An examination of Japanese cases of gynecological cancer can help in understanding the characteristics of rare ovarian cancers and change treatment guidelines.
Ovarian granulosa tumors are a rare kind of ovarian cancer that affect the fallopian tubes and the ovaries and can spread into the lymph nodes and pelvis. Treatment generally follows the same guidelines as other cancers of the ovary and typically sees lymph nodes removed surgically.
Researchers from Hokkaido University and their colleagues have looked into the disease and treatment of hundreds of women suffering from ovarian cancer cells tumors. They suggest that some cases may be treated more conservatively. The findings, published in the journal Gynecologic Oncology, aid in understanding how the disease progresses and responds to treatment.
This study had the main goal to improve our understanding of the pathological, clinical and prognostic features of ovarian cancer granulosa cell tumors.
Yasuhiko Ebina, Gynecological Oncologist, Hokkaido University
To investigate the disease, Ebina along with a team comprised of researchers from various Japanese universities visited the Gynecological Tumor Registry of the Japan Society of Obstetrics and Gynecology. They looked at the records of 1,426 patients in the registry who were diagnosed with ovarian-related granulosa cell tumors between 2002 and 2015. This is the biggest cohort study of cancer of the ovary in Asia and is the second largest sample size for cancers of ovarian granulosa cells in the scientific literature.
The registry found that less than 2percent of women were diagnosed with this type of cancer. The median age was 55. Importantly, microscopic examinations of lymph node tissue that was removed during surgery revealed that early-stage tumors do not spread beyond the ovaries or fallopian tubes.
The team discovered a less favorable prognosis among patients with cancers that had spread to the ovaries and tubes. Patients whose tumors hadn’t been removed during surgery had lower survival rates five years later.
The study also found that women under the age of 50 who had surgery to safeguard fertility (typically by removing an early-stage tumor, or the affected tube and ovary) did not have a less favorable prognosis. This suggests that fertility-saving surgery is a possibility for women who are in the early stages of the disease.
“Our findings have led us to conclude that the dissection of lymph nodes can be avoided when the surgeon discovers that the tumor is restricted to the ovarian and fallopian tube tissue after a thorough examination of the abdominal cavity,” says Ebina. “At the same the same time, as much the tumor must be removed as much as is possible to ensure that any residual tissue is not left at the end of the initial surgery. “
Ebina, Y., and. (2021) Clinicopathological characteristics and prognostic indicators of ovarian granulosa cell tumors: A joint study of JSGO and JSOG. Gynecologic Oncology. doi.org/10.1016/j.ygyno.2021.08.012.
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