Ovarian granulosa cell tumors: Experience of National Institute of Oncology in Morocco.

Abstract

e16527 Background: The granulosa cell tumors are malignancies with a relatively favorable prognosis. They are characterized by prolonged natural history and tendency to late recurrences. The aim of this study is to investigate the epidemiological and pathological characteristics of granulosa cell tumors, and the prognosis factor for recurrences in the national institute of oncology in Rabat in Morocco. Methods: The clinical data of patients with adult granulosa cell tumors of the ovary treated from January 2003 to december 2010 was investigated retrospectively. Data of age, clinical manifestation, imaging, diagnosis, treatment and follow up of the patients were reviewed and analyzed. Histology was obtained in postoperative for all patients. Results: Twenty-seven cases were retrieved. The median age was 53 years. The most common clinical manifestations at diagnosis were: abdominal pain, vaginal bleeding, abdominal distension and hormonal manifestations. The mean tumor size was 14 cm. The majority of patients had stage I (62,96%, n = 17), while (18,51%, n = 5) had stage III, (7,4%, n = 2) had stage IV, and (11,11%, n = 3) of patients had unknown stage.8 patients received adjuvant chemotherapy (4 : bleomycin etoposide, cisplatin (BEP); 1: bleomycin vepeside cisplatin (BVP); 1: endoxan cisplatin; 1: paclitaxel cisplatin; 1: tamoxifene), and 2 patients received chemotherapy for metastatic disease.For a median follow up of 63,44 months, 5 (18,51%) of patients relapsed. The median time to relapse was 41,8 months, (range : 18-62 months).The overall 5-year survival and 9-year survival rates for all stages were 91.3% and 77.3%, respectively. Following univariate Cox regression modeling, the survival depends on stage, it’s better in localized stages (p = 0,05). Conclusions: Granulosa cell tumor of the ovary is an uncommon neoplasm. The adult form progresses slowly and often is diagnosed in an early stage of disease. Surgery is indicated. A prolonged post therapeutic follow-up is necessary because of the risk of recurrences, late and exceptional for the adult form.