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Conservative surgery in stage I adult type granulosa cells tumors of the ovary: Results from the MITO-9 study.

Abstract：

OBJECTIVE:About 30% of Adult type granulosa cell tumors of the ovary (AGCTs) are diagnosed in fertile age. In stage I, conservative surgery (fertility-sparing surgery, FSS), either unilateral salpingo-oophorectomy (USO) or cystectomy are possible options. The aim of this study is to compare oncological outcomes of FSS and radical surgery (RS) in apparently stage I AGCTs treated within the MITO group (Multicenter Italian Trials in Ovarian cancer). METHODS:Survival curves were calculated using the Kaplan-Meier method and compared with log-rank test. The role of clinicopathological variables as prognostic factors for survival was assessed using Cox's regression. RESULTS:Two-hundred and twenty-nine patients were included; 32.6% received FSS, 67.4% RS. In the FSS group, 62.8% underwent USO, 16.7% cystectomy, 20.5% cystectomy followed by USO. After a median follow up of 84 months, median DFS was significantly worse in the FSS-group (10 yr DFS 50% vs 74%, in FSS and RS group, p = 0.006). No significant difference was detected between RS and USO (10 yr DFS 75% vs 70%, p = 0.5).Cystectomy-group showed a significantly worse DFS compared to USO (10 yr DFS 16% vs 70%, p < 0.001). Patients receiving cystectomy and subsequent USO showed a better prognosis, even though significantly worse compared to USO (10 yr DFS 41% vs 70%, p = 0.05). Between FSS and RS, no difference in OS was detected. At multivariate analysis, FIGO stage IC and cystectomy retained significant predictive value for worse survival. CONCLUSIONS:This study supports the oncological safety of FSS in stage I AGCTs, provided that cystectomy is avoided; USO should be the preferred approach.

journal_name

Gynecol Oncol

journal_title

Gynecologic oncology

authors

Bergamini A,Cormio G,Ferrandina G,Lorusso D,Giorda G,Scarfone G,Bocciolone L,Raspagliesi F,Tateo S,Cassani C,Savarese A,Breda E,De Giorgi U,Mascilini F,Candiani M,Kardhashi A,Biglia N,Perrone AM,Pignata S,Mangili G

doi

10.1016/j.ygyno.2019.05.029

subject

Has Abstract

pub_date

2019-08-01 00:00:00

pages

323-327

issue

eissn

0090-8258

issn

1095-6859

pii

S0090-8258(19)31273-9

journal_volume

154

pub_type

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Conservative surgery in stage I adult type granulosa cells tumors of the ovary: Results from the MITO-9 study.