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  • Title: Prognostic factors responsible for survival in sex cord stromal tumors of the ovary--an analysis of 376 women.
    Author: Zhang M, Cheung MK, Shin JY, Kapp DS, Husain A, Teng NN, Berek JS, Osann K, Chan JK.
    Journal: Gynecol Oncol; 2007 Feb; 104(2):396-400. PubMed ID: 17030354.
    Abstract:
    OBJECTIVE: To evaluate prognostic factors that impact on the survival of women with ovarian sex cord stromal tumors (SCST). METHODS: Data including age at diagnosis, stage, histology, grade, treatment, and survival were extracted from the 1988-2001 Surveillance, Epidemiology, and End Results Program. Kaplan-Meier and Cox proportional hazards analyses were used to determine the predictors for survival. RESULTS: 376 women (median age: 51) with ovarian sex cord stromal cell tumors were identified, including 339 with granulosa cell and 37 with Sertoli-Leydig cell tumors. 265 (71%) patients had stage I, 39 (10%) stage II, 40 (11%) stage III, and 32 (8%) had stage IV disease. Women with stage I-II disease had a 5-year disease-specific survival of 95% compared to 59% in those with stage III-IV cancers (p<0.001). Patients<or=50 years had a survival advantage over those>50 years (93% vs. 84%, p<0.001). This age-associated survival advantage was observed for early (97% vs. 92%, p=0.003), but not for advanced-staged (68% vs. 53%, p=0.09) patients. 110 patients with stage I-II disease underwent conservative surgery without hysterectomy. The survival for this group was similar to patients who underwent a standard surgery including a hysterectomy (94.8% and 94.9%, p=0.38). On multivariate analysis, age<or=50 (p=0.001) and early-stage disease (p<0.001) remained significant prognostic factor for improved survival. CONCLUSIONS: Younger age and early-stage disease are important predictors for improved survival in patients with ovarian sex cord stromal tumors. Conservative surgical treatment for early-staged patients wishing to retain fertility appears to be a safe alternative.
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