Abstract：
OBJECTIVE: Uterine tumours resembling ovarian sex cord tumours (UTROSCTs) are extremely rare. To date, most patients with UTROSCTs have undergone hysterectomy and had a benign clinical course. Fertility-preserving surgery should be considered because some patients with UTROSCTs are aged < 40 years. This paper reviews the treatment and prognosis for patients with UTROSCTs, with a focus on fertility.
METHODS: PubMed, MEDLINE and Scopus were searched systematically for case reports and case series of UTROSCTs published in English from inception to December 2022, and initial treatment and recurrence rates were compared. The following data were extracted: age; symptoms; initial therapy; metastasis at diagnosis; disease-free survival (DFS); and recurrence.
RESULTS: In total, 147 patients (72 studies) reporting the clinical course of UTROSCTs were analysed. The median age at diagnosis was 50 years, and 28 (19.0 %) patients were aged < 40 years. Most patients (n = 125, 85.0 %) underwent hysterectomy as the initial surgery, with a recurrence rate of 17.6 % (n = 22). The recurrence rate was 30 % (n = 6) in patients who underwent mass resection (n = 20). Among the 15 patients who underwent mass resection aged < 40 years, seven went on to achieve pregnancy (46.7 %) and six had successful deliveries (40.0 %). No significant differences in 5- and 10-year DFS were found between the hysterectomy and mass resection groups (p = 0.123 and 0.0612, respectively). Bilateral salpingo-oophorectomy in addition to hysterectomy was not significantly associated with 10-year DFS (p = 0.548).
CONCLUSIONS: While total hysterectomy is the recommended treatment for UTROSCTs based on recurrence rates, mass resection is an acceptable treatment option for patients who wish to retain their childbearing potential. It is recommended that these women should plan for pregnancy and delivery as soon as possible after mass resection, and should undergo hysterectomy within 5 years.
METHODS: PubMed, MEDLINE and Scopus were searched systematically for case reports and case series of UTROSCTs published in English from inception to December 2022, and initial treatment and recurrence rates were compared. The following data were extracted: age; symptoms; initial therapy; metastasis at diagnosis; disease-free survival (DFS); and recurrence.
RESULTS: In total, 147 patients (72 studies) reporting the clinical course of UTROSCTs were analysed. The median age at diagnosis was 50 years, and 28 (19.0 %) patients were aged < 40 years. Most patients (n = 125, 85.0 %) underwent hysterectomy as the initial surgery, with a recurrence rate of 17.6 % (n = 22). The recurrence rate was 30 % (n = 6) in patients who underwent mass resection (n = 20). Among the 15 patients who underwent mass resection aged < 40 years, seven went on to achieve pregnancy (46.7 %) and six had successful deliveries (40.0 %). No significant differences in 5- and 10-year DFS were found between the hysterectomy and mass resection groups (p = 0.123 and 0.0612, respectively). Bilateral salpingo-oophorectomy in addition to hysterectomy was not significantly associated with 10-year DFS (p = 0.548).
CONCLUSIONS: While total hysterectomy is the recommended treatment for UTROSCTs based on recurrence rates, mass resection is an acceptable treatment option for patients who wish to retain their childbearing potential. It is recommended that these women should plan for pregnancy and delivery as soon as possible after mass resection, and should undergo hysterectomy within 5 years.
摘要：
目的：类似于卵巢性索肿瘤（UTROSCTs）的子宫肿瘤极为罕见。迄今为止,大多数UTROSCTs患者接受了子宫切除术,且临床病程良性.由于一些UTROSCT患者的年龄<40岁，因此应考虑进行保留生育力的手术。本文就UTROSCTs患者的治疗及预后进行综述,关注生育。
方法：PubMed，系统检索MEDLINE和Scopus从开始至2022年12月以英文发表的病例报告和病例系列UTROSCT，并比较初始治疗和复发率。提取以下数据：年龄；症状；初始治疗；诊断时的转移；无病生存（DFS）；和复发。
结果：总计，分析了147例报告UTROSCTs临床病程的患者（72项研究）。诊断时的中位年龄为50岁，28例（19.0%）患者年龄<40岁。大多数患者（n=125，85.0％）接受了子宫切除术作为初始手术，复发率为17.6%(n=22)。接受大量切除术的患者（n=20）的复发率为30％（n=6）。在15例年龄<40岁的患者中，7人成功怀孕(46.7%)，6人成功分娩(40.0%)。子宫切除术组和肿块切除术组的5年和10年DFS没有显着差异（分别为p=0.123和0.0612）。除子宫切除术外，双侧输卵管卵巢切除术与10年DFS没有显着相关（p=0.548）。
结论：虽然全子宫切除术是基于复发率的UTROSCTs的推荐治疗方法，对于希望保留生育潜力的患者,大规模切除是一种可接受的治疗选择.建议这些妇女在大量切除后应尽快计划怀孕和分娩,并应在5年内进行子宫切除术。
方法：PubMed，系统检索MEDLINE和Scopus从开始至2022年12月以英文发表的病例报告和病例系列UTROSCT，并比较初始治疗和复发率。提取以下数据：年龄；症状；初始治疗；诊断时的转移；无病生存（DFS）；和复发。
结果：总计，分析了147例报告UTROSCTs临床病程的患者（72项研究）。诊断时的中位年龄为50岁，28例（19.0%）患者年龄<40岁。大多数患者（n=125，85.0％）接受了子宫切除术作为初始手术，复发率为17.6%(n=22)。接受大量切除术的患者（n=20）的复发率为30％（n=6）。在15例年龄<40岁的患者中，7人成功怀孕(46.7%)，6人成功分娩(40.0%)。子宫切除术组和肿块切除术组的5年和10年DFS没有显着差异（分别为p=0.123和0.0612）。除子宫切除术外，双侧输卵管卵巢切除术与10年DFS没有显着相关（p=0.548）。
结论：虽然全子宫切除术是基于复发率的UTROSCTs的推荐治疗方法，对于希望保留生育潜力的患者,大规模切除是一种可接受的治疗选择.建议这些妇女在大量切除后应尽快计划怀孕和分娩,并应在5年内进行子宫切除术。
