The diagnosis and treatment of ovarian granulosa cell tumor are progressing. The 5-year survival rate is 90%, but it is prone to distant recurrence and the 20-year survival rate is less than 50%. In recent years, with the increasing understanding of GCT, there have been some new advances in its diagnosis and treatment. The most common clinical symptoms are postmenopausal vaginal bleeding or menstrual disorders, other manifestations such as amenorrhea, infertility, endometrial lesions, pseudoprecocious puberty and abdominal pain and distension. Clinical signs may include pelvic masses or thoracoabdominal fluid, so early detection is possible. However, because the diagnosis of GCT is mainly based on pathological examination, and other tumors of sex cord questioning mass are homologous with it, it is sometimes difficult to distinguish morphologically; secondly, various hypodifferentiated tumors have obvious structural heterogeneity and few normal anatomical structures, so it is easy to cause misdiagnosis. Although the prognosis of stage I GCT is relatively good, the survival rate of stage II-III is only 10%-33%, with the characteristics of late recurrence, the average time of recurrence is between 5-10 years, and the mortality rate of recurrence is as high as 75%, and some of the tumors are aggressive, so clear diagnosis and prediction of prognosis have a crucial role in effective treatment of GCT. The relationship between clinical staging and prognosis Clinical staging is one of the most important factors of prognosis, which is established mainly based on the extent of disease spread detected by thorough exploratory surgery. 5-year survival rate for patients with stage I ovarian granulosa cell tumor is 90%. In contrast, the 5-year survival rate for patients with stage III or higher is less than 20%. Relationship between pathological factors and prognosis Nuclear anisotropy and hyperdisintegrated phase are considered to be independent prognostic influences in ovarian granulosa cell tumors. In general, for early recurrent cases, the tumor has the characteristics of an aggressive tumor. In contrast, late recurrent cases have tumors with low-grade malignant potential. Although the size of the tumor or clinical evidence does not prove a difference between the two tumors, the proliferation pattern of late-recurrent ovarian granulosa cell tumors is considered to be intermediate between that of anaplastic surviving ovarian granulosa cell tumors and early recurrent ovarian granulosa cell tumors. Nuclear heterogeneity and identical cell nuclear division are factors of postoperative recurrence or poor prognosis. Therefore, in determining the prognostic issues of the disease. Most authors now believe that it is difficult to distinguish ovarian granulosa cell tumors from other types of ovarian tumors before surgery to achieve an accurate diagnosis, so surgery remains the treatment of choice for granulosa cell tumors. However, the extent of surgery remains inconclusive. It is generally accepted that conservative surgery is necessary for young patients who need to preserve their reproductive function. That is, adnexal resection on one side, since the incidence of this type of tumor is about 3% in both ovaries simultaneously, and the extent of the first surgery affects the recurrence rate, according to Evans. Of the 108 patients studied by him, 80 were stage I patients, the rest were stage Ic or II or higher, and 1I patients were not staged. The results of their study showed that 17% of women underwent recurrence after total hysterectomy with bilateral adnexal resection. In contrast, the recurrence rate in patients undergoing other conservative procedures, i.e. unilateral adnexal resection, was 24%. Adjuvant therapy after stage I surgery is still controversial; Smith et al. reported that adjuvant postoperative radiotherapy improved survival, and Savage suggested that radiotherapy could provide long-term remission in patients who could not tolerate surgical treatment. Most authors now believe that radiation therapy may be effective in reducing symptoms in recurrent disease or in patients who cannot undergo tumor cytoreductive surgery. Chemotherapy is now widely used in the treatment of granulosa cell tumors of the ovary. There are several reports of long-term remission after chemotherapy, but it is not clear whether it affects overall survival and whether recurrence occurs. Analysis of factors related to the time to recurrence One of the characteristics of granulosa cell tumors is distant recurrence. So far, the two cases with the longest recurrence time reported in the literature were both 37 years. The median time to recurrence ranged from 4.0 to 7.3 years. Generally speaking, recent recurrences are usually more malignant with significant nuclear anisotropy and nuclear schizophrenia. In contrast, those with distant recurrence were often less malignant with lower nuclear anisotropy and nuclear schizophrenia, and the mean tumor size was larger in recent recurrences than in tumor-free survivors. After multifactorial regression analysis, tumor stage was the only major factor associated with prognosis and recurrence.