Granulosa cell tumours of ovary: variables affecting prognosis

Abstract

Background: Granulosa cell tumours account for less than 5% of all ovarian malignancies. Limited data is available from India. Methods: 27 patients with diagnosis of granulosa cell tumour of the ovary were treated between 1991 and 2003 at our Institute. The surgical records were reviewed and the patients were staged according to the FIGO system. The clinical and histological findings are correlated with prognosis and survival. Results: Mean age at diagnosis was 46.2 (2- 64) years. The number of patients in various stages was I-19; II-1; III-5 and IV-2. Menstrual irregularity was diagnosed in 22%, and postmenopausal bleeding in 7.4% of women. Twenty-five patients were treated with primary surgery, 9 patients received adjuvant chemotherapy (CT) and only one patients received chemotherapy as primary treatment. Overall survival was 82% at 5 years. Overall survival for stage I was 100% after 5 and 10 years and in stage II-IV, was 56.4% after 5 and 10 years. Mean tumour size was 18cm (range 3-30 cm). Women with larger tumour diameter (>15cm) had significantly worse outcome than those with tumours of smaller diameter (P<0.05). The frequency of observed mitosis influenced the survival rate; with 0-3/10 HPF the survival was 100% in 5 years and with 4/10 HPF the survival was 2.6 years. Conclusion: The tumour size, mitotic rate and stage of disease are well-defined variables and influence the survival significantly and should be considered as important prognostic factors for treatment planning.