Evaluation of prognostic factors of sex cord stromal tumors: a single-center experience

Year 2026, Volume: 7 Issue: 2, 344 - 348, 27.03.2026

Belma Gözde Özdemir , Meltem Aydoğdu , Rabia Nur Sağlam , İpek Münteha Erdemli Kara , Duygu Çalık , Murat Çelik , Mustafa Gazi Uçar , Ahmet Bilgi , Çetin Çelik

https://izlik.org/JA82PM66FY

Abstract

Aims: Sex cord stromal tumors (SCSTs) constitute a rare subgroup of ovarian tumors, exhibiting heterogeneous clinical course and prognosis. The aim of this study is to evaluate clinicopathological factors affecting prognosis in patients with SCSTs based on single-center experience.
Methods: This retrospective study included patients diagnosed with SCSTs at Selçuk University between 2010-2025. Demographic characteristics, tumor type, tumor stage, tumor size, mitotic index, surgical approach, adjuvant therapy status, and follow-up duration were recorded. Factors affecting prognosis were analyzed in terms of overall survival and disease-free survival.
Results: A total of 94 patients with ovarian SCSTs were included in the study. Granulosa cell tumors constituted the most common histopathological subtype (n=41, 43.6%), followed by fibroma/thecoma (n=25, 26.6%) and other SCSTs (n=28, 29.8%). The mean age at diagnosis was 58.0±14.6 years. Tumor recurrence was observed in 5 patients (5.3%). At the last follow-up, 79 patients (84.0%) were alive and 15 patients (16.0%) had died. Adjuvant therapy was administered to 6 patients (6.4%), all of whom belonged to the other SCST group. Recurrence and mortality were more frequently observed in granulosa cell tumor and other SCST subgroups.
Conclusion: In SCSTs, stage, mitotic activity, and residual disease after surgery are important factors in determining prognosis. Early diagnosis and optimal cytoreduction positively influence disease-free and overall survival. Larger patient series and multicenter studies with long-term follow-up are needed.

Keywords

Sex cord stromal tumors , ovarian tumors , prognostic factors , granulosa cell tumor , survival

Ethical Statement

Ethical approval Number: E-70632468-050.01-1192823

Supporting Institution

none

Project Number

none

Thanks

No conflict of interest.

References

• Young RH. Ovarian sex cord-stromal tumors: reflections on a 40-year experience with a fascinating group of tumors, including comments on the seminal observations of Robert E. Scully, MD. Arch Pathol Lab Med. 2018;142(12):1459-1484. doi:10.5858/arpa.2018-0291-RA
• Schumer ST, Cannistra SA. Granulosa cell tumor of the ovary. J Clin Oncol. 2003;21(6):1180-1189. doi:10.1200/JCO.2003.10.019
• Colombo N, Parma G, Zanagnolo V, Insinga A. Management of ovarian stromal cell tumors. J Clin Oncol. 2007;25(20):2944-2951. doi:10.1200/JCO.2007.11.1005
• Mangili G, Ottolina J, Gadducci A, et al. Long-term follow-up is crucial after treatment for granulosa cell tumours of the ovary. Br J Cancer. 2013;109(1):29-34. doi:10.1038/bjc.2013.241
• Ayhan A, Salman MC, Velipasaoglu M, Sakinci M, Yuce K. Prognostic factors in adult granulosa cell tumors of the ovary: a retrospective analysis of 80 cases. J Gynecol Oncol. 2009;20(3):158-163. doi:10.3802/jgo.2009.20.3.158
• Sun HD, Lin H, Jao MS, et al. A long-term follow-up study of 176 cases with adult- type ovarian granulosa cell tumors. Gynecol Oncol. 2012; 124(2):244-249. doi:10.1016/j.ygyno.2011.10.015
• Thrall MM, Paley P, Pizer E, Garcia R, Goff BA. Patterns of spread and recurrence of sex cord-stromal tumors of the ovary. Gynecol Oncol. 2011;122(2):242-245. doi:10.1016/j.ygyno.2011.03.020
• Prat J; FIGO Committee on Gynecologic Oncology. Staging classification for cancer of the ovary, fallopian tube, and peritoneum. Int J Gynaecol Obstet. 2014;124(1):1-5. doi:10.1016/j.ijgo.2013.10.001
• Seagle BL, Ann P, Butler S, Shahabi S. Ovarian granulosa cell tumor: a National Cancer Database study. Gynecol Oncol. 2017;146(2):285-291. doi:10.1016/j.ygyno.2017.05.020
• Kim U, Oh BC, Bae J, Kang S. Survival outcomes and treatment patterns in malignant ovarian sex cord-stromal tumors: a population-based analysis. Gynecol Oncol. 2025;202:146-153. doi:10.1016/j.ygyno.2025.10.007
• Zhang M, Cheung MK, Shin JY, et al. Prognostic factors responsible for survival in sex cord stromal tumors of the ovary--an analysis of 376 women. Gynecol Oncol. 2007;104(2):396-400. doi:10.1016/j.ygyno.2006. 08.032
• van Meurs HS, van Lonkhuijzen LR, Limpens J, van der Velden J, Buist MR. Hormone therapy in ovarian granulosa cell tumors: a systematic review. Gynecol Oncol. 2014;134(1):196-205. doi:10.1016/j.ygyno. 2014. 03.573
• Thomakos N, Biliatis I, Koutroumpa I, et al. Prognostic factors for recurrence in early stage adult granulosa cell tumor of the ovary. Arch Gynecol Obstet. 2016;294(5):1031- 1036. doi:10.1007/s00404-016-4135-5
• Prat J. Ovarian sex cord-stromal tumours. WHO Classification of Tumours of Female Reproductive Organs. 4th ed. Lyon: IARC; 2014.
• Shah SP, Köbel M, Senz J, et al. Mutation of FOXL2 in granulosa-cell tumors of the ovary. N Engl J Med. 2009;360(26):2719-2729. doi:10.1056/NEJMoa0902542
• Färkkilä A, Haltia UM, Tapper J, McConechy MK, Huntsman DG, Heikinheimo M. Pathogenesis and treatment of adult-type granulosa cell tumor of the ovary. Ann Med. 2017;49(5):435-447. doi:10.1080/07853890. 2017.1294760
• Young RH, Scully RE. Ovarian Sertoli-Leydig cell tumors. A clinicopathological analysis of 207 cases. Am J Surg Pathol. 1985;9(8):543-569. doi:10.1097/00000478- 198508000-00001
• Gershenson DM. Management of ovarian germ cell tumors. J Clin Oncol. 2007;25(20):2938-2943. doi:10.1200/JCO.2007.10.8738
• Colombo N, Peiretti M, Garbi A, et al. Non-epithelial ovarian cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2012;23(Suppl 7):vii20-vii26. doi:10.1093/annonc/mds223
• Miller BE, Barron BA, Wan JY, Delmore JE, Silva EG, Gershenson DM. Prognostic factors in adult granulosa cell tumor of the ovary. Cancer. 1997;79(10):1951-1955. doi:10.1002/(sici)1097-0142(19970515)79:10<1951:: aid-cncr16>3.0.co;2-u
• Ranganath R, Sridevi V, Shirley SS, Shantha V. Clinical and pathologic prognostic factors in adult granulosa cell tumors of the ovary. Int J Gynecol Cancer. 2008;18(5):929-933. doi:10.1111/j.1525-1438.2007.01154.x