{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T20:15:08Z","timestamp":1789676108608,"version":"4.0.1"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T00:00:00Z","timestamp":1680480000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>This study aimed to describe the clinicopathological characteristics of recurrent adult granulosa cell tumor and identify the risk factors for recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Seventy recurrent adult granulosa cell tumor patients treated in Peking Union Medical College Hospital between 2000 and 2020 were retrospectively reviewed. The primary outcomes were progression\u2010free survival after first recurrence (PFS\u2010R), overall survival after first recurrence (OS\u2010R) and recurrence frequency. The Kaplan\u2013Meier analysis, univariate and multivariate Cox proportional hazard analysis, and the Prentice, Williams and Peterson counting process (PWP\u2010CP) model were adopted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 70 patients included in the study, and recurrence occurred twice in more than 71% of patients, and 49.9% of patients relapsed \u2265 three times. The recurrence pattern in over half of the patients at first recurrence was multifocal and distant disease, and abdominal or pelvic mass and liver metastasis were the most common. The 5\u2010year PFS\u2010R was 29.3%, and the 10\u2010year PFS\u2010R was 11.3%; the 5\u2010year OS\u2010R was 94.9%, and the 10\u2010year OS\u2010R was 87.9%. Kaplan\u2013Meier analysis demonstrated that patients with distant recurrence and PFS1 (PFS when first recurrence occurred) \u226460\u2009months had worse PFS\u2010R (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.017, 0.018), and patients with PFS\u2010R\u2009\u2264\u200934\u2009months had worse OS\u2010R (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.023). It demonstrated that PFS1\u2009\u2264\u200960\u2009months (hazard ratio, HR 1.9, 95% confidence interval [CI]: 1.1\u20133.4, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.028) was an independent risk factor for PFS\u2010R, and local lesion at recurrence (HR 0.488, 95% CI: 0.3\u20130.9, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.027) was an independent protective factor for PFS\u2010R. In addition, it demonstrated that PFS\u2010R\u2009\u2264\u200933\u2009months (HR 5.5, 95% CI: 1.2\u201325.3<jats:italic>, p<\/jats:italic>\u00a0=\u00a00.028) was an independent risk factor for OS\u2010R. The PWP\u2010CP analysis showed that laparoscopic operation (at each operation) could significantly increase recurrence times (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.002, HR\u00a0=\u00a03.4), and no existence of gross residual lesion (R0) at each recurrence operation could significantly decrease recurrence frequency (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, HR\u2009&lt;0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The recurrence pattern in patients with recurrent adult granulosa cell tumor was characterized as late and repeated, multifocal, and distant relapse. It has been demonstrated that PFS1\u2009\u2264\u200960\u2009months and distant lesion at recurrence are independent risk factors for PFS\u2010R, and PFS\u2010R\u2009\u2264\u200933\u2009months is an independent risk factor for OS\u2010R. The PWP\u2010CP model showed that the transabdominal approach and surgery reaching R0 could significantly decrease the recurrence frequency.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14558","type":"journal-article","created":{"date-parts":[[2023,4,4]],"date-time":"2023-04-04T02:27:27Z","timestamp":1680575247000},"page":"782-790","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Clinical characteristics and oncological outcomes of recurrent adult granulosa cell tumor of ovary: A retrospective study of seventy patients"],"prefix":"10.1111","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5683-8078","authenticated-orcid":false,"given":"Yu","family":"Gu","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &amp; Peking Union Medical College  Beijing China"},{"name":"National Clinical Research Center for Obstetric &amp; Gynecologic Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &amp; Peking Union Medical College  Beijing China"},{"name":"National Clinical Research Center for Obstetric &amp; Gynecologic Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Congwei","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Pathology, Peking Union Medical College Hospital Chinese Academy of Medical Sciences &amp; Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihua","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &amp; Peking Union Medical College  Beijing China"},{"name":"National Clinical Research Center for Obstetric &amp; Gynecologic Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Cang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &amp; Peking Union Medical College  Beijing China"},{"name":"National Clinical Research Center for Obstetric &amp; Gynecologic Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xirun","family":"Wan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &amp; Peking Union Medical College  Beijing China"},{"name":"National Clinical Research Center for Obstetric &amp; Gynecologic Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junjun","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &amp; Peking Union Medical College  Beijing China"},{"name":"National Clinical Research Center for Obstetric &amp; Gynecologic Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9112-1021","authenticated-orcid":false,"given":"Yang","family":"Xiang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &amp; Peking Union Medical College  Beijing China"},{"name":"National Clinical Research Center for Obstetric &amp; Gynecologic Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,4,3]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/cjp2.198"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2021.09.013"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14189"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.2147\/OTT.S155473"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13048-020-00619-6"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.5301\/tj.5000510"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2016.10.002"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjog.2014.12.007"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1438.2007.01065.x"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2016.03.081"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2021.06.024"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2019.01.016"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2021.08.012"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0412.2001.801120.x"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.2001.6183"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/4547892"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-021-06305-2"},{"key":"e_1_2_12_19_1","first-page":"3495","article-title":"Adult\u2010type granulosa cell tumor of the ovary","volume":"12","author":"Li X","year":"2022","journal-title":"Am J Cancer Res"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/IGC.0000000000000659"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2014.06.021"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2013.04.047"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12720"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-8258(02)00141-5"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13048-018-0396-x"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14122998"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.136773"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/path.5771"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.14558","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T10:36:43Z","timestamp":1743849403000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.14558"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,3]]},"references-count":27,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1111\/aogs.14558"],"URL":"https:\/\/doi.org\/10.1111\/aogs.14558","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,3]]},"assertion":[{"value":"2022-11-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}