OUTCOMES AMONG PATIENTS WITH SEX CORD STROMAL TUMOUR OF OVARY: EXPERIENCE FROM PAKISTAN

Authors

  • Sohail Sarwar
  • Neelam Siddiqui
  • Sohail Ather
  • Abdul Hannan
  • Amir Ali Syed
  • Waleed Zafar

Abstract

Background: Ovarian sex cord-stromal tumours (SCST) are relatively uncommon neoplasms that account for approximately 5–7% of all primary ovarian tumours. The aim was to report experience with sex cord stromal tumours (SCST) of ovary in a low and middle income country. Methods: Clinical records of 56 patients with histopathologically-established SCST of ovary admitted to a tertiary care cancer hospital in Pakistan between April 1995 and December 2011 were reviewed. Results: Median age at presentation was 41 years (Range 4–77). Forty one (73%) patients were premenopausal and 15 (26.8%) were postmenopausal. The most common presenting complaint was abdominal pain (28.1%). Thirty seven patients (66%) had stage–I, 2 had stage II and III each, and 15 (26.8%) had stage IV disease. Five years survival in patients with early stage (stages I & II) was 91% while in those in the late stage (III & IV) was 84% (p=0.79). Histopathologically, 49 patients (85.7%) had Granulosa cell tumour, and 7 (12.5%) had Sertoli Lyedig cell tumour. CA-125 was high only in 8 patients (14.3%). Adjuvant chemotherapy was given in 16 (28.6%). Thirty six (64%) were disease free at last follow up, 10 (18%) succumbed to disease and 10 (18%) were alive with disease. On univariate and multivariate analyses, late stage at presentation was the sole factor significantly associated with mortality. Conclusion: Ovarian sex cord-stromal tumours of ovary are relatively uncommon malignancies with good prognosis if diagnosed early and treated adequately. Survival in our study was comparable to those reported elsewhere. Among various factors, late stage of tumour at presentation was found to be the only factor significantly associated with mortality.Keywords: Sex Cord Stromal Tumour, Ovary, Granulosa cell tumour, Prognosis

References

Koonings PP, Campbell K, Mishell DR, Jr., Grimes DA. Relative frequency of primary ovarian neoplasms: a 10-year review. Obstet Gynecol 1989;74:921–6.

Deavers MT, Malpica A, Liu J, Broaddus R, Silva EG. Ovarian sex cord-stromal tumours: an immunohistochemical study including a comparison of calretinin and inhibin. Mod Pathol 2003;16(6):584–90.

Baker PM, Oliva E. Immunohistochemistry as a tool in the differential diagnosis of ovarian tumours: an update. Int J Gynecol Pathol 2005;24(1):39–55.

McCluggage WG, Young RH. Immunohistochemistry as a diagnostic aid in the evaluation of ovarian tumours. Semin Diagn Pathol 2005;22(1):3–32.

Savage P, Constenla D, Fisher C, Shepherd JH, Barton DP, Blake P, et al. Granulosa cell tumours of the ovary: demographics, survival and the management of advanced disease. Clin Oncol (R Coll Radiol)1998;10:242–5.

Ohel G, Kaneti H, Schenker JG. Granulosa cell tumours in Israel: a study of 172 cases. Gynecol Oncol 1983;15:278–6.

Bouffet E, Dyon JF, Armari C, Bost M. Granulosa cell tumours of the ovary in children and adolescents. Multicentre retrospective study in 40 patients aged 7 months to 22 years. Arch Fr Pediatr 1992;49:793–8.

Evans AT, 3rd, Gaffey TA, Malkasian GD, Jr, Annegers JF. Clinicopathologic review of 118 granulosa and 82 theca cell tumours. Obstet Gynecol 1980;55:231–8.

Stenwig JT, Hazekamp JT, Beecham JB. Granulosa cell tumours of the ovary. A clinicopathological study of 118 cases with long-term follow-up. Gynecol Oncol 1979;7:136–52.

Fox H, Agrawal K, Langley FA. A clinicopathologic study of 92 cases of granulosa cell tumour of the ovary with special reference to the factors influencing prognosis.Cancer 1975;35:231–41.

Zhang M, Cheung MK, Shin JY, Kapp DS, Husain A, Teng NN, et al. Prognostic factors responsible for survival in sex cord stromal tumours of the ovary--an analysis of 376 women. Gynecol Oncol 2007;104:396–400.

Published

2014-09-01