Clinical Retrospective Analyses Of 167 Ovary Sex Cord Stromal Tumors

Objective:To investigate the clinicopathologic characteristics of sex cord stromal tmors of ovary. To analyze the prognostic factors for women with malignant sex cord stromal tumors of ovary. To evaluate the possibility of fertility-preserving therapy for stage I patients and the effect of adjuvant chemotherapy on survival and fertility.Methods: Patients' medical records, pathologic and follow-up information of 167 cases of sex stromal tumors of ovary from 1985-2006 in Qilu Hospital of ShanDong University. Kaplan-Meier and Cox proportional hazards analyses were used to identify predictors of outcome.Results:1. The median age was 45.5 years, presented with symptoms of pelvic mass(41.32%), abdominal pain (29.34%), abnormal vaginal bleeding (25.75%), some patients were asymptomatic. 2. One hundred and ten cases were innocence and had a better outcomes, none of them died of SCST after surgery. 3. Fifty-seven cases with SCST were malignant, including 39 of stage I, 4 of stage II and 14 of stage III. The 5 year survival of stage I was 91.7% while it was 11% in stage II and III (P<0.001) .4. Patients with tumor less than 10cm in diameter had a survival advantage over those large than 10cm( 100% vs 60.4%, P=0.018). 5.There was no significant difference in overall survival between patients with different age, surgery, and chemotherapy (P=0.08, 0.87and 0.23 respectively) . 6. No significant correlation could be established between different operation method, adjuvant chemotherapy and survival rate in thirty-nine Stage I cases(P=0.39 and 0.24 respectively). And adjuvant chemotherapy could not improve survival rate in cases with high risk factors, including tumor rupture, tumor size>10cm and positive peritoneal cytology either. 7. Stage remained to be independent prognostic factor in Cox proportional hazards analyses.Conclusions: Endocrine disturbance and pelvic mass are the most common complaints. Clinico-pathologic stage and diameter of tumor are important prognostic factors for patients with malignant ovarian sex cord stromal tumors. Conservative surgery for stage I patient wishing to preserve fertility appears to be a safe alternative. Adjuvant chemotherapy couldn't improve survival rate, including for patients with high risk factors.