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Less extensive surgery compared to extensive surgery: survival seems similar in young women with adult ovarian granulosa cell tumor.

Eur J Obstet Gynecol Reprod Biol. 2014 Jun;177:61-6. doi: 10.1016/j.ejogrb.2014.02.037. Epub 2014 Mar 12.

Lauszus FF1, Petersen AC2, Neumann G3, Cleemann L4, Rosgaard A5, Jørgensen A6, Vandborg M7, Jakobsen A8.
1Department of Gynecology and Obstetrics at Herning, Denmark; Department of Gynecology and Obstetrics at Holstebro, Denmark. Electronic address: finlau@rm.dk.2Department of Pathology, Aalborg University Hospital, Denmark.3Department of Gynecology and Obstetrics at Herning, Denmark.4Department of Gynecology and Obstetrics at Holstebro, Denmark.5Department of Gynecology and Obstetrics at Viborg, Denmark.6Department of Gynecology and Obstetrics at Aalborg, Denmark.7Department of Gynecology and Obstetrics at Herning, Denmark; Department of Gynecology and Obstetrics at Holstebro, Denmark.8Department of Radiology, Vejle Hospital, Denmark.
Eur J Obstet Gynecol Reprod Biol
ABSTRACT
OBJECTIVE: To describe the outcome of adult granulosa cell tumor (AGCT) with respect to initial clinical findings, methods of surgery, and perioperative treatment.STUDY DESIGN: Retrospective follow-up study. Setting: All hospitals in Jutland. Sample: 163 women diagnosed with AGCT. Methods: Follow-up by hospital data files, general practitioner, death certificate, and autopsy report. Revision of histopathology by a single pathologist. Main outcome measures: Survival and relapse by clinical data, stage, and type of surgery.RESULTS: The incidence of AGCT was 1.37 per year per 100,000 women (95% CI: 1.08, 1.68). The median follow-up time was 15 years and for the 79 surviving women 22 years. Stage I was found in 94% of cases. Relapse occurred in 24% of women in stage I and 100% of the other stages. Survival in stage I was 95%, 89% and 84% after 5, 10 and 20 years respectively. Increased survival of stage I in postmenopausal women was associated with surgery including hysterectomy and bilateral oophorectomy (p<0.001). In women younger than 40 years no difference in survival was found due to type of surgery. Endometrial carcinoma was found 138 times (95% CI: 48, 275) more prevalent than the expected rate.CONCLUSION: The survival of women was better in AGCT than in epithelial ovarian tumor. Age and type of surgery, besides stage, influenced survival. Total abdominal hysterectomy and bilateral salpingo-oophorectomy is the recommended treatment with advancing age. At younger age less extensive surgery was associated with similar survival compared to extensive surgery, but with advancing age conservative surgery increased the risk of relapse and death.Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Full Text Source: Elsevier Science
PMID:24698496 | http://www.ncbi.nlm.nih.gov/pubmed/24698496

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