Background:
The clinical course of adult granulosa cell tumor of the ovary is characterized by indolent growth tending toward late recurrence. a variety of clinical and pathologic parameters have previously been evaluated for prognostication with inconclusive results.
Methods:
The clinical records and tumor sections of 70 patients with adult granulosa cell tumors of the ovary were reviewed. patients with recurrent tumors (rec) (n = 19) were compared with patients who remained without disease (ned) (n = 51).
Results:
Significant differences in stage and tumor size were noted between the two groups; however, after logistic regression analysis, only stage remained statistically significant. pathologic evaluation revealed that call-exner bodies occurred more frequently in tumors of the ned patients. cellular atypia and high mitotic rates were more frequent in the rec group; however, after logistic regression analysis, only atypia remained statistically significant. when early (< 10 years) and late recurring tumors (> 10 years) were compared, statistically significant differences were again noted: early recurring tumors had fewer call-exner bodies, higher mitotic rates, and higher degrees of atypia; late recurring tumors were similar to tumors in the ned patients.
Conclusions:
Tumor stage and, to a lesser extent, tumor size are the only clinical parameters of prognostic importance in adult granulosa cell tumors. cellular atypia and, to lesser extents, mitotic rate and the absence of call-exner bodies are the only significant pathologic prognosticators. it is difficult to predict early recurrences and impossible to predict late recurrences using these clinical and pathologic parameters.