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Abstract: The MITO-9 study
Highlights
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- No clear evidence of benefit from adjuvant therapy in stage I patients has been demonstrated.
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- Surgical staging seems to be an independent prognostic factor.
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- In our study no difference in DFS between stage IC patients administered adjuvant therapy versus no treatment.
Objective
Evidence-based
management of granulosa cell tumors of the ovary (GCT) has been not yet
standardized: surgery, including fertility-sparing procedures for young
women, has been traditionally the standard treatment; on the other
hand, chemotherapy has been used for treatment of advanced and/or
recurrent disease. However, very limited experience, has been
selectively focused on the role of adjuvant chemotherapy in stage IC
patients. The objective of this retrospective study was to assess the
efficacy of first line postoperative chemotherapy in patients with stage
IC treated at the Italian Centers involved in the MITO (Multicenter
Italian Trials in Ovarian cancer) Group.
Patients and methods
A
retrospective multi-institutional review of patients with GCT of the
ovary at FIGO stage IC treated or referred to MITO centers was
conducted. Surgical outcome, pathological findings and follow-up data
were analysed. Kaplan–Meier and Cox proportional hazards analyses were
used to determine the predictors factors for disease free survival.
Results
A
total of 40 patients with primary GCT of the ovary at FIGO stage IC
were identified. The median follow-up period was 96 months (range
7–300). At multivariate analysis, surgical treatment outside MITO
centers and incomplete surgical staging were independent poor prognostic
indicators for recurrence; adjuvant chemotherapy did not retain
significant predictive value for recurrence.
Conclusions
This
study raises the question about the value of adjuvant chemotherapy in
stage IC GCT: a comprehensive evaluation of a larger series is urgently
needed in order to characterize stage IC substages who can be spared
treatment toxicity.
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