Impact of surgical modalities on the survival of stage I adult-type ovarian granulosa cell tumor: a comprehensive analysis of 101 cases.

Background: Only small-sample retrospective studies have been performed to assess the efficacy of current treatment modalities for adult-type ovarian granulosa cell tumor. Therefore, we retrospectively evaluated patients with stage I AGCT admitted to our center over the past two decades and systematically analyzed the impact of different surgical modalities on the survival of these patients.

Methods: All patients with stage I AGCT treated in Sun Yat-sen University Cancer Center from May 1998 to April 2020 were enrolled and analyzed in this retrospective study.

Results: A total of 101 patients with stage I AGCT were identified, among whom 49 were stage Ia and 52 were stage Ic. The median follow up was 47.7 months. The 10-year cancer specific survival (CSS) and disease-free survival (DFS) rates were 90% and 53%, respectively. Multivariate analysis showed that only surgical extent (conservative vs. radical, HR: 2.738, p-value = 0.034) was an independent prognostic factor for disease-free survival. Subgroup analysis suggested that both surgical extent and surgical approach had a significant impact on the disease-free survival of patients with stage Ic (conservative vs. radical, HR: 4.021, p-value = 0.007; laparoscopic vs. open, HR: 2.926, p-value = 0.035) and tumor larger than 5 cm (conservative vs. radical, HR: 4.437, p-value = 0.001; laparoscopic vs. open, HR: 3.367, p-value = 0.006).

Conclusions: Patients with stage I AGCT generally have a favorable prognosis. Surgical extent is an independent prognostic factor. For high risk patients with stage Ic disease or tumor larger than 5 cm, our study supports the selection of radical and open surgery as a potentially preferred option.