Surgery represents the mainstay of treatment for uterine leiomyosarcomas (u-LMS) [1]. Resection of disease without fragmentation and with negative surgical margins seemingly provides survival advantage [1]. For macroscopically uterus-limited disease, total abdominal hysterectomy (TAH) should be considered as the standard management of choice [1]. Uterine leiomyosarcomas usually are discovered as incidental findings after hysterectomy or myomectomy for presumed benign pathology (e.g., fibroid uterus). For peri-menopausal or post-menopausal women, routine bilateral salpingo-oophorectomy (BSO) is usually performed; however, amongst pre-menopausal women with uterus-limited disease, the role of ovarian preservation (OP), as part of the staging process, remains to date a field of contention.