Survival outcomes and treatment patterns in malignant ovarian sex cord-stromal tumors: A population-based analysis

IF 4.1 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Gynecologic oncology Pub Date : 2025-10-16 DOI:10.1016/j.ygyno.2025.10.007

Uisuk Kim , Byeong-Chan Oh , Jaekyung Bae , Sokbom Kang

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引用次数: 0

Abstract

Objective

This study aimed to evaluate treatment patterns and survival outcomes by histologic subtype and stage in malignant ovarian sex cord-stromal tumors (SCSTs), focusing on the impact of adjuvant chemotherapy to inform histology-specific treatment strategies.

Methods

This retrospective cohort study identified adult patients newly diagnosed with malignant ovarian SCSTs using nationwide claims data from Korea (2012–2019). Patients were classified into granulosa-type and other subtypes. Treatment patterns, including upfront cytoreductive surgery and adjuvant chemotherapy, were described. Overall survival (OS) and time to first subsequent therapy or death (TFST) were estimated using Kaplan–Meier methods and compared across subgroups. In localized-stage patients undergoing upfront surgery, the association between adjuvant chemotherapy and survival outcomes was further evaluated. Sensitivity and landmark analyses assessed the robustness of findings.

Results

Among 314 patients (256 granulosa-type and 58 non-granulosa), localized disease was more common in both groups (granulosa-type: 68.4 %, non-granulosa: 67.2 %). Most patients received upfront cytoreductive surgery (granulosa-type: 88.7 %, non-granulosa: 89.7 %, overall: 88.9 %), while adjuvant chemotherapy was more commonly administered in non-granulosa tumors. In the localized-stage subgroup, adjuvant chemotherapy was associated with longer TFST in non-granulosa SCSTs (5-year TFST: 94.1 % vs. 61.9 %), whereas no significant benefit was observed in granulosa-type tumors. OS remained high (>85 %) across all histologic subtypes and treatment.

Conclusions

This study supports upfront cytoreductive surgery as the primary treatment for ovarian SCSTs and suggests the role of adjuvant chemotherapy should be guided by histologic subtype. These findings support histology-driven treatment strategies and the need for prospective studies to optimize individualized management.

查看原文本刊更多论文

恶性卵巢性索间质瘤的生存结局和治疗模式：一项基于人群的分析。

目的：本研究旨在评估恶性卵巢性索间质瘤（SCSTs）的组织学亚型和分期的治疗模式和生存结果，重点关注辅助化疗的影响，为组织特异性治疗策略提供信息。方法：本回顾性队列研究使用韩国2012-2019年全国索赔数据，确定新诊断为恶性卵巢SCSTs的成年患者。患者分为颗粒型和其他亚型。治疗模式，包括前期细胞减少手术和辅助化疗，被描述。使用Kaplan-Meier方法估计总生存期（OS）和到首次后续治疗或死亡的时间（TFST），并在亚组间进行比较。在接受前期手术的局部期患者中，进一步评估辅助化疗与生存结果之间的关系。敏感性和里程碑分析评估了研究结果的稳健性。结果：314例患者（颗粒型256例，非颗粒型58例）中，两组均以局限性病变多见（颗粒型68.4%，非颗粒型67.2%）。大多数患者接受了前期细胞减缩手术（颗粒型：88.7%，非颗粒型：89.7%，总体：88.9%），而辅助化疗更常见于非颗粒性肿瘤。在局部期亚组中，辅助化疗与非颗粒性SCSTs中更长的TFST相关（5年TFST: 94.1% vs. 61.9%），而在颗粒型肿瘤中没有观察到明显的益处。在所有组织学亚型和治疗中，OS仍然很高（bbb85 %）。结论：本研究支持前期细胞减少手术作为卵巢SCSTs的主要治疗方法，并提示辅助化疗的作用应根据组织学亚型进行指导。这些发现支持组织学驱动的治疗策略和前瞻性研究的需要，以优化个体化管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gynecologic oncology 医学-妇产科学

CiteScore

8.60

自引率

6.40%

发文量

1062

审稿时长

37 days

期刊介绍： Gynecologic Oncology, an international journal, is devoted to the publication of clinical and investigative articles that concern tumors of the female reproductive tract. Investigations relating to the etiology, diagnosis, and treatment of female cancers, as well as research from any of the disciplines related to this field of interest, are published. Research Areas Include: • Cell and molecular biology • Chemotherapy • Cytology • Endocrinology • Epidemiology • Genetics • Gynecologic surgery • Immunology • Pathology • Radiotherapy