A long-term follow-up study of 176 cases with adult-type ovarian granulosa cell tumors

Objective: Because of rarity, indolent clinical course, and of most importance, small sample size studies of previous ovarian granulosa cell tumors (GCTs), this study was conducted to report the clinical characteristics and long-term outcomes of 176 pathologically confirmed GCTs. Methods: Between 1984 and 2010, we retrospectively evaluated 176 patients from multiple medical centers in Taiwan. Results: The mean age at the diagnosis was 46 years and nearly half of the patients (45.7%) were in their fourth or fifth decades of life. The most common symptoms included abdominal pain (28.5%), followed by irregular menstruation (16.7%). The mean tumor size was 10.4 cm. The stage distribution at diagnosis was stage I in 77.8% of patients, stage II in 5.1%, stages III-V in 6.1%, and unknown in 11% of patients. The median follow-up period was 60.7 months. The recurrence rate was 21%. The overall 5- and 10-year survival rates were 96.5% and 94.1%, respectively. In univariate analysis, initial stage, presence of residual tumor after initial surgery, need for adjuvant chemotherapy, and tumor size were associated with disease recurrence. In the multivariate analysis, only the presence of residual tumor after initial surgery and tumor size were significantly associated with recurrence. Conclusions: The outcomes of patients with GCTs were good, with nearly to 95% of patients surviving 5 and 10 years. The prognosis was related to initial stage, presence of residual tumor after initial surgery, and tumor size (> 13.5 cm). Different surgical methods and/or adjuvant therapy appear not to affect the outcome.