Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy for Recurrent Adult Granulosa Cell Tumor of the Ovary: A Retrospective Case Series
Location
Center for Advanced Learning & Simulation (CALS)
Publication Date
May 2026
Start Date
8-5-2026 10:30 AM
End Date
8-5-2026 10:45 AM
Description
Background: Adult granulosa cell tumor (AGCT) of the ovary is a rare sex cord-stromal neoplasm characterized by an indolent but relapsing clinical course. While the initial prognosis is generally favorable, AGCT is associated with a high rate of late recurrence, which can sometimes occur decades after diagnosis. The standard management for recurrent AGCT consists primarily of repeat cytoreductive surgery (CRS), as systemic chemotherapy and hormonal therapy have shown limited efficacy in the salvage setting. Hyperthermic intraperitoneal chemotherapy (HIPEC) in combination with CRS has shown potential benefits in epithelial ovarian cancers and certain rare ovarian tumors. However, evidence supporting the use of HIPEC in recurrent AGCT is limited. This study reports the institutional experience with CRS and HIPEC in patients with recurrent AGCT.
Methods: A retrospective chart review was completed for patients with histologically confirmed AGCT of the ovary who underwent CRS and HIPEC at our institution between 2022 and 2024. HIPEC was performed after optimal or complete cytoreduction with cisplatin 100 mg/msq over 90 minutes. Descriptive statistics were applied.
Results: Four patients with recurrent AGCT were treated with CRS and HIPEC. Median age at the time of HIPEC was 45 years old, and the average number of recurrences before HIPEC was 1.5. All patients except one had received at least one prior line of adjuvant platinum-based chemotherapy as front-line before recurrence and HIPEC. At the time of HIPEC, all patients underwent complete cytoreduction to no visible disease. The procedure was well tolerated without perioperative mortality or complications. Median length of hospital stay was 4 days. After cytoreductive surgery and HIPEC, treatment included adjuvant platinum-based chemotherapy and maintenance hormonal therapy. Median progression-free survival was 22.5 months (range 10-36 months). The median overall survival from the time of HIPEC was 25.5 months, with 100% of patients alive at last follow-up.
Conclusions: This case series provides novel evidence that CRS and HIPEC is feasible and potentially effective in recurrent AGCT. The high rate of sustained progression-free survival in this cohort is notable, given the refractory nature of recurrent AGCT. Importantly, no grade II or higher adverse events attributable to HIPEC were observed, suggesting an acceptable safety profile. Larger multi-institutional studies are needed to further support HIPEC as a potential therapeutic option for recurrent AGCT.
Recommended Citation
Malone, Kristin MD/MPH; Sutton, Elizabeth F. PhD; Castellano, Tara MD; Agyemang, Amma MD/MPH; and Backer-Meurke, Sean DO, "Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy for Recurrent Adult Granulosa Cell Tumor of the Ovary: A Retrospective Case Series" (2026). Dept. of Obstetrics & Gynecology Resident Research Day. 7.
https://digitalscholar.lsuhsc.edu/obgyn_rd/2026/presentations/7
Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy for Recurrent Adult Granulosa Cell Tumor of the Ovary: A Retrospective Case Series
Center for Advanced Learning & Simulation (CALS)
Background: Adult granulosa cell tumor (AGCT) of the ovary is a rare sex cord-stromal neoplasm characterized by an indolent but relapsing clinical course. While the initial prognosis is generally favorable, AGCT is associated with a high rate of late recurrence, which can sometimes occur decades after diagnosis. The standard management for recurrent AGCT consists primarily of repeat cytoreductive surgery (CRS), as systemic chemotherapy and hormonal therapy have shown limited efficacy in the salvage setting. Hyperthermic intraperitoneal chemotherapy (HIPEC) in combination with CRS has shown potential benefits in epithelial ovarian cancers and certain rare ovarian tumors. However, evidence supporting the use of HIPEC in recurrent AGCT is limited. This study reports the institutional experience with CRS and HIPEC in patients with recurrent AGCT.
Methods: A retrospective chart review was completed for patients with histologically confirmed AGCT of the ovary who underwent CRS and HIPEC at our institution between 2022 and 2024. HIPEC was performed after optimal or complete cytoreduction with cisplatin 100 mg/msq over 90 minutes. Descriptive statistics were applied.
Results: Four patients with recurrent AGCT were treated with CRS and HIPEC. Median age at the time of HIPEC was 45 years old, and the average number of recurrences before HIPEC was 1.5. All patients except one had received at least one prior line of adjuvant platinum-based chemotherapy as front-line before recurrence and HIPEC. At the time of HIPEC, all patients underwent complete cytoreduction to no visible disease. The procedure was well tolerated without perioperative mortality or complications. Median length of hospital stay was 4 days. After cytoreductive surgery and HIPEC, treatment included adjuvant platinum-based chemotherapy and maintenance hormonal therapy. Median progression-free survival was 22.5 months (range 10-36 months). The median overall survival from the time of HIPEC was 25.5 months, with 100% of patients alive at last follow-up.
Conclusions: This case series provides novel evidence that CRS and HIPEC is feasible and potentially effective in recurrent AGCT. The high rate of sustained progression-free survival in this cohort is notable, given the refractory nature of recurrent AGCT. Importantly, no grade II or higher adverse events attributable to HIPEC were observed, suggesting an acceptable safety profile. Larger multi-institutional studies are needed to further support HIPEC as a potential therapeutic option for recurrent AGCT.
Comments
Advisor: Amelia Jernigan MD