TY - JOUR
T1 - Adjuvant chemotherapy does not improve disease-free survival in FIGO stage IC ovarian granulosa cell tumors
T2 - The MITO-9 study
AU - Mangili, Giorgia
AU - Ottolina, Jessica
AU - Cormio, Gennaro
AU - Loizzi, Vera
AU - De Iaco, Pierandrea
AU - Pellegrini, Domenica
AU - Candiani, Massimo
AU - Giorda, Giorgio
AU - Scarfone, Giovanna
AU - Cecere, Sabrina
AU - Frigerio, L.
AU - Gadducci, A.
AU - Marchetti, Claudia
AU - Ferrandina, Gabriella
PY - 2016/11/1
Y1 - 2016/11/1
N2 - Objective Evidence-based management of granulosa cell tumors of the ovary (GCT) has been not yet standardized: surgery, including fertility-sparing procedures for young women, has been traditionally the standard treatment; on the other hand, chemotherapy has been used for treatment of advanced and/or recurrent disease. However, very limited experience, has been selectively focused on the role of adjuvant chemotherapy in stage IC patients. The objective of this retrospective study was to assess the efficacy of first line postoperative chemotherapy in patients with stage IC treated at the Italian Centers involved in the MITO (Multicenter Italian Trials in Ovarian cancer) Group. Patients and methods A retrospective multi-institutional review of patients with GCT of the ovary at FIGO stage IC treated or referred to MITO centers was conducted. Surgical outcome, pathological findings and follow-up data were analysed. Kaplan–Meier and Cox proportional hazards analyses were used to determine the predictors factors for disease free survival. Results A total of 40 patients with primary GCT of the ovary at FIGO stage IC were identified. The median follow-up period was 96 months (range 7–300). At multivariate analysis, surgical treatment outside MITO centers and incomplete surgical staging were independent poor prognostic indicators for recurrence; adjuvant chemotherapy did not retain significant predictive value for recurrence. Conclusions This study raises the question about the value of adjuvant chemotherapy in stage IC GCT: a comprehensive evaluation of a larger series is urgently needed in order to characterize stage IC substages who can be spared treatment toxicity.
AB - Objective Evidence-based management of granulosa cell tumors of the ovary (GCT) has been not yet standardized: surgery, including fertility-sparing procedures for young women, has been traditionally the standard treatment; on the other hand, chemotherapy has been used for treatment of advanced and/or recurrent disease. However, very limited experience, has been selectively focused on the role of adjuvant chemotherapy in stage IC patients. The objective of this retrospective study was to assess the efficacy of first line postoperative chemotherapy in patients with stage IC treated at the Italian Centers involved in the MITO (Multicenter Italian Trials in Ovarian cancer) Group. Patients and methods A retrospective multi-institutional review of patients with GCT of the ovary at FIGO stage IC treated or referred to MITO centers was conducted. Surgical outcome, pathological findings and follow-up data were analysed. Kaplan–Meier and Cox proportional hazards analyses were used to determine the predictors factors for disease free survival. Results A total of 40 patients with primary GCT of the ovary at FIGO stage IC were identified. The median follow-up period was 96 months (range 7–300). At multivariate analysis, surgical treatment outside MITO centers and incomplete surgical staging were independent poor prognostic indicators for recurrence; adjuvant chemotherapy did not retain significant predictive value for recurrence. Conclusions This study raises the question about the value of adjuvant chemotherapy in stage IC GCT: a comprehensive evaluation of a larger series is urgently needed in order to characterize stage IC substages who can be spared treatment toxicity.
KW - Adjuvant chemotherapy
KW - Granulosa cell tumors of the ovary
KW - MITO
KW - Prognostic factors
KW - Relapse
KW - Stage IC
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U2 - 10.1016/j.ygyno.2016.08.316
DO - 10.1016/j.ygyno.2016.08.316
M3 - Article
VL - 143
SP - 276
EP - 280
JO - Gynecologic Oncology
JF - Gynecologic Oncology
SN - 0090-8258
IS - 2
ER -