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OBJETIVOS: avaliar estadiamento, procedimentos cirúrgicos e evolução dos tumores das células da granulosa (TCG) dos ovários, dando ênfase à possibilidade de cirurgia conservadora (ooforectomia unilateral). MÉTODOS: este é um estudo de coorte retrospectivo no qual foram incluídas 24 pacientes com TCG tratadas no período de janeiro de 1994 a janeiro de 2004. Foram analisadas variáveis de interesse, tais como idade da paciente, sintomatologia, tamanho tumoral ao exame físico, estadiamento, modalidades de tratamento (tipos de cirurgia e adjuvância com quimioterapia e/ou radioterapia) e prognóstico. As associações entre as variáveis foram avaliadas pelo teste do chi-quadrado e para significância estatística considerou-se p < 0,05, sempre se descrevendo o teste exato bicaudado de Fisher. RESULTADOS: a idade das 24 pacientes variou de 30 a 82 (média 51,7) anos. O sintoma mais freqüente foi a dor pélvica (n = 10; 41,7%). Quatorze pacientes (58,3%) apresentavam estádio clínico (EC) Ic, 5 (20,8%) EC IIIc e 5 (20,8%) EC Ia. Estadiamentos mais avançados foram significativamente associados com o achado de massas pélvicas palpáveis (p < 0,04). Hiperplasias endometriais típicas foram encontradas em 3 (25%) de 12 espécimes de histerectomia. O tempo de seguimento variou de 2 a 114 (média 42,5) meses. Dentre as 16 (66,7%) pacientes vivas e sem doença, 4 eram EC Ia (25%), 11 EC Ib (68,8%) e 1 EC Ic (6,3%), enquanto todas as pacientes que faleceram eram EC IIIc (p = 0,0008). Todas as 6 pacientes (25%) que se submeteram à cirurgia conservadora estavam vivas e sem recidiva. CONCLUSÃO: embora os TCG geralmente apresentem baixa agressividade, o estadiamento continua sendo o principal fator prognóstico e assim ele determina a opção de cirurgia conservadora e do uso de tratamento adjuvante. OBJECTIVE: to evaluate staging, surgical procedures and outcome of ovarian granulosa cell tumors (GCT), with emphasis in the possibility of conservative surgery (unilateral ooforectomy). METHODS: this is a retrospective cohort study in which 24 patients treated with GCT during the period of January 1994 to January 2004 were included. Variables of interest such as patient's age, symptoms, tumor size on physical examination, staging, treatment modalities (types of surgery and of adjuvant chemotherapy and/or radiotherapy) and prognosis have been analyzed. The chi-square test was used to check the association between variables, and the level of significance was set at p < 0.05, always describing the two-tailed Fisher exact test. RESULTS: the patients' age varied from 30 to 82 (mean 51.7) years old. The most frequently referred symptom was pelvic pain (n = 10; 41.7%). Fourteen patients (58.3%) presented clinical stage (CS) Ic, 5 (20.8%) CS IIIc and 5 (20.8%) CS Ia. More advanced clinical stages were significantly associated with palpable pelvic masses (p < 0.04). Endometrial hyperplasias were found in 3 (25%) of the 12 hysterectomy specimens. The follow-up period varied from 2 to 114 (mean 42.5) months. Among the 16 (66.7%) surviving and disease-free patients, 4 had CS Ia (25%), 11 CS Ib (68.8%) and 1 CS Ic (6.3%), whereas all patients who died had CS IIIc (p = 0.0008). All 6 patients (25%) that underwent conservative surgery were alive and without recurrence. CONCLUSION: although GCT usually present low aggressiveness, the clinical staging continues to be the main prognostic factor and hence it determines the option for conservative surgery and the use of adjuvant therapy

Tumores das células da granulosa dos ovários: estudo de 24 casos