Skip to main content
SpringerLink
Log in

Ovarian Sertoli-Leydig and granulosa cell tumor: comparison of epidemiology and survival outcomes

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To investigate the epidemiology, clinico-pathological characteristics and outcomes of patients diagnosed with malignant ovarian Sertoli-Leydig cell tumors (SLCTs) in comparison to granulosa cell tumors (GCTs).

Methods

The National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database were accessed and patients diagnosed with a malignant SLCT and GCT between 1988 and 2013 were selected. Demographic and clinico-pathological characteristics were compared using the Mann–Whitney and chi-square tests. Overall (OS) and cancer-specific survival (CSS) rates were estimated with the Kaplan–Meier method and compared with the log-rank test. Cox hazard models were constructed to control for confounders.

Results

A total of 175 and 1361 patients diagnosed with SLCT and GCT, respectively, were identified. Compared to patients with GCT, those with SLCT were younger (median age 32 vs. 51 years, p < 0.001) and more likely to present with larger tumors (median size 15 vs 9.5 cm, p < 0.001) confined to the ovary (77.5% vs 69.2%, p = 0.031). Patients with SLCTs had worse CSS compared to those with GCTs, p < 0.001 (5-year rate was 76.2% vs 90.7%). After controlling for the presence of extra-ovarian disease and tumor size (≤ 10 vs > 10 cm), SCLTs were associated with a worse cancer-specific mortality compared to GCTs.

Conclusions

SLCTs are extremely rare, commonly arise in premenopausal patients. They are associated with a poorer prognosis compared to GCT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Nasioudis D, Kanninen TT, Holcomb K, Sisti G, Witkin SS (2017) Prevalence of lymph node metastasis and prognostic significance of lymphadenectomy in apparent early-stage malignant ovarian sex cord-stromal tumors. Gynecol Oncol 145(2):243–247

    Article  Google Scholar 

  2. Colombo N, Parma G, Zanagnolo V, Insinga A (2007) Management of ovarian stromal cell tumors. J Clin Oncol 25(20):2944–2951

    Article  CAS  Google Scholar 

  3. Schultz KA, Harris AK, Schneider DT, Young RH, Brown J, Gershenson DM, Dehner LP, Hill DA, Messinger YH, Frazier AL (2016) Ovarian sex cord-stromal tumors. J Oncol Pract 12(10):940–946

    Article  Google Scholar 

  4. Litta P, Saccardi C, Conte L, Codroma A, Angioni S, Mioni R (2013) Sertoli-Leydig cell tumors: current status of surgical management: literature review and proposal of treatment. Gynecol Endocrinol 29(5):412–417

    Article  Google Scholar 

  5. Young RH, Scully RE (1985) Ovarian Sertoli-Leydig cell tumors. A clinicopathological analysis of 207 cases. Am J Surg Pathol. 9(8):543–569

    Article  CAS  Google Scholar 

  6. Young RH, Prat J, Scully RE (1982) Ovarian Sertoli-Leydig cell tumors with heterologous elements. I. Gastrointestinal epithelium and carcinoid: a clinicopathologic analysis of thirty-six cases. Cancer 50(11):2448–2456

    Article  CAS  Google Scholar 

  7. Bhat RA, Lim YK, Chia YN, Yam KL (2013) Sertoli-Leydig cell tumor of the ovary: analysis of a single institution database. J Obstet Gynaecol Res 39(1):305–310

    Article  Google Scholar 

  8. Gui T, Cao D, Shen K, Yang J, Zhang Y, Yu Q, Wan X, Xiang Y, Xiao Y, Guo L (2012) A clinicopathological analysis of 40 cases of ovarian Sertoli-Leydig cell tumors. Gynecol Oncol 127(2):384–389

    Article  Google Scholar 

  9. Zhang HY, Zhu JE, Huang W, Zhu J (2014) Clinicopathologic features of ovarian Sertoli-Leydig cell tumors. Int J Clin Exp Pathol 7(10):6956–6964

    PubMed  PubMed Central  Google Scholar 

  10. Sigismondi C, Gadducci A, Lorusso D, Candiani M, Breda E, Raspagliesi F, Cormio G, Marinaccio M, Mangili G (2012) Ovarian Sertoli-Leydig cell tumors. A retrospective MITO study. Gynecol Oncol 125(3):673–676

    Article  Google Scholar 

  11. Melero Cortés LM, Martínez Maestre MÁ, Vieites Pérez-Quintela MB, Gambadauro P (2017) Ovarian Sertoli-Leydig cell tumours: how typical is their typical presentation? J Obstet Gynaecol 37(5):655–659

    Article  Google Scholar 

  12. Schneider DT, Orbach D, Cecchetto G, Stachowicz-Stencel T, Brummel B, Brecht IB, Bisogno G, Ferrari A, Reguerre Y, Godzinski J, Bien E, Calaminus G, Göbel U, Patte C (2015) Ovarian Sertoli Leydig cell tumours in children and adolescents: an analysis of the European Cooperative Study Group on Pediatric Rare Tumors (EXPeRT). Eur J Cancer 51(4):543–550

    Article  Google Scholar 

  13. Roth LM, Anderson MC, Govan AD, Langley FA, Gowing NF, Woodcock AS (1981) Sertoli-Leydig cell tumors: a clinicopathologic study of 34 cases. Cancer 48(1):187–197

    Article  CAS  Google Scholar 

  14. Weng CS, Chen MY, Wang TY, Tsai HW, Hung YC, Yu KJ, Chiang YC, Lin H, Lu CH, Chou HH (2013) Sertoli-Leydig cell tumors of the ovary: a Taiwanese Gynecologic Oncology Group study. Taiwan J Obstet Gynecol 52(1):66–70

    Article  Google Scholar 

  15. Akman L, Ertas IE, Gokcu M, Terek MC, Sanci M, Sanli UA, Zekioglu O, Ozsaran AA (2016) Ovarian sertoli-leydig cell tumors: a multicenter long-term clinicopathological analysis of 27 patients. J Cancer Res Ther 12(1):290–294

    Article  CAS  Google Scholar 

  16. Nam SM, Kim JW, Eoh KJ, Kim HM, Lee JY, Nam EJ, Kim S, Kim SW, Kim YT (2017) A novel clinicopathological analysis of early stage ovarian Sertoli-Leydig cell tumors at a single institution. Obstet Gynecol Sci 60(1):39–45

    Article  Google Scholar 

  17. https://seer.cancer.gov. Accessed June 2018

  18. Nasioudis D, Sisti G, Kanninen TT, Holcomb K, Di Tommaso M, Fambrini M, Witkin SS (2016) Epidemiology and outcomes of squamous ovarian carcinoma; a population-based study. Gynecol Oncol 141(1):128–133

    Article  Google Scholar 

  19. https://seer.cancer.gov/seerstat/. Accessed June 2018

  20. Goulvent T, Ray-Coquard I, Borel S, Haddad V, Devouassoux-Shisheboran M, Vacher-Lavenu MC, Pujade-Laurraine E, Savina A, Maillet D, Gillet G, Treilleux I, Rimokh R (2016) DICER1 and FOXL2 mutations in ovarian sex cord-stromal tumours: a GINECO Group study. Histopathology 68(2):279–285

    Article  Google Scholar 

  21. Schultz KAP, Harris AK, Finch M, Dehner LP, Brown JB, Gershenson DM, Young RH, Field A, Yu W, Turner J, Cost NG, Schneider DT, Stewart DR, Frazier AL, Messinger Y, Hill DA (2017) DICER1-related Sertoli-Leydig cell tumor and gynandroblastoma: clinical and genetic findings from the International Ovarian and Testicular Stromal Tumor Registry. Gynecol Oncol 147(3):521–527

    Article  CAS  Google Scholar 

  22. Stewart CJ, Charles A, Foulkes WD (2016) Gynecologic manifestations of the DICER1 syndrome. Surg Pathol Clin 9(2):227–241

    Article  Google Scholar 

  23. Morgan RJ Jr, Armstrong DK, Alvarez RD, Bakkum-Gamez JN, Behbakht K, Chen LM, Copeland L, Crispens MA, DeRosa M, Dorigo O, Gershenson DM, Gray HJ, Hakam A, Havrilesky LJ, Johnston C, Lele S, Martin L, Matulonis UA, O'Malley DM, Penson RT, Percac-Lima S, Pineda M, Plaxe SC, Powell MA, Ratner E, Remmenga SW, Rose PG, Sabbatini P, Santoso JT, Werner TL, Burns J, Hughes M (2016) Ovarian cancer, version 1.2016, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw 14(9):1134–1163

    Article  Google Scholar 

  24. Ray-Coquard I, Morice P, Lorusso D et al (2018) Non-epithelial ovarian cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 29(Suppl 4):iv1–iv18. https://doi.org/10.1093/annonc/mdy001

    Article  CAS  Google Scholar 

  25. Brown J, Brady WE, Schink J, Van Le L, Leitao M, Yamada SD, de Geest K, Gershenson DM (2014) Efficacy and safety of bevacizumab in recurrent sex cord-stromal ovarian tumors: results of a phase 2 trial of the Gynecologic Oncology Group. Cancer 120(3):344–351

    Article  CAS  Google Scholar 

  26. Lashkari HP, Nash R, Albanese A, Okoye B, Millar R, Pritchard-Jones K (2013) Treatment of high risk Sertoli-Leydig cell tumors of the ovary using a gonadotropin releasing hormone (GnRH) analog. Pediatr Blood Cancer 60(6):E16–E18

    Article  Google Scholar 

Download references

Funding

The authors declare no source of funding for the research conducted.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Helen O’Dickens Women’s Health Center, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, USA

    Dimitrios Nasioudis, Spyridon A. Mastroyannis, Ashley F. Haggerty, Emily M. Ko & Nawar A. Latif

Authors
  1. Dimitrios Nasioudis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Spyridon A. Mastroyannis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ashley F. Haggerty
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Emily M. Ko
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nawar A. Latif
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dimitrios Nasioudis.

Ethics declarations

Conflict of interest

All authors declare no potential conflict of interest, including and financial or personal relationship which could viewed as one.

Ethical approval

The SEER is a public dataset available to the public for research purpose. All patient data are de-identified. The present study was deemed exempt by the institutional review board.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nasioudis, D., Mastroyannis, S.A., F. Haggerty, A. et al. Ovarian Sertoli-Leydig and granulosa cell tumor: comparison of epidemiology and survival outcomes. Arch Gynecol Obstet 302, 481–486 (2020). https://doi.org/10.1007/s00404-020-05633-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-020-05633-z

Keywords

Search

Navigation