Use of staging for sex cord stromal tumours

Abstract

Purpose of reviewSex cord-stromal tumours (SCSTs) are rare ovarian cancers. As in the literature, only small case series or case reports are published, gathering solid evidence about their management is challenging. Surgery plays a pivotal role, and accurate staging is one of the most important prognostic factors. This review focuses on the current evidence for surgical staging in the management of SCSTs. Recent findingsStaging procedures have been inferred by epithelial ovarian cancers; however, they are often only partially performed, and most SCSTs therefore end up incompletely staged, raising the issue of the need for restaging or further treatments. In addition, some parts of the staging procedure have been questioned over the years, and lymphadenectomy is now considered unnecessary for SCSTs. The generally favourable prognosis of SCSTs, the introduction of minimally invasive surgery and fertilitysparing approaches is empowering the question of which staging procedures are beneficial for these patients. We reviewed the role of each staging procedure proposed by the guidelines in light of new scientific updates.

Sertoli-Leydig cell tumor with DICER1 mutation

“…A lymphadenectomy is not commonly performed due to low risk of nodal spread or recurrence. In many cases, peritoneal staging is not performed during a primary surgery because tumor pathology is not identified until the final pathology report is finalized postoperatively ( Negri et al, 2022 ). In this reported case, only pelvic washings were completed as the mass was not grossly suspicious, and the case was completed at an outside facility with limited ability to assess a frozen section.…”

Obstetric Results after Fertility-Sparing Management of Non-Epithelial Ovarian Cancer

“…The restaging surgery involves two issues: peritoneal procedures and lymph node assessments. Peritoneal staging is important for SCST, because these tumors mainly spread intraperitoneally [ 11 ]. The European Society of Medical Oncology indicates that performing a lymphadenectomy on SCST patients is not recommended because the incidence of lymph node metastases is low [ 12 , 13 ], whereas, in GCT, the significance of lymphadenectomy is not clear.…”

Review on Sertoli-Leydig Cell Tumours of the Ovary

“…However, the expression of markers of sex cord differentiation may be absent or minimal in poorly differentiated SLCTs, making their diagnosis more difficult [31]. USO in patients with well-differentiated stage Ia/Ib tumours (with or without assessment of the contralateral ovary), or if fertility needs to be conserved [13,58].…”