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Review
Fertility sparing surgery in sex-cord stromal tumors: oncological and reproductive outcomes
  1. Alice Bergamini1,
  2. Fais Maria Luisa2,
  3. Miriam Dellino3,
  4. Silvestri Erica4,
  5. Vera Loizzi5,
  6. Luca Bocciolone6,
  7. Emanuela Rabaiotti1,
  8. Raffaella Cioffi7,
  9. Giulia Sabetta7,
  10. Gennaro Cormio5 and
  11. Giorgia Mangili8
  1. 1 Ospedale San Raffaele, Milano, Lombardia, Italy
  2. 2 Department of Surgical Sciences, Division of Gynecology and Obstetrics, Cagliari, Italy
  3. 3 Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy
  4. 4 IRCCS Istituto Tumori “Giovanni Paolo II” Gynecologic Oncology Unit, Bari, Italy
  5. 5 Department of Gynecology, University of Bari, Bari, Puglia, Italy
  6. 6 Department of Obstetrics and Gynecology, IRCCS San Raffaele, Milan, Italy
  7. 7 IRCCS San Raffaele Scientific Institute, Milan, Italy
  8. 8 Gynecology Department, I.R.C.C.S. San Raffaele Hospital, Milan, Italy
  1. Correspondence to Dr Miriam Dellino, Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy; miriamdellino{at}hotmail.it

Abstract

Sex cord stromal tumors are rare neoplasms, frequently diagnosed in young women often as early-stage disease. In patients who desire to preserve fertility, when possible, unilateral salpingo-oophorectomy with peritoneal surgical staging is a safe alternative to radical treatment. In this review, we analyze the available literature on the obstetrical outcomes after fertility-sparing surgery in a total of 255 patients with sex cord stromal tumors. We found that the spontaneous conception rate in granulosa cells tumor is encouraging (88.5%). In particular, juvenile granulosa cell tumors are associated with a more successful pregnancy rate than adult granulosa cells tumors (11/26 (42.3%) in juvenile granulosa cells tumors compared with 28.5% in adult granulosa cell tumors, respectively.) On the other hand, the results of obstetrical outcomes in Sertoli-Leydig cells tumors are less promising (7/36 (19.4%)). Unfortunately, no evidence on this topic is available for sex cord tumor with annular tubules due to the low incidence. Regarding the oncological outcomes of 900 cases of sex cord stromal tumors treated conservatively, data are reassuring with comparable outcomes between patients treated with conservative and radical surgery. Given the limited available data on this rare tumor, further studies are needed to evaluate the safety of conservative approaches and to define the obstetrical outcomes in this patient population.

  • surgery
  • sertoli cell tumor
  • leydig cell tumor
  • ovarian cancer
  • surgical oncology

https://doi.org/10.1136/ijgc-2021-003241

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    Footnotes

    • AB and FML are joint first authors.

    • Contributors AB and FML: project development, manuscript writing, data collection; MD: manuscript reviewing, support writing, data collection; SE, LB, ER, and GS: manuscript reviewing; VL: manuscript editing; RC and GC: support writing; GM: project development, manuscript writing, manuscript editing.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.