Pharmacotherapy and surgical treatment of adult granulosa cell ovarian tumors: analysis of own and literature data
E.V. Bakhidze (1, 2), V.A. Belyaeva (3), A.A. Domansky (1), N.A. Mikaya (1), I.V. Berlev (1, 2)
1) N.N. Petrov National Medical Research Center of Oncology, St. Petersburg, Russia;
2) North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russia;
3) St. Petersburg Clinical Research and Practical Center for Specialized Types of Medical Care (Oncological), St. Petersburg, Russia
Background. Granulosa cell ovarian tumors (GCOTs) are rare non-epithelial neoplasms, and according to some data, their incidence rate is about 3-5% of all malignant ovarian tumors. However, according to a number of authors, the data on the incidence rate of GCOTs do not sufficiently reflect the true situation, since the majority of cancer registries in the world do not take into account these tumors.
Objective. Determination of the role of pharmacotherapy and surgical methods in the treatment of patients with adult granulosa cell ovarian tumors (AGCOTs).
Methods. The study included data on 93 patients with AGCOTs who were treated and followed up at the N.N. Petrov NRMCO from 1980 to 2017. The median follow-up period was 118 months (from 6 to 423 months).
Results. 74 (79.6%) patients were diagnosed with stage I disease. The IA stage was identified in 51 (54.8%) patients, IB – in 6 (6.5%), and IC – in 17 (18.3%) patients. 19 (20.4%) patients were diagnosed with stage II – IV of the disease. The stage of the disease significantly influenced the 5-year survival rates (p<0.05). It was 43.8% in patients with III – IV stage. All patients with stage III – IV had a relapse of the disease. All patients underwent surgical treatment. Adjuvant chemotherapy (AHT) in stage I was administered for 51 patients, in II – IV stages of the disease – for all patients. Relapse of the disease occurred in 34 (36.6%) patients. The average time to the first recurrence was 55 months (from 3 to 312). Among 74 patients with stage I disease, relapses were observed in 18 (24.3%). In stage II – IV, AGCOT recurrences were registered in all cases.
Conclusion. Tere were no significant differences in the overall and relapse-free survival of patients with AGCOTs, depending on the options of surgical treatment and pharmacotherapy. The results obtained and literature data indicate a favorable course of the disease in the IA stage and in the absence of adverse risk factors, which allows to perform the operations that preserve fertility in patients of reproductive age. Additional multicentre randomized studies to clarify the effectiveness of various surgical and drug treatment options for patients with AGCOTs are required.
Keywords: granulosa cell tumors, nonepithelial ovarian tumors, chemotherapy of granulosa cell tumors, surgical treatment of granulosa cell tumors
About the Autors
Corresponding author: Elena V. Bakhidze, MD, Leading researcher at the Department of Onogynecology, .N. Petrov National Medical Research Center of Oncology; Associate Professor at the Department of Obstetrics and Gynecology, North-Western State Medical University n.a.I.I. Mechnikov, St. Petersburg, Russia; e-mail: firstname.lastname@example.org
Address: 68, Leningradskaya Street, Pesochny settlement, St. Petersburg 197758, Russian Federation