Adult Granulosa Cell Tumors of the Ovary: A RetrospectiveStudy of 36 FIGO Stage I Cases with Emphasis on PrognosticPathohistological Features

Objective. Adult granulosa cell tumors (AGCTs) represent 2%–5% of all ovarian malignancies. The aim of this study was to analyzeclinical and pathohistological parameters and their impact on recurrence, overall, and disease-free survival in FIGO stage I AGCTpatients.Methods.The tumor specimens analyzed in this retrospective study were obtained from a total of 36 patients withdiagnosis of ovarian AGCT surgically treated at the Department of Gynecology, Rijeka University Hospital Centre, between1994 and 2012. Clinical, pathological, and follow-up data were collected.Results.The mean age at diagnosis was 54.5 years witha range of 24–84. The majority of the patients, 30 (83%), were in FIGO stage IA, 3 (8%) in stage IC1, 1 (3%) in stage IC2, and 2(6%) in stage IC3. During follow-up period (median 117.5 months, range 26–276), recurrence occurred in 4 patients (12%) with2 deaths of the disease recorded. In univariate analysis, the 5-year survival rates were significantly shorter in patients with FIGOsubstage IC (p=0019), with positive LVSI (p=0022), with presence of necrosis (p=0040), and with hemorrhage (p=0017).In univariate analysis, the 5-year disease-free survival rates were significantly shorter in patients treated with fertility surgery(p=0004), with diffuse growth pattern (p=0012), with moderate and severe nuclear atypia (p=0032), and with presence ofhemorrhage (p=0022). FIGO substage IC proved to be independent predictor for recurrence (OR = 16.87,p=0015, andOR = 23.49,p=0023, resp.) and disease-free survival (p=00002; HR 20.84,p=002) at the uni- and multivariate analyses.Conclusions.FIGO substage IC is predictive of recurrence and disease-free survival in patients with early-stage AGCTs. LVSI,presence of necrosis and hemorrhage, diffuse growth pattern, and nuclear atypia in AGCTs seem to be associated with overalland disease-free survival, so these pathological features should be taken into consideration when managing patients with AGCT.