Sexcord/ stromal ovarian tumors surgery
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Sexcord/ stromal ovarian tumors Microchapters |
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Differentiating Sexcord/ Stromal Ovarian Tumors from other Diseases |
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Sexcord/ stromal ovarian tumors surgery On the Web |
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Risk calculators and risk factors for Sexcord/ stromal ovarian tumors surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Surgical intervention is not recommended for the management of [disease name].
OR
Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]
OR
The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].
OR
The feasibility of surgery depends on the stage of [malignancy] at diagnosis.
OR
Surgery is the mainstay of treatment for [disease or malignancy].
Indications
- Surgical intervention is not recommended for the management of [disease name].
OR
- Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either:
- [Indication 1]
- [Indication 2]
- [Indication 3]
- The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either:
- [Indication 1]
- [Indication 2]
- [Indication 3]
Surgery
- Surgery is the mainstay of treatment for sexcord/ stromal ovarian tumors[1][2][3][4][5][6][7][8]
- Both benign and malignant ovarian sex cord-stromal tumors are managed surgically
- The schematic approach to malignant sexcord/ stromal ovarian tumors is decribed below
| Malignant sexcord-stromal tumors | |||||||||||||||||||||||||||||||||||||||
| Stage IA/IC: fertility desired | All others | ||||||||||||||||||||||||||||||||||||||
| Fertility sparing surgery with complete staging | Complete staging | ||||||||||||||||||||||||||||||||||||||
| Stage I, low risk | Stage I high risk(eg, ruptured stage IC or poorly differentiated stage I) or Intermediate risk(eg, heterologous elements | Stage II-IV | |||||||||||||||||||||||||||||||||||||
| Observe | Observe or consider platinum based chemotherapy | platinum based chemotherapy or radiotherapy for limited disease | |||||||||||||||||||||||||||||||||||||
| Surveillance | Surveillance | Surveillance | |||||||||||||||||||||||||||||||||||||
| If clinical relapse: Clinical trial, consider secondary cytoreductive surgery, or recurrence therapy | |||||||||||||||||||||||||||||||||||||||
Complete surgical staging includes a total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH-BSO). One notable difference between sex cord-stromal versus other ovarian neoplasms is that lymph node metastases are rare [3,4] (see 'Patterns of spread' above). Pelvic and paraaortic lymphadenectomy may result in lymphedema that impacts postoperative quality of life. Thus, for most women with malignant sex cord-stromal neoplasms, we suggest not performing pelvic and paraaortic lymphadenectomy. Nodes should be palpated, however, and lymphadenectomy is required for women with palpable nodal enlargement. Pelvic and paraaortic lymphadenectomy should also be performed in women in whom there is a suspicion of a different histologic type of ovarian malignant neoplasm.
Contraindications
References
- ↑ Gurumurthy M, Bryant A, Shanbhag S (April 2014). "Effectiveness of different treatment modalities for the management of adult-onset granulosa cell tumours of the ovary (primary and recurrent)". Cochrane Database Syst Rev (4): CD006912. doi:10.1002/14651858.CD006912.pub2. PMID 24753008.
- ↑ Gremeau AS, Bourdel N, Jardon K, Rabischong B, Mage G, Pouly JL, Canis M (January 2014). "Surgical management of non-epithelial ovarian malignancies: advantages and limitations of laparoscopy". Eur. J. Obstet. Gynecol. Reprod. Biol. 172: 106–10. doi:10.1016/j.ejogrb.2013.10.023. PMID 24315353.
- ↑ Schultz KA, Schneider DT, Pashankar F, Ross J, Frazier L (May 2012). "Management of ovarian and testicular sex cord-stromal tumors in children and adolescents". J. Pediatr. Hematol. Oncol. 34 Suppl 2: S55–63. doi:10.1097/MPH.0b013e31824e3867. PMID 22525408.
- ↑ Gershenson DM (June 2012). "Current advances in the management of malignant germ cell and sex cord-stromal tumors of the ovary". Gynecol. Oncol. 125 (3): 515–7. doi:10.1016/j.ygyno.2012.03.019. PMID 22426486.
- ↑ Färkkilä A, Haltia UM, Tapper J, McConechy MK, Huntsman DG, Heikinheimo M (August 2017). "Pathogenesis and treatment of adult-type granulosa cell tumor of the ovary". Ann. Med. 49 (5): 435–447. doi:10.1080/07853890.2017.1294760. PMID 28276867.
- ↑ Uma Devi K, Purushotham N, Jayashree N (2015). "Management of Ovarian Cancer In Younger Women". Rev Recent Clin Trials. 10 (4): 263–9. PMID 26411956.
- ↑ Qian Q, You Y, Yang J, Cao D, Zhu Z, Wu M, Chen J, Lang J, Shen K (April 2015). "Management and prognosis of patients with ovarian sex cord tumor with annular tubules: a retrospective study". BMC Cancer. 15: 270. doi:10.1186/s12885-015-1277-y. PMC 4408581. PMID 25886261.
- ↑ Chatziioannidou K, Botsikas D, Tille JC, Dubuisson J (May 2015). "Preservation of fertility in non-Peutz-Jegher syndrome-associated ovarian sex cord tumour with annular tubules". BMJ Case Rep. 2015. doi:10.1136/bcr-2014-207841. PMC 4434316. PMID 25969483.