Progress in the management of ovarian granulosa cell tumor: A review

Ovarian granulosa cell tumor (GCT) is a rare, low‐grade malignant tumor that accounts for 70% of the sex cord‐stromal tumors. It has two histopathologic types with different clinical and biologic features: adult GCT and juvenile GCT. Most women diagnosed with the adult GCT have a favorable prognosis, with a 5‐year survival rate of 97%–98%, but adult GCT has a feature of late relapse; the recurrence time could be more than 20 years after diagnosis. Juvenile GCT has a survival rate of 97% in stage I and a 5‐year survival rate of 0%–22% in advanced stage with earlier recurrence than adult GCT. Consequently, the scenario emphasizes the need for early diagnosis, standardized treatment protocols, and long‐term follow up. However, there is a lack of consensus regarding accurate diagnosis of GCT and adjuvant treatment. Furthermore, GCT tends to occur in young women, which emphasizes the viability of fertility‐sparing surgery. The current review performed a systematic literature review of 60 articles to summarize the latest advances in GCT, with an emphasis on the molecular pathogenesis and survival after fertility‐sparing surgery. We found that young women with fertility‐sparing surgery had a desirable reproductive and survival outcome compared with those undergoing radical surgery.