Clinicopathological features and prognostic factors of ovarian sex-cord stromal tumors

Objective: In this study the authors aimed to evaluate the clinicopathological features and prognostic factors of sex-cord stromal tumors (SCST). Materials and Methods: The medical and pathological records of patients with SCST who were operated and followed up in a tertiary university clinic between March 1991 and October 2013 were reviewed. Clinical, surgical and pathological characteristics, follow-up data of the patients, and the effect of this parameters on survival were investigated. Results: One hundred and three women with a mean age of 45 ± 12.8 (range 16-78) were included. Histopathological diagnosis was found as granulosa cell tumor in 95 (92.2%), Sertoli-Leydig cell tumor (SLCT) in six (5.8%), Leydig cell tumor (LCT) in one, and Sertoli cell tumor (SCT) in one of the cases. Sixty-eight percent of the patients had Stage I, 8.7% Stage II, 15.5% Stage III, and 6.8% had Stage IV disease. On univariate analysis; stage, age greater than 50 years, suboptimal cytoreduction, bilaterality, and non-BEP chemotherapy were determined as poor prognostic indicators. On multivariate analysis, age, stage, and optimal cytoreduction were found to be independent prognostic factors for overall survival, while only optimal cytoreduction was detected as an independent prognostic factor for disease-free survival (DFS). Fertility-sparing surgical procedures (FSS) were performed in 22 patients (21.4%). Among these 22 cases 16 (72.7%) pregnancies (13 resulted in a live birth and three in abortion) were achieved through a median period of 72 months (24-240). Conclusion: It was concluded that the most effective parameters on survival were stage and optimal cytoreduction. FSS is an effective approach for preserving the reproductive functions of young patients with SCST.

Sex-cord stromal tumors; Granulosa cell tumor; Prognostic factor; Overall survival (OS); Disease-free survival (DFS); Fertility-sparing surgery.

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