Effectiveness of adjuvant systemic therapy following complete cytoreductive surgery in patients with recurrent granulosa cell tumours of the ovary.
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
10 Jan 2024
10 Jan 2024
Historique:
received:
09
09
2023
accepted:
09
01
2024
medline:
11
1
2024
pubmed:
11
1
2024
entrez:
10
1
2024
Statut:
epublish
Résumé
Aim of the present analysis is to compare the impact of antihormonal therapy versus cytotoxic chemotherapy versus a watch a wait approach on disease-free survival (DFS) in the adjuvant setting of patients who underwent complete cytoreductive surgery(CRS) for recurrent adult type granulosa cell tumours of the ovary (GCT). Moreover, we wished to identify prognostic risk factors for recurrence. We included recurrent GCT-patients who underwent CRS resulting in total macroscopic tumour clearance, treated in two gynaecological cancer centres over a 20-year period (2000-2020). CRS was performed for 51 recurrences in 26 GCT-patients. Adjuvant systemic treatments were as follows: chemotherapy in 21 cases, hormonotherapy in 10 cases, no systemic treatment in 20 cases. There were no statistically significant differences in DFS between chemotherapy, hormonotherapy and no systemic treatment: median DFS was 57, 36 and 57 months, respectively (p = 0.616). Extra-pelvic and/or multifocal tumour dissemination were found to be independent predictive factors for subsequent recurrences. In the cases with both lower and upper abdominal involvement (n = 18), patients who received chemotherapy (n = 9) had longer DFS than those who had hormonotherapy (n = 2) or no adjuvant therapy (n = 7) at all: median DFS was 36, 13 and 15 months, respectively (p = 0.9). Our findings do not encourage the administration of adjuvant therapy following complete CRS for GCT-relapse. Selected high-risk patients with disseminated disease may derive clinical benefit from additional chemotherapy, larger-scale multicentre studies are warranted to define treatment algorithms for this rare disease.
Identifiants
pubmed: 38200105
doi: 10.1038/s41598-024-51752-x
pii: 10.1038/s41598-024-51752-x
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
993Informations de copyright
© 2024. The Author(s).
Références
Seagle, B. L., Ann, P., Butler, S. & Shahabi, S. Ovarian granulosa cell tumor: A National Cancer Database study. Gynecol. Oncol. 146, 285–291. https://doi.org/10.1016/j.ygyno.2017.05.020 (2017).
doi: 10.1016/j.ygyno.2017.05.020
pubmed: 28532858
Fotopoulou, C. et al. Adult granulosa cell tumors of the ovary: Tumor dissemination pattern at primary and recurrent situation, surgical outcome. Gynecol. Oncol. 119(2), 285–290. https://doi.org/10.1016/j.ygyno.2010.06.031 (2010).
doi: 10.1016/j.ygyno.2010.06.031
pubmed: 20637497
Ovarian Cancer guideline (ver. 5. 2022). NCCN Clinical Practice Guidelines in Oncology. Available online: https://www.nccn.org/professionals/physician_gls/pdf/ovarian.pdf
Alhilli, M. M., Long, H. J., Podratz, K. C. & Bakkum-Gamez, J. N. Aromatase inhibitors in the treatment of recurrent ovarian granulosa cell tumors: Brief report and review of the literature. J. Obstet. Gynaecol. Res. 38, 340–344 (2012).
doi: 10.1111/j.1447-0756.2011.01698.x
pubmed: 22136798
ESGO Rare Cancers guideline. Available online: https://guidelines.esgo.org/rare-cancers-algorithms/
Ray-Coquard, I. et al. Gynecologic Cancer InterGroup (GCIG) consensus review for ovarian sex cord stromal tumors. Int. J. Gynecol. Cancer. 24, S42–S47. https://doi.org/10.1097/IGC.0000000000000249 (2014).
doi: 10.1097/IGC.0000000000000249
pubmed: 25341579
Berek, J. S., Renz, M., Kehoe, S., Kumar, L. & Friedlander, M. Cancer of the ovary, fallopian tube, and peritoneum: 2021 update. Int. J. Gynaecol. Obstet. 155(Suppl 1), 61–85. https://doi.org/10.1002/ijgo.13878 (2021).
doi: 10.1002/ijgo.13878
pubmed: 34669199
pmcid: 9298325
Gurumurthy, M., Bryant, A. & Shanbhag, S. Effectiveness of different treatment modalities for the management of adult-onset granulosa cell tumours of the ovary (primary and recurrent). Cochrane Database Syst. Rev. 2014, CD006912. https://doi.org/10.1002/14651858.CD006912.pub2 (2014).
doi: 10.1002/14651858.CD006912.pub2
pubmed: 24753008
pmcid: 6513416
Brink, G. J., Groeneweg, J. W., Hooft, L., Zweemer, R. P. & Witteveen, P. O. Response to systemic therapies in ovarian adult granulosa cell tumors: A literature review. Cancers (Basel) 14(12), 2998. https://doi.org/10.3390/cancers14122998 (2022).
doi: 10.3390/cancers14122998
pubmed: 35740663
Foster, K. I. et al. Clinical outcomes of leuprolide acetate in the treatment of recurrent ovarian granulosa cell tumors. Am. J. Obstet. Gynecol. 228(6), 724.e1-724.e9. https://doi.org/10.1016/j.ajog.2023.02.029 (2023).
doi: 10.1016/j.ajog.2023.02.029
pubmed: 36907533
Meisel, J. L. et al. The role of systemic chemotherapy in the management of granulosa cell tumors. Gynecol. Oncol. 136(3), 505–511. https://doi.org/10.1016/j.ygyno.2014.12.026 (2015).
doi: 10.1016/j.ygyno.2014.12.026
pubmed: 25546114
Mangili, G. et al. Recurrent granulosa cell tumors (GCTs) of the ovary: A MITO-9 retrospective study. Gynecol. Oncol. 130(1), 38–42. https://doi.org/10.1016/j.ygyno.2013.04.047 (2013).
doi: 10.1016/j.ygyno.2013.04.047
pubmed: 23623833
Nakai, H. et al. Clinical determinants affecting indications for surgery and chemotherapy in recurrent ovarian granulosa cell tumor. Healthcare (Basel) 7(4), 145. https://doi.org/10.3390/healthcare7040145 (2019).
doi: 10.3390/healthcare7040145
pubmed: 31739624
Zhao, D. et al. Characteristics and treatment results of recurrence in adult-type granulosa cell tumor of ovary. J. Ovarian Res. 13(1), 19. https://doi.org/10.1186/s13048-020-00619-6 (2020).
doi: 10.1186/s13048-020-00619-6
pubmed: 32059683
pmcid: 7020364
Zhuang, Y. & Yang, H. The prognostic significance of adjuvant chemotherapy in adult ovarian granulosa cell tumors: A systematic review and meta-analysis. Cancer Control 30, 10732748231215164. https://doi.org/10.1177/10732748231215165 (2023).
doi: 10.1177/10732748231215165
pubmed: 37957122
pmcid: 10644757
Gu, Y. et al. Clinical characteristics and oncological outcomes of recurrent adult granulosa cell tumor of ovary: A retrospective study of seventy patients. Acta Obstet. Gynecol. Scand. 102(6), 782–790. https://doi.org/10.1111/aogs.14558 (2023).
doi: 10.1111/aogs.14558
pubmed: 37012211
pmcid: 10201956
Shim, S. H. et al. A Long-term follow-up study of 91 cases with ovarian granulosa cell tumors. Anticancer Res. 34(2), 1001–1010 (2014) (PMID: 24511046).
pubmed: 24511046
van Meurs, H. S., van Lonkhuijzen, L. R., Limpens, J., van der Velden, J. & Buist, M. R. Hormone therapy in ovarian granulosa cell tumors: A systematic review. Gynecol. Oncol. 134(1), 196–205. https://doi.org/10.1016/j.ygyno.2014.03.573 (2014).
doi: 10.1016/j.ygyno.2014.03.573
pubmed: 24713548
Moon, A. S. & Dorigo, O. Long-term efficacy of megestrol acetate and tamoxifen in a recurrent adult granulosa cell tumor of the ovary. Gynecol. Oncol. Rep. 36, 100770. https://doi.org/10.1016/j.gore.2021.100770 (2021).
doi: 10.1016/j.gore.2021.100770
pubmed: 34013014
pmcid: 8113997
Brown, J. et al. Efficacy and safety of bevacizumab in recurrent sex cord-stromal ovarian tumors: Results of a phase 2 trial of the Gynecologic Oncology Group. Cancer 120(3), 344–351. https://doi.org/10.1002/cncr.28421 (2014).
doi: 10.1002/cncr.28421
pubmed: 24166194
Ray-Coquard, I. et al. Effect of weekly paclitaxel with or without bevacizumab on progression-free rate among patients with relapsed ovarian sex cord-stromal tumors: The ALIENOR/ENGOT-ov7 randomized clinical trial. JAMA Oncol. 6(12), 1923–1930. https://doi.org/10.1001/jamaoncol.2020.4574 (2020).
doi: 10.1001/jamaoncol.2020.4574
pubmed: 33030515
Pilsworth, J. A. et al. Adult-type granulosa cell tumor of the ovary: A FOXL2-centric disease. J. Pathol. Clin. Res. 7(3), 243–252. https://doi.org/10.1002/cjp2.198 (2021).
doi: 10.1002/cjp2.198
pubmed: 33428330
pmcid: 8072996