The Prognostic Factors Of Adult Granulosa Cell Tumor Of The Ovary:A Meta-Analysis

Objective:Through collect clinical case studies related to the prognosis of adult granulosa cell tumor of the ovary,The tumor staging,treatment methods,clinical pathology,and general basic characteristics were analyzed by evidence-based medicineto explore the relevant factors that affect overall survival and provide some theoretical support for guiding clinical treatment.Research Methods:We mainly searched China National Knowledge Infrastructure(CNKI),China Biomedical Literature Database(CBM),Wanfang Database,VIP,Pubmed,EMBase,Cochrane Library and other databases,and retrieved relevant references.Search for studies related to prognosis of adult ovarian granulosa cell tumors before December 2019.Two researchers conducted document selection,quality evaluation,and data extraction through the established of strict inclusion and exclusion criteria,then Stata 15.1 software was used to perform statistical analysis and draw conclusions.Research Results:This study finally included 27 related literatures,including 18 Chinese literatures and 9 English literatures,and a total of 1581 patients.The statistical results were as follows:1.There was no significant difference in 5-year overall survival between patients aged?40 years and aged>40 years old(OR=0.87,95%CI [0.38,2.02],P=0.753).2.There was no significant difference in 5-year overall survival compared with tumor diameters>10 cm and?10 cm(OR=0.18,95%CI [0.03,1.04],P=0.056),but the data included in this study were few and need further verification.3.The 5-year overall survival of stage I was higher than that of stage II-IV,which was statistically significant(OR=14.11,95%CI [7.81,25.49],P=0.000).4.surgical approaches:(1)Regardless of overall analysis or stage I,the 5-year overall survival of radical surgery was higher than that ofconservative surgery,andthe difference was statistically significant(OR=0.45,95%CI [0.20,0.99],P= 0.047;OR=0.21,95%CI [0.05,0.93],P=0.040);(2)There was no significant difference in 5-year overall survival and 10-year overall survival between cystectomy and unilateral appendectomy(OR=0.92,95%CI[0.15,5.77],P=0.929;OR=0.97,95%CI [0.20,4.70],P=0.968);(3)Whether to perform lymph node dissection,there was no significant difference in 5-year overall survival and 10-year overall survival(OR=1.57,95%CI[0.65,3.79],P=0.314;OR=0.89,95%CI [0.39,2.05],P=0.790).5.The 5-year overall survival of patients with residual tumors was significantly reduced(OR=0.08,95%CI [0.03,0.18],P=0.000).6.There was no significant difference in the effect of adjuvant therapy on the5-year overall survival(OR=1.42,95%CI [0.27,7.40],P=0.677),but can significantly improve the 10-year overall survival(OR=3.16,95%CI [1.09,9.19],P=0.035);Whether stage I patients undergo adjuvant chemotherapy,it had no significant difference in5-year overall survival and 10-year overall survival(OR=1.35,95%CI [0.50,3.62],P=0.280;OR= 2.13,95%CI [0.81,5.66],P=0.127).7.The 5-year overall survival of patients with mitosis figures ?4/10 HPF was significantly improved(OR=0.09,95%CI [0.03,0.22],P= 0.000).8.The 5-year overall survival for patients with poorly differentiated tumors was significantly reduced(OR=0.07,95%CI [0.02,0.21],P=0.000).9.The recurrence with surgery combined with adjuvant chemotherapy had a better prognosis than patients with surgery or adjuvant therapy(OR=6.10,95%CI [1.3727.05],P=0.017).Conclusion:1.Age,tumor diameter and lymph node dissection had no significant effect on the overall survival of patients with adult granulosa cell tumor of the ovary.2.Radical surgery can increase the overall survival and improve the prognosis,but the conclusion was not stable and need further verification.3.FIGO stage,clinicopathological characteristics and residual tumor wereimportant factors affecting prognosis,FIGO II-IV,mitosis figures > 4/10 HPF,poorly differentiated tumors and residual tumor as adverse prognostic factors.4.Overall analysis,adjuvant therapy had no significant effect on the short-term overall survival,but affected long-term overall survival.For patients with FIGO I stage,adjuvant chemotherapy had no significant effect on short-term and long-term overall survival.5.Surgery combined with adjuvant therapy can improve the overall survival of patients with recurrence.