The role of systemic chemotherapy in the management of granulosa cell tumors Journal Article

Authors: Meisel, J. L.; Hyman, D. M.; Jotwani, A.; Zhou, Q.; Abu-Rustum, N. R.; Iasonos, A.; Pike, M. C.; Aghajanian, C.
Article Title: The role of systemic chemotherapy in the management of granulosa cell tumors
Abstract: Objective: Granulosa cell tumors (GCTs) are rare, and the role of chemotherapy in their management is not clearly defined. Methods: We performed a retrospective cohort study of GCT patients diagnosed from January 1996 through June 2013 at the Memorial Sloan Kettering Cancer Center, comparing those who received adjuvant chemotherapy to those who did not. Differences between groups were assessed using the log-rank test. Statistical significance was set at p < 0.05. Results: Of 118 patients, 10 (8%) received adjuvant chemotherapy (1 [1%] of 103 stage I and 9 [60%] of 15 stage II-IV patients). Thirty-two patients (27%) experienced disease recurrence. Four patients had residual disease after initial surgery, and all received adjuvant chemotherapy; each recurred within 24.3 months (median PFS, 8.2 months). The time to first recurrence was longer in patients who did not receive adjuvant chemotherapy. For patients with recurrent disease, receiving chemotherapy after surgery for first recurrence did not seem to improve time to second recurrence versus surgery alone (HR 0.98; p = 0.965). Additionally, 12 patients (10%) had a previous diagnosis of breast cancer - an incidence rate 3.22 times higher than Surveillance, Epidemiology, and End Results (SEER) data predicts (p < 0.001). Conclusions: Although the numbers were small, in this analysis chemotherapy was not found to improve the recurrence-free interval of patients with GCTs, a finding that requires prospective validation. Residual disease after surgery was associated with poor prognosis. Finally, there was a significantly higher than expected incidence of antecedent breast cancer in this population, an association that deserves further exploration. © 2015 Elsevier Inc. All rights reserved.
Keywords: adult; cancer chemotherapy; cancer survival; aged; cancer surgery; major clinical study; overall survival; cancer recurrence; multimodality cancer therapy; systemic therapy; disease free survival; chemotherapy; cancer staging; follow up; carboplatin; progression free survival; breast cancer; etoposide; incidence; cohort analysis; recurrence; cyclophosphamide; retrospective study; cancer hormone therapy; ovary; body mass; minimal residual disease; adjuvant chemotherapy; granulosa cell tumor; bleomycin; tamoxifen; cancer registry; estrogen receptor; progesterone receptor; cancer prognosis; human; female; priority journal; article; granulosa cell tumors
Journal Title: Gynecologic Oncology
Volume: 136
Issue: 3
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2015-03-01
Start Page: 505
End Page: 511
Language: English
DOI: 10.1016/j.ygyno.2014.12.026
PROVIDER: scopus
PUBMED: 25546114
PMCID: PMC4532352
Notes: Export Date: 2 April 2015 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Malcolm Pike
    133 Pike
  2. Qin Zhou
    120 Zhou
  3. Alexia Elia Iasonos
    179 Iasonos
  4. David Hyman
    187 Hyman
  5. Jane Lowe Meisel
    9 Meisel