Prognostic factors responsible for survival in sex cord stromal tumors of the ovary--an analysis of 376 women

Gynecol Oncol. 2007 Feb;104(2):396-400. doi: 10.1016/j.ygyno.2006.08.032. Epub 2006 Oct 9.


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.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Child
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Staging
  • Ovarian Neoplasms / mortality*
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / surgery*
  • Prognosis
  • Proportional Hazards Models
  • Risk Factors
  • Sex Cord-Gonadal Stromal Tumors / mortality*
  • Sex Cord-Gonadal Stromal Tumors / pathology
  • Sex Cord-Gonadal Stromal Tumors / surgery*
  • Survival Rate
  • Treatment Outcome