A 20 YEARS’ EXPERIENCE ON GRANULOSA CELL TUMOUR
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 26
Abstract
BACKGROUND The prognostic factors and the recurrent nature of Granulosa cell tumour is unclear. Chemotherapy has a compelling role in locally advanced cases, inoperable cases and metastatic cases. This retrospective study results elucidate the need for chemotherapy in advanced cases which then translates to a better overall survival benefit, increased disease free survival and delay in progression. The prognostic factors and the recurrent nature of Granulosa cell tumour is unclear and unpredictable added to the fact that these tumours are rare and have an indolent course. There is only a scarce data on the optimum treatment for this group of patient. The aim of this study was to pursue the clinico-pathological features and prognostic factors for the recurrence patterns and the optimal management of these cases. MATERIALS AND METHODS This is a descriptive study with secondary data from records. A retrospective multi-institutional review of patients with GCTs of the ovary treated or referred were analysed. Surgical outcome, pathological details, chemotherapy details, follow-up details, relapse pattern and the treatment of the relapse disease were analysed. Kaplan-Meier survival analysis was used to determine the prognostic and predictive markers for survival. RESULTS This is an analysis of the survival rate and the treatment results of Granulosa cell tumour between 1995 and 2015 over a period of 20 years. We have analysed the results of 126 patients, of which 53 patients (42%) were premenopausal and 73 patients (58%) were postmenopausal. Out of the 126 patients 84 patients had complete surgical staging which constitutes transabdominal hysterectomy and bilateral salpingo-oophorectomy and a staging laparotomy, 35 patients had incomplete or suboptimal surgery, 7 patients had fertility sparing operation. The 67 patients who had complete surgery and early stage disease with no risk factors were on observation. These patients have not had relapse. A dataset of 34 relapsed granulosa cell tumour patients were analysed. Out of these, 19 patients have survived cancer. Out of 34 cases, 10 patients had complete surgery and 15 patients had incomplete surgery including fertility preserving surgery. Kaplan-Meier survival analysis results show that cancer was cured by complete surgery followed in chemotherapy wherever high-risk factors were present, whereas the survival rate drastically declined in the cases of incomplete surgery without adjuvant chemotherapy. For patient’s stage of cancer size of the tumour, type of surgery done, tumour spill, histopathology and chemotherapy in positive high-risk parameters have relatively more effect on survival chance. CONCLUSION Granulosa cell tumours are known for their rarity. Chemotherapy has a compelling role in locally advanced cases, inoperable cases, metastatic cases, in cases with tumour spill or rupture, certain histopathological variants (such as juvenile granulosa cell tumour, yolk sac tumour) and tumours > 9 cm. Other factors which do contribute to the prognosis would be age at diagnosis, nuclear atypia, mitotic index, surgical method and presence of residual disease after initial surgery
Authors and Affiliations
P. Jovita M. Martin, Kalaichelvi K, Lakshminarasimhan Lakshminarasimhan, Ramkumar Ramkumar, Dheenadhayalan Dheenadhayalan
Keywords
Related Articles
- EP ID EP466466
- DOI 10.14260/jemds/2018/676
- Views 79
- Downloads 0
OCULAR MANIFESTATION AND LONG STANDING VISUAL IMPAIRMENT FOLLOWING VENOMOUS SNAKE BITE
[b] OBJECTIVE[/b]: Snake bite is an environmental hazard associated with significant ocular morbidity and some have sight threatening complications. Objective of this study was to determine the ocular manifest...
A MORPHOLOGICAL STUDY ON PATTERNS OF HUMAN CALCANEAL ARTICULAR FACETS FOR TALUS IN POPULATION OF BIHAR AND ITS CLINICAL IMPLICATIONS
BACKGROUND The calcaneum is the largest and strongest bone of all tarsal bones. It articulates above with talus to form talocalcaneal joint. In the middle third of superior surface, there is an oval shaped posterior arti...
CORRECTION OF MYOPIA USING CORNEA SPARING LASIK (ABLATION ON FLAP
Cornea sparing lasik is useful tool allowing surgeons to preserve the posterior stroma. The study comprised of prospective evaluation of 17 eyes treated with CSL – Cornea Sparing Lasik at Mahatme Eye Bank Eye...
IRRATIONAL PRESCRIBING OF ANTIBIOTICS FOR VIRAL RESPIRATORY TRACT INFECTIONS IN CHILDREN AGED 1 - 14 YEARS- A STUDY IN RURAL AREA OF CHANDU-BUDHERA
BACKGROUND During the winter season, viral respiratory tract infections are most common amongst children and prescribing of antibiotics has become a routine practice. This study was undertaken to know the extent of irrat...
EFFECT OF TOTAL SURGICAL TIME ON PATIENT’S COMPLAINT OF MOUTH OPENING AFTER TRANSALVEOLAR REMOVAL OF IMPACTED MANDIBULAR WISDOM TEETH- A RANDOMISED, CONTROLLED, CLINICAL TRIAL
BACKGROUND Trismus has a number of potential causes, the most common dental procedure leading to trismus is surgical removal of impacted wisdom tooth. Aim- To study the effect of total surgical time on post-operative tri...