% CI = 1.62-19.19) were independent risk factors for cancer-specific survival. Conclusions. In the initial surgery for GCTs, lymph node dissection can be omitted if the operative finding is pT1. In cases of pT2 or higher, lymph node dissection should be considered. Debulking is critical for achieving no gross residual tumor at the end of the surgery. (c) 2021 Elsevier Inc. All rights reserved.

Automated summary

The study aimed to elucidate the clinicopathological features of ovarian granulosa cell tumors (GCTs) and identify prognostic factors. Lymph node metastasis rates increased with higher pathological stages in GCT patients, with residual disease after initial surgery and lymph node metastasis identified as independent risk factors for cancer-specific survival. Surgical strategies should be tailored based on pathological staging to optimize outcomes for GCT patients.