Abstract：
Background and Objectives: Uterine sarcomas represents only 3% of all the female genital tract ones. The tumoral stage is the most significant prognostic factor. The role of the bilateral salpingo-oophorectomy (BSO) in the surgical management of FIGO stage IA and IB appears still controversial. This review aims to investigate the impact of bilateral adnexectomy in the treatment of uterine sarcoma. Methods: Following the recommendations in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we systematically searched the PubMed, Scopus, Cochrane, Medline, and Medscape databases in February 2022. We applied no language or geographical restrictions, but we considered only English studies. We included the studies containing data about Recurrence Rate (RR), Disease-free Survival (DFS), and Overall Survival (OS). We used comparative studies for meta-analysis. Results: Seventeen studies fulfilled the inclusion criteria; 2 retrospective observational studies, and 15 retrospective comparative studies, And 14 out of the 15 comparative studies were enrolled in meta-analysis. A total of 3743 patients were analyzed concerning the use of adnexectomy with hysterectomy in patients with uterine sarcoma and compared with those who did not. Meta-analysis highlighted a non-significant worsening of the OS in the BSO group compared to the OP group and showed that adnexectomy does not improve the DFS (BSO OR 1.23 (95% CI 0.81-1.85) p = 0.34; I2 = 24% p = 0.22). Conclusions: Most studies selected for our review showed that adnexectomy does not significantly affect the RR, OS, and PFS in treating FIGO stage I uterine sarcomas. Therefore, even if there is a unanimous consensus about bilateral adnexectomy in menopausal patients, preservation of ovarian tissue may be considered in premenopausal women. Nonetheless, there are not enough cases in the literature to recommend this procedure.
摘要：
背景和目的：子宫肉瘤仅占所有女性生殖道肉瘤的3％。肿瘤分期是最重要的预后因素。双侧输卵管卵巢切除术（BSO）在FIGOIA和IB期手术治疗中的作用仍然存在争议。本文旨在探讨双侧附件切除术在子宫肉瘤治疗中的作用。方法：遵循系统审查和荟萃分析（PRISMA）声明的首选报告项目中的建议，我们系统地搜索了PubMed,Scopus,科克伦,Medline,和Medscape数据库在2022年2月。我们没有语言或地理限制，但我们只考虑学习英语。我们纳入了包含复发率(RR)数据的研究，无病生存率（DFS），总生存率（OS）。我们使用比较研究进行荟萃分析。结果：17项研究符合纳入标准；2项回顾性观察研究，和15项回顾性比较研究，15项比较研究中有14项纳入了荟萃分析。对3743例子宫肉瘤患者进行了子宫切除术和子宫切除术的分析，并与未进行子宫切除术的患者进行了比较。Meta分析显示，与OP组相比，BSO组的OS无明显恶化，并显示附件切除术不能改善DFS（BSOOR1.23（95％CI0.81-1.85）p=0.34；I2=24％p=0.22）。结论：我们回顾选择的大多数研究表明附件切除术对RR没有显著影响，操作系统,和PFS治疗FIGOI期子宫肉瘤。因此,即使对更年期患者的双侧附件切除术有一致的共识，绝经前妇女可考虑保留卵巢组织。尽管如此，文献中没有足够的案例推荐此程序。
