Ovarian sex cord stromal tumor is a general term for all kinds of rare tumors derived from ovarian stroma and cells around oocytes. Because it is very rare, it is difficult to clearly recommend its treatment. Operation is a necessary means of treatment and diagnosis. The staging system is the same as that of epithelial ovarian cancer. Most malignant ovarian sex cord stromal tumors tend to have early onset age and early stage, and relapse later after a silent period, so they can be treated conservatively. Chan et al reviewed 83 patients with ovarian sex cord stromal tumors, nearly 50% of whom were less than 50 years old and 70% were early stage. Similar to previous reports, they confirmed that tumor size (< 10cm) and lack of residual lesions can improve prognosis.
On average, each reduction of lcm residual lesions reduced mortality by 8 per cent, and no residual lesions increased overall survival by 66 months. Although the researchers did not report a significant difference in overall survival between unstaged and staged patients, the recurrence rate of unstaged patients was significantly higher (64% vs 28%). Because most sex cord stromal tumors secrete sex steroids, including estrogen, 55% of patients are complicated with endometrial hyperplasia and 10% of patients have endometrial adenocarcinoma. Total hysterectomy and bilateral salpingectomy are recommended for postmenopausal and postpartum women. If patients want to retain fertility, unilateral salpingectomy is feasible for early patients, and endometrial biopsy is performed before operation to rule out the possibility of endometrial adenocarcinoma. Because the tumor is resistant to chemotherapy and radiotherapy, surgery is the first choice for patients with recurrence and metastasis, and it has been reported to control the local recurrence by complete resection.
