Treatment and outcomes of neuroendocrine malignancies (NEMs) of the rectum.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 594-594
Author(s):  
Erica Tsang ◽  
Caroline Speers ◽  
Hagen F. Kennecke
Keyword(s):  
Surgical Resection ◽  
Local Excision ◽  
Early Stage ◽  
Univariate Analysis ◽  
Mitotic Count ◽  
Stage I ◽  
High Power Field ◽  
Early Stage Disease ◽  
Pelvic Radiation ◽  
Distant Relapse

594 Background: NEMs of the rectum are rare and standard therapy is not well defined. We sought to characterize the clinicopathologic features, locoregional, and systemic management of a series of rectal NEMs and correlated these with outcomes. Methods: Patients referred to the BC Cancer Agency with rectal NEMs between 2005-2011 were included. Well-differentiated tumors with a Ki67 ≤20% and/or mitotic count ≤ 20 per high power field were classified as neuroendocrine tumors (NETs) while poorly differentiated tumors with higher Ki67 and/or mitotic count were classified as neuroendocrine carcinomas (NECs). Results: Of 28 NEMs, 18 (64%) NETs, and 9 (36%) NECs were identified with a median age of 56 and 59, respectively. Of 15 patients with stage I-III NETs, 13 underwent local excision, 2 had a surgical resection and none received pelvic radiation. Univariate analysis demonstrated an association between tumor size (< 1cm, 1-2 cm, > 2cm) and T stage (χ2 = 10.7, p = 0.03). One of 15 NETs developed distant relapse 8.9 months after surgical resection of a T1bN1 tumor. Of 9 NECs, only 2 presented with stage I-III tumors and were treated with radiation (1) or surgery (1). One patient developed distant relapse 4.8 months after radiation. Among all NEMs, liver was the most common site of metastasis (n = 10) followed by bone (n = 3). Median overall survival was 46.5 and 4.8 months for NETs and NECs (p < 0.01), respectively. Conclusions: Rectal NEMs comprise a rare subgroup of rectal tumors and may be classified as NETs or NECs. NETs generally present with early stage disease and are associated with good outcomes with local excision and without pelvic radiation. Rectal NECs frequently present with advanced disease and are associated with poor outcomes.

Loco-regional outcomes of a population-based cohort of rectal neuroendocrine tumors.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 668-668
Author(s):  
Erica S Tsang ◽  
Yarrow Jean McConnell ◽  
David F. Schaeffer ◽  
Caroline Speers ◽  
Hagen F. Kennecke
Keyword(s):  
Surgical Resection ◽  
Neuroendocrine Tumors ◽  
Local Excision ◽  
Univariate Analysis ◽  
Local Relapse ◽  
Population Based ◽  
Mitotic Count ◽  
Margin Status ◽  
Ki 67 ◽  
Pelvic Radiation

668 Background: Optimal management of rectal neuroendocrine tumors (NETs) is not well defined. We characterized the clinicopathologic features, loco-regional, and systemic management of a population-based cohort of rectal NETs. Methods: Patients diagnosed with rectal NETs from 1999-2011 were identified from British Columbia provincial databases. NETs were classified as G1 and G2 tumors with a Ki-67 ≤ 20% and/or mitotic count ≤ 20 per high power field. Results: Of 91 rectal NETs, median age was 58 (IQR 48-65) years and 35 (38%) were male. Median tumor size was 6 (IQR 4-8) mm. Median overall survival was 164.7 months, with 3 patients presenting with stage IV disease. Treatment included local excision (n = 79), surgical resection (n = 6), and pelvic radiation (n = 1; T3N1 tumor). Final margin status was positive in 17 (20%) cases. Local relapse occurred in 8 (9%) cases, and one relapse to bone 13 months after T3N1 tumor resection. Univariate analysis demonstrated an association between local relapse and T classification, Ki-67, mitotic count, grade, and perineural invasion (p< 0.01), but not N or M classification, or lymphovascular invasion. Local relapse was not associated with surgical management or margin status. Of 3 patients with metastatic disease, two received systemic management, with capecitabine and temozolomide. Conclusions: Rectal NETs generally presented with small, early tumors and were treated with local excision or surgical resection without pelvic radiation. [Table: see text]

Ovarian Yolk Sac Tumor: The Experience of a Regional Cancer Center

2016 ◽  
Vol 26 (5) ◽  
pp. 884-891 ◽  
Author(s):  
Xiaojing Wang ◽  
Zebiao Ma ◽  
Yanfang Li
Keyword(s):  
Prognostic Factor ◽  
Early Stage ◽  
Clinical Stage ◽  
Univariate Analysis ◽  
Yolk Sac ◽  
Stage I ◽  
Yolk Sac Tumor ◽  
Cancer Center ◽  
Significant Prognostic Factor ◽  
Early Stage Disease

ObjectiveThe aim of this study was to evaluate the clinicopathologic characteristics of patients with ovarian yolk sac tumor and the benefit of omentectomy in patients with clinical early-stage disease.MethodsThe medical records of 66 patients with ovarian yolk sac tumor were reviewed retrospectively.ResultsThere were 37, 8, 14, and 7 patients with stages I, II, III, and IV disease, respectively. Sixty-five patients received surgery and adjuvant chemotherapy, and 1 had chemotherapy only. The median follow-up was 78 months. The overall 5-year survival rate was 86.0%. Univariate analysis revealed that stage (P = 0 .022), age (P = 0.001), residual tumor (P = 0.036), and satisfactory α-fetoprotein (AFP) decline (defined as normalization of AFP after the first or second cycles of postsurgery chemotherapy, P = 0.006) were significant prognostic factors. Multivariate analysis revealed that satisfactory AFP decline was an independent significant prognostic factor for overall survival (P = 0.028). The postoperative pathology showed that only 1 (2.7%) of 37 patients who received omentectomy without gross spread had omentum metastasis microscopically. The 5-year survival rates were 89.2% and 100.0% for stage I-II patients with (36 cases) or without (9 cases) omentectomy, respectively (P > 0.05). Three of the 7 patients with recurrence were successfully salvaged and lived 38.0, 102.6, and 45.2 months after initial diagnosis.ConclusionsPostsurgery satisfactory AFP decline was an independent significant prognostic factor for patient survival. Omentectomy might not be of therapeutic significance for clinical stage I-II patients.

Prognostic significance of HER2 expression and associated clinical characteristics in esophageal adenocarcinoma.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 114-114
Author(s):  
Ellie Chan ◽  
Ahmad Alkhasawneh ◽  
Lizette Vila Duckworth ◽  
Tania Zuluaga Toro ◽  
Wei Hou ◽  
...  
Keyword(s):  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Early Stage ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Stage I ◽  
Stage Iii ◽  
Her2 Overexpression ◽  
Her2 Expression ◽  
Early Stage Disease

114 Background: The incidence of adenocarcinoma of the esophagus (EA) and gastroesophageal junction (GEJ) is on the rise. Her2Neu (HER2) is overexpressed in 20-25% of gastric cancers and is associated with poor prognosis. However, the prognostic significance of HER2 in EA/GEJ is less clear. Methods: This retrospective analysis included all sequential patients (pts) with EA or GEJ who underwent primary resection at the University of Florida from 2001 to 2011without neoadjuvant therapy or HER2 inhibition. Demographics, risk factors, tumor features, and outcome data were analyzed. Central blinded immunohistochemistry (IHC) was performed on paraffin embedded tumor specimens with HER2 expression scored as negative (-) (0 or 1+), indeterminate (2+) or positive (+) (3+). Results: 56 pts were eligible for analysis (45 M/11 F) with median age 67 years (37-83). Mean BMI was 29.6±6.6 and 43 pts (92%) had underlying Barrett’s esophagus. Most tumors (60%) were stage I (T1N0). Overall testing revealed tumors to be HER2 + (38%), indeterminate (21%) or - (41%). 50% of Stage I, 18% of stage IIA, 33% of stage IIB, and 14% of stage III tumors were HER2 + (p=0.035 for stage I compared to other stages). Underlying Barrett’s esophagus was associated with HER2 + (60 vs. 0%; p=0.045). The median follow up of the entire cohort was 2.9 years. Overall survival (OS) at 3 years was 80% for stage I, 50% for stage IA, 40% for stage IIB and 50% for stage III (p= 0.153). 3 year OS for HER2+ pts was 64% vs. 70% for HER2- (p=0.63). Univariate analysis did not show significant correlation among tobacco use, BMI, disease progression, survival and HER2 expression. Conclusions: This data suggests that HER2 overexpression is more frequent in early stage disease with underlying Barrett’s esophagus. Our data do not support HER2 as a prognostic factor in EA/GEJ. The relationship of HER2 overexpression in the development of early stage GEJ, particularly in the setting of Barrett’s, is of clinical interest. Further investigation is warranted.

scholarly journals Surgery in Small-Cell Lung Cancer

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 390
Author(s):  
Nicola Martucci ◽  
Alessandro Morabito ◽  
Antonello La Rocca ◽  
Giuseppe De Luca ◽  
Rossella De Cecio ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Early Stage ◽  
Small Cell ◽  
Stage I ◽  
Phase Iii ◽  
Small Cell Lung ◽  
Early Stage Disease ◽  
Stage Disease

Small-cell lung cancer (SCLC) is one of the most aggressive tumors, with a rapid growth and early metastases. Approximately 5% of SCLC patients present with early-stage disease (T1,2 N0M0): these patients have a better prognosis, with a 5-year survival up to 50%. Two randomized phase III studies conducted in the 1960s and the 1980s reported negative results with surgery in SCLC patients with early-stage disease and, thereafter, surgery has been largely discouraged. Instead, several subsequent prospective studies have demonstrated the feasibility of a multimodality approach including surgery before or after chemotherapy and followed in most studies by thoracic radiotherapy, with a 5-year survival probability of 36–63% for patients with completely resected stage I SCLC. These results were substantially confirmed by retrospective studies and by large, population-based studies, conducted in the last 40 years, showing the benefit of surgery, particularly lobectomy, in selected patients with early-stage SCLC. On these bases, the International Guidelines recommend a surgical approach in selected stage I SCLC patients, after adequate staging: in these cases, lobectomy with mediastinal lymphadenectomy is considered the standard approach. In all cases, surgery can be offered only as part of a multimodal treatment, which includes chemotherapy with or without radiotherapy and after a proper multidisciplinary evaluation.

scholarly journals Treatment Outcomes of Early-Stage Natural-Killer/T-Cell Lymphomas Treated with Chemoradiotherapy: Data from 3 Tertiary Cancer Centres in Singapore

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 5274-5274
Author(s):  
Ya Hwee Tan ◽  
Siqin Zhou ◽  
Liu Xin ◽  
Soon Thye Lim ◽  
Miriam Tao ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Chemotherapy Regimen ◽  
Early Stage ◽  
Univariate Analysis ◽  
Stage I ◽  
Survival Outcomes ◽  
Natural Killer T Cell ◽  
End Of Treatment ◽  
Pre Treatment ◽  
Killer T Cell

Background: Extranodal natural killer/T cell lymphoma (ENKL) is an aggressive Epstein-Barr virus (EBV) associated lymphoma with a strong geographical predilection for Asia and South America. While treatment outcomes of advanced stage (AS) disease (i.e., stage III and IV) are uniformly poor, early stage (ES) disease treated with concomitant or sequential chemotherapy (ChT) and radiotherapy (RT) can yield good long-term outcomes. Currently there is no standard therapy for ES ENKL. We describe our experience treating patients with ES ENKL in 3 tertiary cancer centres in Singapore. Method: We performed a retrospective analysis using data from Singapore Lymphoma Study Group database which captures patients from 3 largest tertiary cancer centres in Singapore: National Cancer Centre Singapore (NCCS), Singapore General Hospital (SGH) and National University Cancer Institute, Singapore (NCIS). We included patients with stage I or II ENKL that were treated with ChT and RT from 1996 to March 2019. Patients who did not receive treatment or received radiotherapy alone were excluded. We recorded data on patient demographics, chemotherapy regimen, radiotherapy dosage, sequencing of treatment, response and survival outcomes. End of treatment overall response rates (ORR) included those who achieved complete response (CR) and a partial response (PR). Progression free survival (PFS) was defined as date of diagnosis to date of progression, relapse or death. Overall survival (OS) was defined as date of diagnosis to date of death from all causes. Survival distributions were estimated by the Kaplan-Meier method. Assuming cox proportional hazards models, univariate analysis for OS was performed and Wald tests were used to evaluate the statistical significance. All the statistical analysis was performed using R. Results: There were 56 patients who fulfilled the inclusion criteria. Forty (71%) were male, 47 (84%) were Chinese and the median age of this cohort was 50 (range 18-80). Thirty-one (55%) patients had stage I disease and all had nasal involvement. All patients had ECOG performance status of 0 or 1 and most had low or low-intermediate international prognostic index (IPI) score. Ten patients (18%) had B-symptoms and LDH was elevated in 22 (39%). Pre-treatment positron emission tomography-computed tomography (PET/CT) was performed in 36 (64%) patients. Pre-treatment EBV titres were tested in only 23 patients and they were detected in 17 (74%) of patients. Twenty-five patients (45%) had sandwich (ChT, RT then ChT), 25 (45%) had ChT followed by RT, while 6 had RT followed by ChT. None had concurrent ChT/RT. The most commonly used ChT regimen was ICE (ifosfamide, carboplatin, etoposide) in 19 patients and SMILE (steroids, methotrexate, ifosfamide, L-asparaginase, etoposide) was used in 9 patients. Most patients (75%) did not receive L-asparaginase containing regimens. The median RT dose was 50Gy. The ORR for this cohort was 87.5% and 7 patients (12.5%) progressed at the end of treatment. Our median duration of follow up is 3.5 years (range: 0.25 - 21.6 years). The 5-year OS for stage I and II disease were 78.5% (95% CI, 64.2%-96.0%) and 65.6% (95% CI 47.5% to 90.5%) respectively. The 5-year PFS for stage I and II disease was 78.5% (95% CI 64.2%-96.0%) and 58.8% (95% CI 40.9% to 84.5%) respectively. On univariate analysis, only the sequence of therapy i.e., the sandwich ChT-RT-ChT approach when compared to sequential treatment with ChT followed by RT, was associated with better OS with a hazard ratio (HR) of 0.18 (95% CI 0.04 to 0.84 , p = 0.03). When L-asparaginase containing regimens were compared against those without, no statistical significant difference was observed in OS in ES ENKL, with HR of 3.38 (95%CI 0.44-26.15, p=0.243) Conclusion: Survival outcomes for ES ENKL especially that of stage I ENKL, are good with chemoradiotherapy. This contrasts against the treatment outcomes of AS ENKL. It is likely that many patients in this study were under-staged since PET scans were only performed in 64% of patients. Within the limits of this retrospective analysis and the small numbers, the ICE chemotherapy regimen appears to be an effective treatment when "sandwich"-sequenced with radiotherapy. Disclosures Lim: National Cancer Centre Singapore: Employment.

Clinical study of mucosa-associated lymphoid tissue lymphomas of the head and neck

2011 ◽  
Vol 126 (3) ◽  
pp. 271-275
Author(s):  
S Hosokawa ◽  
J Okamura ◽  
Y Takizawa ◽  
G Takahashi ◽  
K Hosokawa ◽  
...  
Keyword(s):  
Head And Neck ◽  
Surgical Resection ◽  
Lymphoid Tissue ◽  
Early Stage ◽  
Local Treatment ◽  
Response To Treatment ◽  
Limited Information ◽  
Early Stage Disease ◽  
First Choice

AbstractBackground:Limited information is available on mucosa-associated lymphoid tissue lymphomas arising in the head and neck.Method:A retrospective analysis was conducted of 20 patients who were histologically diagnosed with mucosa-associated lymphoid tissue lymphoma and treated at our institution between January 1990 and December 2009.Results:Treatment consisted of surgical resection alone in two patients (10 per cent), surgical resection with consecutive radiotherapy in one (5 per cent), and radiotherapy alone in eight (40 per cent). Three patients (15 per cent) were treated with systemic chemotherapy, and three (15 per cent) received chemoradiotherapy. Three patients (15 per cent) were informed of the diagnosis but not treated for their condition.Conclusion:All of the 20 patients were still alive after a mean follow-up period of 50.8 months. Local treatment for mucosa-associated lymphoid tissue lymphoma of the head and neck should be the first choice in early-stage disease. However, prolonged follow up is important to determine these patients' long-term response to treatment.

scholarly journals International Study of Primary Mucinous Ovarian Carcinomas Managed at Tertiary Medical Centers

2018 ◽  
Vol 28 (5) ◽  
pp. 915-924 ◽  
Author(s):  
Jennifer J. Mueller ◽  
Henrik Lajer ◽  
Berit Jul Mosgaard ◽  
Slim Bach Hamba ◽  
Philippe Morice ◽  
...  
Keyword(s):  
Early Stage ◽  
Statistical Tests ◽  
Stage Iv ◽  
Stage I ◽  
Stage Iii ◽  
Oncologic Outcomes ◽  
Disease Stage ◽  
Ovarian Carcinomas ◽  
Early Stage Disease ◽  
Medical Centers

ObjectiveWe sought to describe a large, international cohort of patients diagnosed with primary mucinous ovarian carcinoma (PMOC) across 3 tertiary medical centers to evaluate differences in patient characteristics, surgical/adjuvant treatment strategies, and oncologic outcomes.MethodsThis was a retrospective review spanning 1976–2014. All tumors were centrally reviewed by an expert gynecologic pathologist. Each center used a combination of clinical and histologic criteria to confirm a PMOC diagnosis. Data were abstracted from medical records, and a deidentified dataset was compiled and processed at a single institution. Appropriate statistical tests were performed.ResultsTwo hundred twenty-two patients with PMOC were identified; all had undergone primary surgery. Disease stage distribution was as follows: stage I, 163 patients (74%); stage II, 8 (4%); stage III, 40 (18%); and stage IV, 10 (5%). Ninety-nine (45%) of 219 patients underwent lymphadenectomy; 41 (19%) of 215 underwent fertility-preserving surgery. Of the 145 patients (65%) with available treatment data, 68 (47%) had received chemotherapy—55 (81%) a gynecologic regimen and 13 (19%) a gastrointestinal regimen. The 5-year progression-free survival (PFS) rates were 80% (95% confidence interval [CI], 73%–85%) for patients with stage I to II disease and 17% (95% CI, 8%–29%) for those with stage III to IV disease. The 5-year PFS rate was 73% (95% CI, 50%–86%) for patients who underwent fertility-preserving surgery.ConclusionsMost patients (74%) presented with stage I disease. Nearly 50% were treated with adjuvant chemotherapy using various regimens across institutions. The PFS outcomes were favorable for those with early-stage disease and lower but acceptable for those who underwent fertility preservation.

Robotic Transhiatal Esophagectomy in a Community Hospital: Evolution of Technique

2016 ◽  
Vol 82 (8) ◽  
pp. 730-732
Author(s):  
Vernon D. Horst ◽  
Hetal D. Patel ◽  
Stan C. Hewlett
Keyword(s):  
Minimally Invasive ◽  
Surgical Resection ◽  
Early Stage ◽  
Esophageal Resection ◽  
Transhiatal Esophagectomy ◽  
Robotic Technology ◽  
Early Stage Disease ◽  
Invasive Approach ◽  
Stage Disease ◽  
Perioperative Course

Esophageal cancer is an uncommon but highly lethal disease. Surgical resection is the gold standard of treatment for early-stage disease. Traditional surgical approach entailed significant convalescence, hospital stay, and morbidity and mortality. Transhiatal esophagectomy (THE) involves blind dissection of the esophagus with minimal mediastinal lymphadenectomy. Integration of robotic surgery is an alternate platform for minimally invasive approach while maintaining safety and following oncologic principles. We review our technique for minimally invasive THE using robotic technology, demonstrating the safety and efficacy of robotic technology surgery. We present a retrospective review of a single surgeon's data of patients treated with robotic-assisted THE, with a chart review to evaluate pathology, adequacy of surgical resection, nodal harvest, and perioperative course. Robotic THE (rTHE) shows promise as a valid option for esophageal resection, including premalignant and advanced stages of cancer. Adequate transhiatal mediastinal nodal resection can be performed with the robot.

scholarly journals The correlation between the levels of tissue inhibitor of metalloproteinases 1 in plasma and tumour response and survival after preoperative radiochemotherapy in patients with rectal cancer

2013 ◽  
Vol 47 (2) ◽  
pp. 138-144 ◽  
Author(s):  
Irena Oblak ◽  
Vaneja Velenik ◽  
Franc Anderluh ◽  
Barbara Mozina ◽  
Janja Ocvirk
Keyword(s):  
Rectal Cancer ◽  
Early Stage ◽  
Univariate Analysis ◽  
Tumour Response ◽  
Disease Free Survival ◽  
Enzyme Linked Immunosorbent Assay ◽  
Tissue Inhibitor Of Metalloproteinases ◽  
Preoperative Radiochemotherapy ◽  
Tissue Inhibitor ◽  
Early Stage Disease

Background. The aim of this study was to analyse whether the level of tissue inhibitor of metalloproteinases (TIMP) 1 is associated with the tumour response and survival to preoperative radiochemotherapy in rectal cancer patients. Patients and methods. Ninety-two patients with histologically confirmed non-metastatic rectal cancer of clinical stage I- III were treated with preoperative radiochemotherapy, surgery and postoperative chemotherapy. Plasma TIMP-1 concentrations were measured prior to the start of the treatment with an enzyme-linked immunosorbent assay (ELISA). Results. Median follow-up time was 68 months (range: 3-93 months) while in survivors it was 80 months (range: 68-93 months). The 5-year locoregional control (LRC), disease-free survival (DFS), disease-specific survival (DSS) and overall survival (OS) rates for all patients were 80.2%, 56.4%, 63.7% and 52.2%, respectively. The median TIMP-1 level was 185 ng/mL (range: 22-523 ng/mL) and the mean level (±standard deviation) was 192 (±87) ng/mL. Serum TIMP-1 levels were found to be significantly increased in patients with preoperative CRP>12 mg/L and in those who died from rectal cancer or had cT4 tumours. No correlation was established for age, gender, carcinoembriogenic antigene (CEA) level, platelets count, histopathological grade, response to preoperative therapy, resectability and disease reappearance. On univariate analysis, various parameters favourably influenced one or more survival endpoints: TIMP-1 <170 ng/mL, CRP <12 mg/L, platelets count <290 10E9/L, CEA <3.4mg/L, age <69 years, male gender, early stage disease (cN0 and/or cT2-3), radical surgery (R0) and response to preoperative radiochemotherapy. In multivariate model, LRC was favourably influenced by N-downstage, DFS by lower CRP and N-downstage, DSS by lower CRP and N-downstage and OS by lower TIMP-1 level, lower CRP and N-downstage. Conclusions. Although we did not find any association between pretreatment serum TIMP-1 levels and primary tumour response to preoperative radiochemotherapy in our cohort of patients with rectal cancer, TIMP-1 levels were recognized as an independent prognostic factor for OS in these patients.

scholarly journals Granulosa Cell Tumor of the Ovary: A Retrospective Study of 31 Cases and a Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Manel Dridi ◽  
Nesrine Chraiet ◽  
Rim Batti ◽  
Mouna Ayadi ◽  
Amina Mokrani ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Mitotic Index ◽  
Granulosa Cell ◽  
Early Stage ◽  
Abdominal Mass ◽  
Univariate Analysis ◽  
Hepatic Metastases ◽  
Stage I

Background. Adult granulosa cell tumors (AGCTs) are the most common sex cord-stromal tumors. Unlike epithelial ovarian tumors, they occur in young women and are usually detected at an early stage. The aim of this study was to report the clinical and pathological characteristics of AGCT patients and to identify the prognostic factors. Methods. All cases of AGCTs, treated at Salah Azaïz Institute between 1995 and 2010, were retrospectively included. Kaplan-Meier’s statistical method was used to assess the relapse-free survival and the overall survival. Results. The final cohort included 31 patients with AGCT. The mean age was 53 years (35–73 years). Patients mainly presented with abdominal mass and/or pain (61%, n=19). Mean tumor size was 20 cm. The majority of patients had a stage I disease (61%,  n=19). Two among 3 patients with stage IV disease had liver metastasis. Mitotic index was low in 45% of cases (n=14). Surgical treatment was optimal in almost all cases (90%, n=28). The median follow-up time was 14 years (1–184 months). Ten patients relapsed (32%) with a median RFS of 8.4 years (6.8–9.9 years). Mean overall survival was 13 years (11–15 years). Stage I disease and low-to-intermediate mitotic index were associated with a better prognosis in univariate analysis (resp., p=0.05 and p=0.02) but were not independent prognostic factors. Conclusion. GCTs have a long natural history with common late relapses. Hence, long active follow-up is recommended. In Tunisian patients, hepatic metastases were more frequent than occidental series. The prognosis remains good and initial staging at diagnosis is an important prognostic factor.

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