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DOI: 10.1055/s-2003-43157
© Georg Thieme Verlag Stuttgart · New York
Stellenwert der systemischen Chemotherapie beim Granulosazelltumor des Ovars: Eine Langzeitanalyse von 25 Patientinnen
Chemotherapy for Granulosa Cell Tumors of the Ovary: A Review of 25 Patients with Long-term Follow-upPublication History
received: 27.11.2002
accepted: 23.4.2003
Publication Date:
05 November 2003 (online)

Zusammenfassung
Granulosazelltumoren sind seltene Tumoren und machen einen Anteil von etwa 2 - 3 % aller Ovarialtumoren aus. Auch wenn sich der Granulosazelltumor sowohl tumorbiologisch als auch prognostisch von den epithelialen Tumoren abgrenzen lässt, orientiert sich die Therapie an den Empfehlungen zum Ovarialkarzinom. Methodik: Im Rahmen einer multizentrischen, retrospektiven Studie wurden die Krankheitsverläufe von 25 Patientinnen mit einem histologisch gesicherten Granulosazelltumor des Ovars analysiert, die eine systemische Chemotherapie erhielten.Ergebnisse: Das mediane Alter der Patientinnen zum Zeitpunkt der Chemotherapie lag bei 51 Jahren (Spannbreite 26 - 75 Jahre). Hierzu zählten neun Patientinnen mit Stadium I, neun Patientinnen mit Stadium II - IV und sieben Patientinnen wurden in der Rezidivsituation behandelt. Das mediane Follow-up betrug 98 Monate (Spannbreite 6 - 189 Monate). Insgesamt wurden neun verschiedene Therapieregime eingesetzt, wobei nur in einem Fall diese als Monotherapie erfolgte. Bei 60 % der Patientinnen wurden platinhaltige Kombinationen appliziert. Die Überlebenszeiten zwischen der Behandlung mit platinhaltigen versus nichtplatinhaltigen Substanzen erwiesen sich als nicht signifikant unterschiedlich (p = 0,3). Diese Aussage ist jedoch aufgrund der sehr kleinen Fallzahl erheblich eingeschränkt. Das mittlere Gesamtüberleben aller Patientinnen, die eine Chemotherapie erhalten hatten, lag bei 96,6 Monaten (95 %-CI: 78,22 - 115,04 Monate), wobei das mediane Gesamtüberleben nicht erreicht wurde. Das mittlere Gesamtüberleben der Patientinnen mit fortgeschrittenem Tumorstadium oder Rezidiv lag bei 81,4 Monaten (95 %-CI: 53,8 - 108,9 Monate). Das mediane Gesamtüberleben wurde hierbei nicht erreicht. Schlussfolgerungen: Wegen der Seltenheit von Granulosazelltumoren sollte eine zentrale Datenerfassung erfolgen, die dann die Grundlage für die Konzeption von multizentrischen adjuvanten Studien sein können.
Abstract
Purpose Granulosa cell tumors account for 2 - 3 % of ovarian malignancies. Treatment recommendations are based loosely on those for ovarian carcinoma, although the two entitites differ considerably in tumor biology and prognosis. Methods: We reviewed 25 women (median age, 51 years; range, 26 - 75) who received chemotherapy after surgery for ovarian granulosa cell tumors. Eighteen patients received adjuvant chemotherapy as a component of primary treatment (9 FIGO stage I, 9 stage II - IV) and seven after recurrence. Nine chemotherapy regimens were used and 15 patients received platinum-based regimens. Results: The median follow-up was 98 months (range, 6 - 189). Although the number of patients was small, there was no significant difference in overall survival between patients who received platinum-based regimens and those who received chemotherapy without platinum. The average overall survival was 96.6 months (95 % CI, 78 - 115). The average overall survival of women with stage II - IV disease or recurrence was 81.4 months (95 % CI, 54 - 109). Conclusion: The rarity of ovarian granulsa cell tumors suggests a need for a central registry and prospective studies to compare chemotherapy regimens.
Schlüsselwörter
Granulosazelltumor - Ovarialtumor - Chemotherapie - Langzeitergebnisse
Key words
Granulosa cell tumor - tumor of the ovary - chemotherapy - long term follow-up
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Dr. Jalid Sehouli
Klinik für Frauenheilkunde und Geburtshilfe Charité, Campus Virchow-Klinikum Medizinische Fakultät der Humboldt-Universität zu Berlin
Augustenburger Platz 1
13353 Berlin
Email: sehouli@aol.com