Single tertiary care centre experience of ovarian granulosa cell tumour in Chennai, India: a retrospective analysis

Deenadayalan T., S. Lakshmi Narasimhan, K. Kalaichelvi, B. Ramkumar, Kanchana Madurai Padmanabhan


Background: Granulosa cell tumours of ovary are rare sex-cord stromal tumours characterized by long natural history and favourable prognosis. The present study was done to evaluate the clinical presentation, treatment, outcome, and prognostic factors for patients diagnosed as granulosa cell tumours.

Methods: A Retrospective study of Granulosa cell tumour of the ovary was done for a period of five years from January 2011 to December 2015 at a tertiary care centre, Institute of Obstetrics and Gynaecology, Madras Medical College, Chennai. The clinical data and the treatment details were retrieved from the records of medical oncology department and the data were analysed.

Results: Twenty five patients were diagnosed as granulose cell tumours of ovary during the study period. The median patient age was 48 years. The most common clinical presentation at diagnosis was vaginal bleeding (76%) followed by abdominal pain (40%). Mean tumor size was 9.6cm. The majority of patients were diagnosed in FIGO stage Ia (84%, n = 21). Thirteen patients (52%) underwent complete staging laparotomy. Twenty three patients (92%) had Adult Granulosa cell tumour. Two patients (8%)had juvenile Granulosa cell tumour. After surgery, all patients were put on observation except two patients who received adjuvant chemotherapy (EP: Etoposide, Cisplatin). The median followup period was 48 months. Five patients (20%) had recurrence; The average time to relapse was 29.6 months. Patients who had tumour size more than 9.7cm had more recurrence events (Hazard Ratio(HR):1.058), but their association is not significant (P value-0.839). The association between menopausal status, torsion of tumour mass, tumour stage with recurrence rate were not significant. The estimated mean overall survival was 84.8 months. Following univariate Cox regression modeling, survival appeared to be independent of age range, post operative residual tumour and the FIGO stage.

Conclusions: Granulosa cell tumours of ovary are rare, often diagnosed in early stage. Patients who had tumour size of more than 9.7cm had more recurrence events. A prolonged post therapeutic follow-up is necessary to pick up the late relapses.


Chemotherapy, Granulosa cell tumour, Juvenile granulosa cell tumour, Metastasis, Recurrence

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