Ovarian Sertoli-Leydig cell tumors. A retrospective MITO study

ObjectiveTo evaluate clinicopathologic features and to investigate the outcome of patients with ovarian Sertoli-Leydig cell tumors (SLCTs).MethodsData concerning 21 patients treated in 11 MITO centers were retrospectively reviewed.ResultsMedian age was 37 (range 16–76). FIGO stage was: 17 (81%) IA, 1 (4.8%) IC, 1 (4.8%) IIB and 2 (9.5%) IIIC. Five patients (23.8%) had G1 tumor, ten (47.6%) had G2, and six (28.6%) had G3. Fertility-sparing operation was performed in 11 patients, while hysterectomy with bilateral salpingo-oophorectomy was executed in 10 patients; five patients received adjuvant chemotherapy (G2–3). Seven patients (33.3%) relapsed with a median time to recurrence of 14 months. Six recurrent patients had G2–3 disease, while one had G1. Four patients had stage IA disease, one IC and 2 stage IIIC. Patients with stage IA disease did not receive adjuvant chemotherapy. Two patients had pelvic recurrence, 4 abdominal (one with lymph nodal involvement), one on the contralateral ovary and the trocar access. Five patients underwent salvage surgery plus chemotherapy, while one received only salvage chemotherapy and one palliation.Five patients died of disease, four had received first treatment not in a MITO center. 5 year overall survival was 100% for patients with G1 disease and 77.8% for G2–3. 5 year overall survival was 92.3% for stage I and 33.3% for stage > I.ConclusionsThe prognosis of patients with grade 1 SLCT is excellent without adjuvant chemotherapy. Patients with advanced stage or grade 2–3 tumors appear to benefit from postoperative chemotherapy.

► Stage I grade 1 SLCTs have an excellent prognosis and surgery is curative.
► Intermediate and poorly differentiated SLCTs require more aggressive management.
► Complete surgical staging and adjuvant chemotherapy should be considered.