Abstract
Objective: About 30% of Adult type granulosa cell tumors of the ovary (AGCTs) are diagnosed in fertile age. In stage I, conservative surgery (fertility-sparing surgery, FSS), either unilateral salpingo-oophorectomy (USO) or cystectomy are possible options. The aim of this study is to compare oncological outcomes of FSS and radical surgery (RS) in apparently stage I AGCTs treated within the MITO group (Multicenter Italian Trials in Ovarian cancer). Methods: Survival curves were calculated using the Kaplan-Meier method and compared with log-rank test. The role of clinicopathological variables as prognostic factors for survival was assessed using Cox's regression. Results: Two-hundred and twenty-nine patients were included; 32.6% received FSS, 67.4% RS. In the FSS group, 62.8% underwent USO, 16.7% cystectomy, 20.5% cystectomy followed by USO. After a median follow up of 84 months, median DFS was significantly worse in the FSS-group (10 yr DFS 50% vs 74%, in FSS and RS group, p = 0.006). No significant difference was detected between RS and USO (10 yr DFS 75% vs 70%, p = 0.5).Cystectomy-group showed a significantly worse DFS compared to USO (10 yr DFS 16% vs 70%, p < 0.001). Patients receiving cystectomy and subsequent USO showed a better prognosis, even though significantly worse compared to USO (10 yr DFS 41% vs 70%, p = 0.05). Between FSS and RS, no difference in OS was detected. At multivariate analysis, FIGO stage IC and cystectomy retained significant predictive value for worse survival. Conclusions: This study supports the oncological safety of FSS in stage I AGCTs, provided that cystectomy is avoided; USO should be the preferred approach.
| Original language | English |
|---|---|
| Journal | Gynecologic Oncology |
| DOIs | |
| Publication status | Published - Jan 1 2019 |
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Keywords
- Cystectomy
- Fertility sparing surgery
- Granulosa cell tumors
- Ovary
- Unilateral oophorectomy
ASJC Scopus subject areas
- Oncology
- Obstetrics and Gynaecology
Cite this
Conservative surgery in stage I adult type granulosa cells tumors of the ovary : Results from the MITO-9 study. / Bergamini, A.; Cormio, G.; Ferrandina, G.; Lorusso, D.; Giorda, G.; Scarfone, G.; Bocciolone, L.; Raspagliesi, F.; Tateo, S.; Cassani, C.; Savarese, A.; Breda, E.; De Giorgi, U.; Mascilini, F.; Candiani, M.; Kardhashi, A.; Biglia, N.; Perrone, A. M.; Pignata, S.; Mangili, G.
In: Gynecologic Oncology, 01.01.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Conservative surgery in stage I adult type granulosa cells tumors of the ovary
T2 - Results from the MITO-9 study
AU - Bergamini, A.
AU - Cormio, G.
AU - Ferrandina, G.
AU - Lorusso, D.
AU - Giorda, G.
AU - Scarfone, G.
AU - Bocciolone, L.
AU - Raspagliesi, F.
AU - Tateo, S.
AU - Cassani, C.
AU - Savarese, A.
AU - Breda, E.
AU - De Giorgi, U.
AU - Mascilini, F.
AU - Candiani, M.
AU - Kardhashi, A.
AU - Biglia, N.
AU - Perrone, A. M.
AU - Pignata, S.
AU - Mangili, G.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Objective: About 30% of Adult type granulosa cell tumors of the ovary (AGCTs) are diagnosed in fertile age. In stage I, conservative surgery (fertility-sparing surgery, FSS), either unilateral salpingo-oophorectomy (USO) or cystectomy are possible options. The aim of this study is to compare oncological outcomes of FSS and radical surgery (RS) in apparently stage I AGCTs treated within the MITO group (Multicenter Italian Trials in Ovarian cancer). Methods: Survival curves were calculated using the Kaplan-Meier method and compared with log-rank test. The role of clinicopathological variables as prognostic factors for survival was assessed using Cox's regression. Results: Two-hundred and twenty-nine patients were included; 32.6% received FSS, 67.4% RS. In the FSS group, 62.8% underwent USO, 16.7% cystectomy, 20.5% cystectomy followed by USO. After a median follow up of 84 months, median DFS was significantly worse in the FSS-group (10 yr DFS 50% vs 74%, in FSS and RS group, p = 0.006). No significant difference was detected between RS and USO (10 yr DFS 75% vs 70%, p = 0.5).Cystectomy-group showed a significantly worse DFS compared to USO (10 yr DFS 16% vs 70%, p < 0.001). Patients receiving cystectomy and subsequent USO showed a better prognosis, even though significantly worse compared to USO (10 yr DFS 41% vs 70%, p = 0.05). Between FSS and RS, no difference in OS was detected. At multivariate analysis, FIGO stage IC and cystectomy retained significant predictive value for worse survival. Conclusions: This study supports the oncological safety of FSS in stage I AGCTs, provided that cystectomy is avoided; USO should be the preferred approach.
AB - Objective: About 30% of Adult type granulosa cell tumors of the ovary (AGCTs) are diagnosed in fertile age. In stage I, conservative surgery (fertility-sparing surgery, FSS), either unilateral salpingo-oophorectomy (USO) or cystectomy are possible options. The aim of this study is to compare oncological outcomes of FSS and radical surgery (RS) in apparently stage I AGCTs treated within the MITO group (Multicenter Italian Trials in Ovarian cancer). Methods: Survival curves were calculated using the Kaplan-Meier method and compared with log-rank test. The role of clinicopathological variables as prognostic factors for survival was assessed using Cox's regression. Results: Two-hundred and twenty-nine patients were included; 32.6% received FSS, 67.4% RS. In the FSS group, 62.8% underwent USO, 16.7% cystectomy, 20.5% cystectomy followed by USO. After a median follow up of 84 months, median DFS was significantly worse in the FSS-group (10 yr DFS 50% vs 74%, in FSS and RS group, p = 0.006). No significant difference was detected between RS and USO (10 yr DFS 75% vs 70%, p = 0.5).Cystectomy-group showed a significantly worse DFS compared to USO (10 yr DFS 16% vs 70%, p < 0.001). Patients receiving cystectomy and subsequent USO showed a better prognosis, even though significantly worse compared to USO (10 yr DFS 41% vs 70%, p = 0.05). Between FSS and RS, no difference in OS was detected. At multivariate analysis, FIGO stage IC and cystectomy retained significant predictive value for worse survival. Conclusions: This study supports the oncological safety of FSS in stage I AGCTs, provided that cystectomy is avoided; USO should be the preferred approach.
KW - Cystectomy
KW - Fertility sparing surgery
KW - Granulosa cell tumors
KW - Ovary
KW - Unilateral oophorectomy
UR - http://www.scopus.com/inward/record.url?scp=85067067462&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85067067462&partnerID=8YFLogxK
U2 - 10.1016/j.ygyno.2019.05.029
DO - 10.1016/j.ygyno.2019.05.029
M3 - Article
AN - SCOPUS:85067067462
JO - Gynecologic Oncology
JF - Gynecologic Oncology
SN - 0090-8258
ER -