Molecularly Defined Adult Granulosa Cell Tumor of the Ovary: The Clinical Phenotype

Melissa K McConechy, Anniina Färkkilä, Hugo M Horlings, Aline Talhouk, Leila Unkila-Kallio, Hannah S van Meurs, Winnie Yang, Nirit Rozenberg, Noora Andersson, Katharina Zaby, Saara Bryk, Ralf Bützow, Johannes B G Halfwerk, Gerrit K J Hooijer, Marc J van de Vijver, Marrije R Buist, Gemma G Kenter, Sara Y Brucker, Bernhard Krämer, Annette Staebler & 6 others Maaike C G Bleeker, Markku Heikinheimo, Stefan Kommoss, C Blake Gilks, Mikko Anttonen, David G Huntsman

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

The histopathologic features of adult granulosa cell tumors (AGCTs) are relatively nonspecific, resulting in misdiagnosis of other cancers as AGCT, a problem that has not been well characterized. FOXL2 mutation testing was used to stratify 336 AGCTs from three European centers into three categories: 1) FOXL2 mutant molecularly defined AGCT (MD-AGCT) (n = 256 of 336), 2) FOXL2 wild-type AGCT (n = 17 of 336), 3) misdiagnosed other tumor types (n = 63 of 336). All statistical tests were two-sided. The overall and disease-specific survival of the misdiagnosed cases was lower than in the MD-AGCTs (P < .001). The misdiagnosed cases accounted for 71.9% of disease-specific deaths within five years. In the population-based cohort, overall survival of MD-AGCT patients was not different from age-matched, population-based controls. Even though 35.2% of all the MD-AGCT patients in our study experienced a relapse, AGCT is usually an indolent disease. The historical, premolecular data underpinning our clinical understanding of AGCT was likely skewed by inclusion of misdiagnosed cases, and future management strategies should reflect the potential for surgical cure and long survival even after relapse.

Original languageEnglish
JournalJournal of the National Cancer Institute
Volume108
Issue number11
DOIs
Publication statusPublished - Nov 2016

Cite this

McConechy, M. K., Färkkilä, A., Horlings, H. M., Talhouk, A., Unkila-Kallio, L., van Meurs, H. S., ... Huntsman, D. G. (2016). Molecularly Defined Adult Granulosa Cell Tumor of the Ovary: The Clinical Phenotype. Journal of the National Cancer Institute, 108(11). https://doi.org/10.1093/jnci/djw134
McConechy, Melissa K ; Färkkilä, Anniina ; Horlings, Hugo M ; Talhouk, Aline ; Unkila-Kallio, Leila ; van Meurs, Hannah S ; Yang, Winnie ; Rozenberg, Nirit ; Andersson, Noora ; Zaby, Katharina ; Bryk, Saara ; Bützow, Ralf ; Halfwerk, Johannes B G ; Hooijer, Gerrit K J ; van de Vijver, Marc J ; Buist, Marrije R ; Kenter, Gemma G ; Brucker, Sara Y ; Krämer, Bernhard ; Staebler, Annette ; Bleeker, Maaike C G ; Heikinheimo, Markku ; Kommoss, Stefan ; Blake Gilks, C ; Anttonen, Mikko ; Huntsman, David G. / Molecularly Defined Adult Granulosa Cell Tumor of the Ovary : The Clinical Phenotype. In: Journal of the National Cancer Institute. 2016 ; Vol. 108, No. 11.
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abstract = "The histopathologic features of adult granulosa cell tumors (AGCTs) are relatively nonspecific, resulting in misdiagnosis of other cancers as AGCT, a problem that has not been well characterized. FOXL2 mutation testing was used to stratify 336 AGCTs from three European centers into three categories: 1) FOXL2 mutant molecularly defined AGCT (MD-AGCT) (n = 256 of 336), 2) FOXL2 wild-type AGCT (n = 17 of 336), 3) misdiagnosed other tumor types (n = 63 of 336). All statistical tests were two-sided. The overall and disease-specific survival of the misdiagnosed cases was lower than in the MD-AGCTs (P < .001). The misdiagnosed cases accounted for 71.9{\%} of disease-specific deaths within five years. In the population-based cohort, overall survival of MD-AGCT patients was not different from age-matched, population-based controls. Even though 35.2{\%} of all the MD-AGCT patients in our study experienced a relapse, AGCT is usually an indolent disease. The historical, premolecular data underpinning our clinical understanding of AGCT was likely skewed by inclusion of misdiagnosed cases, and future management strategies should reflect the potential for surgical cure and long survival even after relapse.",
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McConechy, MK, Färkkilä, A, Horlings, HM, Talhouk, A, Unkila-Kallio, L, van Meurs, HS, Yang, W, Rozenberg, N, Andersson, N, Zaby, K, Bryk, S, Bützow, R, Halfwerk, JBG, Hooijer, GKJ, van de Vijver, MJ, Buist, MR, Kenter, GG, Brucker, SY, Krämer, B, Staebler, A, Bleeker, MCG, Heikinheimo, M, Kommoss, S, Blake Gilks, C, Anttonen, M & Huntsman, DG 2016, 'Molecularly Defined Adult Granulosa Cell Tumor of the Ovary: The Clinical Phenotype' Journal of the National Cancer Institute, vol. 108, no. 11. https://doi.org/10.1093/jnci/djw134

Molecularly Defined Adult Granulosa Cell Tumor of the Ovary : The Clinical Phenotype. / McConechy, Melissa K; Färkkilä, Anniina; Horlings, Hugo M; Talhouk, Aline; Unkila-Kallio, Leila; van Meurs, Hannah S; Yang, Winnie; Rozenberg, Nirit; Andersson, Noora; Zaby, Katharina; Bryk, Saara; Bützow, Ralf; Halfwerk, Johannes B G; Hooijer, Gerrit K J; van de Vijver, Marc J; Buist, Marrije R; Kenter, Gemma G; Brucker, Sara Y; Krämer, Bernhard; Staebler, Annette; Bleeker, Maaike C G; Heikinheimo, Markku; Kommoss, Stefan; Blake Gilks, C; Anttonen, Mikko; Huntsman, David G.

In: Journal of the National Cancer Institute, Vol. 108, No. 11, 11.2016.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Molecularly Defined Adult Granulosa Cell Tumor of the Ovary

T2 - The Clinical Phenotype

AU - McConechy, Melissa K

AU - Färkkilä, Anniina

AU - Horlings, Hugo M

AU - Talhouk, Aline

AU - Unkila-Kallio, Leila

AU - van Meurs, Hannah S

AU - Yang, Winnie

AU - Rozenberg, Nirit

AU - Andersson, Noora

AU - Zaby, Katharina

AU - Bryk, Saara

AU - Bützow, Ralf

AU - Halfwerk, Johannes B G

AU - Hooijer, Gerrit K J

AU - van de Vijver, Marc J

AU - Buist, Marrije R

AU - Kenter, Gemma G

AU - Brucker, Sara Y

AU - Krämer, Bernhard

AU - Staebler, Annette

AU - Bleeker, Maaike C G

AU - Heikinheimo, Markku

AU - Kommoss, Stefan

AU - Blake Gilks, C

AU - Anttonen, Mikko

AU - Huntsman, David G

N1 - © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

PY - 2016/11

Y1 - 2016/11

N2 - The histopathologic features of adult granulosa cell tumors (AGCTs) are relatively nonspecific, resulting in misdiagnosis of other cancers as AGCT, a problem that has not been well characterized. FOXL2 mutation testing was used to stratify 336 AGCTs from three European centers into three categories: 1) FOXL2 mutant molecularly defined AGCT (MD-AGCT) (n = 256 of 336), 2) FOXL2 wild-type AGCT (n = 17 of 336), 3) misdiagnosed other tumor types (n = 63 of 336). All statistical tests were two-sided. The overall and disease-specific survival of the misdiagnosed cases was lower than in the MD-AGCTs (P < .001). The misdiagnosed cases accounted for 71.9% of disease-specific deaths within five years. In the population-based cohort, overall survival of MD-AGCT patients was not different from age-matched, population-based controls. Even though 35.2% of all the MD-AGCT patients in our study experienced a relapse, AGCT is usually an indolent disease. The historical, premolecular data underpinning our clinical understanding of AGCT was likely skewed by inclusion of misdiagnosed cases, and future management strategies should reflect the potential for surgical cure and long survival even after relapse.

AB - The histopathologic features of adult granulosa cell tumors (AGCTs) are relatively nonspecific, resulting in misdiagnosis of other cancers as AGCT, a problem that has not been well characterized. FOXL2 mutation testing was used to stratify 336 AGCTs from three European centers into three categories: 1) FOXL2 mutant molecularly defined AGCT (MD-AGCT) (n = 256 of 336), 2) FOXL2 wild-type AGCT (n = 17 of 336), 3) misdiagnosed other tumor types (n = 63 of 336). All statistical tests were two-sided. The overall and disease-specific survival of the misdiagnosed cases was lower than in the MD-AGCTs (P < .001). The misdiagnosed cases accounted for 71.9% of disease-specific deaths within five years. In the population-based cohort, overall survival of MD-AGCT patients was not different from age-matched, population-based controls. Even though 35.2% of all the MD-AGCT patients in our study experienced a relapse, AGCT is usually an indolent disease. The historical, premolecular data underpinning our clinical understanding of AGCT was likely skewed by inclusion of misdiagnosed cases, and future management strategies should reflect the potential for surgical cure and long survival even after relapse.

KW - Journal Article

U2 - 10.1093/jnci/djw134

DO - 10.1093/jnci/djw134

M3 - Article

VL - 108

JO - Journal of the National Cancer Institute

JF - Journal of the National Cancer Institute

SN - 0027-8874

IS - 11

ER -

McConechy MK, Färkkilä A, Horlings HM, Talhouk A, Unkila-Kallio L, van Meurs HS et al. Molecularly Defined Adult Granulosa Cell Tumor of the Ovary: The Clinical Phenotype. Journal of the National Cancer Institute. 2016 Nov;108(11). https://doi.org/10.1093/jnci/djw134