Recurrence of Adult Granulosa Cell Tumors: The Factors Affecting Secondary Recurrence and Survival After Recurrence

Ege, Hasan; Bagaran, Derman; GÜLTEKİN, MURAT; Ozgul, Nejat; Boran, Nurattin; KOÇ, Sevgi; ÜSTÜN, Yaprak; ÇAKIR, Caner; Yüksel, Dilek; Oktar, Okan; Ege, Gökçen; Tokalıoğlu, Abdurrahman; Şahin, Mustafa; Uçar, Yeşim; Kılıç, Fatih; Aytekin, Okan; Ersak, Burak; Ünsal, Mehmet; Tekin, Özlem; Kılıç, Çiğdem; Koçak, Özgür; Öztürk, Çağatayhan; Taşkın, Salih; Ortaç, Fırat; ÜREYEN, Işın; TOPTAŞ, Tayfun; BAŞ, Sevda; NARİN, Mehmet; Taşçı, Tolga; Uçar, Gökhan; Şendur, Mehmet; Civelek, Burak; Uncu, Doğan; Erdoğan, Özgür; SANCI, Muzaffer; YALÇIN, Hakan; Selçuk, İlker; Turan, Taner

doi:10.7150/jca.127596

Recurrence of Adult Granulosa Cell Tumors: The Factors Affecting Secondary Recurrence and Survival After Recurrence

Ege H. V., Bagaran D., GÜLTEKİN M., Ozgul N., Boran N., KOÇ S., ...Daha Fazla

Journal of Cancer, cilt.17, sa.3, ss.637-645, 2026 (SCI-Expanded, Scopus)

Yayın Türü: Makale / Tam Makale
Cilt numarası: 17 Sayı: 3
Basım Tarihi: 2026
Doi Numarası: 10.7150/jca.127596
Dergi Adı: Journal of Cancer
Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, Directory of Open Access Journals, Academic Search Ultimate (EBSCO), Health Research Premium Collection (ProQuest)
Sayfa Sayıları: ss.637-645
Anahtar Kelimeler: adult granulosa cell tumors, complete cytoreduction, recurrence, salvage chemotherapy
Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Introduction: Adult-type granulosa cell tumors (AGCTs) are rare ovarian neoplasms with a low overall incidence of recurrence, and also data on secondary recurrence and survival after relapse remain limited. This study aimed to identify factors associated with secondary recurrence and survival after recurrence in patients with recurrent AGCTs. Methods: This multicenter retrospective study included 52 patients with recurrent AGCTs identified among 484 patients treated between 2000 and 2023. Clinical characteristics, treatment modalities, and outcomes were analyzed, with a particular focus on factors associated with secondary recurrence and survival after first recurrence. Recurrence-free survival and overall survival after first recurrence (OS-FR) were evaluated using Kaplan–Meier analysis. Results: The mean follow-up duration was 99.2 ± 61.5 months. Secondary recurrence occurred in 17 patients (32.7%). A serum CA-125 level >35 U/mL at the time of first recurrence was significantly associated with an increased risk of secondary recurrence (p=0.01). Factors significantly associated with improved OS-FR included a CA-125 level ≤35 U/mL at initial diagnosis and at first recurrence, absence of residual disease following surgery for the first recurrence, and administration of salvage chemotherapy (all p<0.05). In subgroup analysis, salvage chemotherapy was associated with improved OS-FR in patients with residual disease or those who did not undergo surgery (p < 0.01), but not in patients who achieved complete cytoreduction (p = 0.67). Conclusions: Secondary recurrence remains a significant clinical challenge in AGCTs. Serum CA-125 levels, surgical outcomes at first recurrence, and the use of salvage chemotherapy may help management strategies in recurrent disease.