Impact of Different Prognostic Factors on the Survival of Patients with Malignant Granulosa Cell Tumors of the Ovary: An Institutional Based Study at the Egyptian National Cancer Institute

Author(s): Ihab Samy Fayek MD, Alfred Elias Namour MD, Nelly Alieldin MD, Iman Gouda Farahat MD

Introduction: Emphasizing and evaluating different prognostic factors including the age, size of the tumor, type of surgery, capsular infiltration and administration of adjuvant chemotherapy, which may affect the disease free survival (DFS) and overall survival (OS) in patients with malignant Granulosa cell tumors (MGCTs).

Patients and Methods: A retrospective study of 36 female patients diagnosed with MGCTs and managed at the National Cancer Institute – Cairo University-Egypt, in the period from May 2007 –October 2012. Follow –up reached up to 116 months (3-116 mo.) with a median of 72 months. Prognostic factors as the age, size of the tumor, type of surgery, capsular infiltration and administration of adjuvant chemotherapy with number of cycles in correlation with DFS and OS were statistically analyzed to detect any significant correlation.

Results: The median age was 44 years. The median tumor size was 12 cm. The median DFS was 41.9 months. The median OS was 45.0 months. The disease free survival (DFS) was not significantly affected by the size of the tumor (<10 cm/ ≥10 cm) nor the type of surgery (Panhysterectomy or salpingo-oophorectomy) nor administration of adjuvant chemotherapeutic agents where p-value=0.4487, 0.8471 and 0.0986 respectively. However, capsular invasion significantly affected the DFS (p-value=0.0076). The overall survival (OS) was not affected by the size of the tumor (<10 cm/ ≥10 cm) with a nearly significant correlation (p=0.0615). No statistical significance on OS regarding the type of surgery (Panhysterectomy or salpingo-oophorectomy) (p=0.7792), the capsular affection (p=0.0871), nor the adjuvant chemotherapeutic administration (p= 0.2848).

Conclusion: Capsular infiltration is by far the most independent prognostic factor affecting disease free survival (DFS) in patients with malignant granulosa cell tumors an