{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:23:28Z","timestamp":1790061808677,"version":"4.0.1"},"reference-count":16,"publisher":"Wiley","license":[{"start":{"date-parts":[[2018,1,1]],"date-time":"2018-01-01T00:00:00Z","timestamp":1514764800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["International Journal of Surgical Oncology"],"published-print":{"date-parts":[[2018]]},"abstract":"<jats:p><jats:italic>Background.<\/jats:italic> Adult granulosa cell tumors (AGCTs) are the most common sex cord-stromal tumors. Unlike epithelial ovarian tumors, they occur in young women and are usually detected at an early stage. The aim of this study was to report the clinical and pathological characteristics of AGCT patients and to identify the prognostic factors.<jats:italic> Methods.<\/jats:italic> All cases of AGCTs, treated at Salah Aza\u00efz Institute between 1995 and 2010, were retrospectively included. Kaplan-Meier\u2019s statistical method was used to assess the relapse-free survival and the overall survival.<jats:italic> Results.<\/jats:italic> The final cohort included 31 patients with AGCT. The mean age was 53 years (35\u201373 years). Patients mainly presented with abdominal mass and\/or pain (61%, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn fontstyle=\"italic\">19<\/mml:mn><\/mml:math>). Mean tumor size was 20\u2009cm. The majority of patients had a stage I disease (61%,\u2009\u2009<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn fontstyle=\"italic\">19<\/mml:mn><\/mml:math>). Two among 3 patients with stage IV disease had liver metastasis. Mitotic index was low in 45% of cases (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\"><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn fontstyle=\"italic\">14<\/mml:mn><\/mml:math>). Surgical treatment was optimal in almost all cases (90%, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\"><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn fontstyle=\"italic\">28<\/mml:mn><\/mml:math>). The median follow-up time was 14 years (1\u2013184 months). Ten patients relapsed (32%) with a median RFS of 8.4 years (6.8\u20139.9 years). Mean overall survival was 13 years (11\u201315 years). Stage I disease and low-to-intermediate mitotic index were associated with a better prognosis in univariate analysis (resp., <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\"><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn fontstyle=\"italic\">0.05<\/mml:mn><\/mml:math> and <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\"><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn fontstyle=\"italic\">0.02<\/mml:mn><\/mml:math>) but were not independent prognostic factors.<jats:italic> Conclusion.<\/jats:italic> GCTs have a long natural history with common late relapses. Hence, long active follow-up is recommended. In Tunisian patients, hepatic metastases were more frequent than occidental series. The prognosis remains good and initial staging at diagnosis is an important prognostic factor.<\/jats:p>","DOI":"10.1155\/2018\/4547892","type":"journal-article","created":{"date-parts":[[2018,3,29]],"date-time":"2018-03-29T19:32:46Z","timestamp":1522351966000},"page":"1-4","source":"Crossref","is-referenced-by-count":22,"title":["Granulosa Cell Tumor of the Ovary: A Retrospective Study of 31 Cases and a Review of the Literature"],"prefix":"10.1155","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9180-8261","authenticated-orcid":true,"given":"Manel","family":"Dridi","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Salah Aza\u00efz Institute, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nesrine","family":"Chraiet","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Salah Aza\u00efz Institute, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rim","family":"Batti","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Salah Aza\u00efz Institute, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mouna","family":"Ayadi","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Salah Aza\u00efz Institute, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amina","family":"Mokrani","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Salah Aza\u00efz Institute, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khedija","family":"Meddeb","sequence":"additional","affiliation":[{"name":"Department 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