May Lymphadenectomy Be Omitted in Granulosa Cell Tumors of the Ovary?

Abstract

Granulosa cell tumors (GCTs) of the ovary are rare tumors and they are generally detected in early stages with a favorable prognosis. However, the controversies over the extend of surgery are still judging the surgical management. We retrospectively evaluated demographic and clinical variables of granulosa cell tumors of the ovary with probable prognostic factors to identify the clinicopathological features. Women with adult type granulosa cell tumor pathology result between March 2007 and April 2013 were evaluated retrospectively using computerized database of the institution. Age, stage, menopausal status, parity, clinical presentation, surgical procedures, histopathologic results, preoperative tumor markers, tumor diameter and laterality were the reviewed parameters. Patients were staged according to the International Federation of Gynecology and Obstetrics (FIGO) staging system for ovarian tumors that was revised in 2014. A total of 40 patients were retrospectively evaluated. We further categorized patients as stage 1A and more advanced stage disease. Twenty-seven patients (67.5%) were within Stage 1A disease and 13 (32.5%) patients had more advanced stage of disease. Only one patient had retroperitoneal lymph node involvement and recurred 2 years after the completion of the chemotherapy, and died of disease after 2 years from recurrence. Since the risk of unintended complications and morbidity, which is related with lymph node dissection, the rare incidence of lymph node involvement should be kept on mind. So that omitting lymphadenectomy could be an option for GCTs if a low mitotic index (