Survival outcomes of sex cord-stromal tumors of the ovary

Objective: To evaluate the role of retroperitoneal lymphadenectomy and the survival outcomes of malignant ovarian sex cord-stromal tumors (SCSTs). Materials and Methods: Patients with malignant SCSTs of the ovary who underwent surgery between January 2005 and March 2017 were retrospectively reviewed. The authors analyzed stage, histology, clinical presentation, type of surgery, the role of lymphadenectomy, five-year disease-free survival, and five-year overall survival. Results: Fifty-four patients with malignant SCSTs of the ovary were identified in this study. Retroperitoneal lymph node dissection was performed in 30 (55.6%) patients. No lymph node metastasis was detected. At the median follow-up time of 35 months, the five-year disease-free survival and the five-year overall survival was 88.7% and 92.4%, respectively. Conclusion: The survival outcomes of women with ovarian sex cord-stromal malignancies are favorable. No lymph node metastasis is detected in this study. Retroperitoneal lymphadenectomy may be omitted in a surgical staging procedure for these patients.

Ovarian sex cord-stromal tumor; Survival outcomes; Chemotherapy

[1] Quirk JT., Natarajan N.: “Ovarian cancer incidence in the United States, 1992-1999”. Gynecol Oncol., 2005, 97, 519.

[2] Brown J., Sood AK., Deavers MT., Milojevic L., Gershenson DM.: “Patterns of metastasis in sex cord-stromal tumors of the ovary: can routine staging lymphadenectomy be omitted?”. Gynecol Oncol., 2009, 113, 86.

[3] Chan JK, Zhang M, Kaleb V, Loizzi V, Benjamin J, Vasilev S, et al.: “Prognostic factors responsible for survival in sex cord stromal tu- mors of the ovary—a multivariate analysis”. Gynecol Oncol., 2005, 96, 204.

[4] Meisel JL, Hyman DM, Jotwani A, Zhou Q, Abu-Rustum NR, Iasonos A, et al.: “The role of systemic chemotherapy in the management of granulosa cell tumors”. Gynecol Oncol., 2015, 136, 505.

[5] Zhang M, Cheung MK, Shin JY, Kapp DS, Husain A, Teng NN, et al.: “Prognostic factors responsible for survival in sex cord stromal tumors of the ovary—an analysis of 376 women”. Gynecol Oncol., 2007, 104, 396.

[6] Evans AT 3rd, Gaffey TA, Malkasian GD Jr, Annegers JF.: “Clinicopathologic review of 118 granulosa and 82 theca cell tumors”. Obstet Gynecol., 1980, 55, 231.

[7] ACOG Committee Opinion: number 280, December 2002.: “The role of the generalist obstetrician-gynecologist in the early detection of ovarian cancer”. Obstet Gynecol., 2002, 100, 1413.

[8] Cronjé HS, Niemand I, Bam RH, Woodruff JD.: “Review of the granulosa-theca cell tumors from the emil Novak ovarian tumor registry”. Am J Obstet Gynecol., 1999, 180, 323.

[9] Prat J.: “Staging classification for cancer of the ovary, fallopian tube, and peritoneum”. Int. J. Gynaecol. Obstet., 2014, 124, 1.

[10] Ottolina J, Ferrandina G, Gadducci A, Scollo P, Lorusso D, Giorda G, et al.: “Is the endometrial evaluation routinely required in patients with adult granulosa cell tumors of the ovary?”. Gynecol Oncol., 2015, 136, 230.

[11] van Meurs HS, Bleeker MC, van der Velden J, Overbeek LI, Kenter GG, Buist MR.: “The incidence of endometrial hyperplasia and cancer in 1031 patients with a granulosa cell tumor of the ovary: longterm follow-up in a population-based cohort study”. Int. J. Gynecol. Cancer, 2013, 23, 1417.

[12] Kleppe M, Amkreutz LC, Van Gorp T, Slangen BF, Kruse AJ, Kruit- wagen RF.: “Lymph-node metastasis in stage I and II sex cord stromal and malignant germ cell tumours of the ovary: a systematic review”. Gynecol Oncol., 2014, 133, 124.

[13] Nasioudis D, Kanninen TT, Holcomb K, Sisti G, Witkin SS.: “Prevalence of lymph node metastasis and prognostic significance of lymphadenectomy in apparent early-stage malignant ovarian sex cord-stromal tumors”. Gynecol Oncol., 2017, 145, 243.

[14] Park JY, Jin KL, Kim DY, Kim JH, Kim YM, Kim KR, et al.: “Surgical staging and adjuvant chemotherapy in the management of patients with adult granulosa cell tumors of the ovary”. Gynecol. Oncol., 2012, 125, 80.

[15] Thrall MM, Paley P, Pizer E, Garcia R, Goff BA.: “Patterns of spread and recurrence of sex cord-stromal tumors of the ovary”. Gynecol. Oncol., 2011, 122, 242.

[16] Di Re F, Baiocchi G.: “Value of lymph node assessment in ovarian cancer: Status of the art at the end of the second millennium”. Int. J. Gynecol. Cancer, 2000, 10, 435.

[17] Schumer ST, Cannistra SA.: “Granulosa cell tumor of the ovary”. J. Clin. Oncol., 2003, 21, 1180.