The Value of Surgery and the Prognostic Factors for Patients with Recurrent Low-grade Endometrial Stromal Sarcoma: a Retrospective Study of 38 Patients

Overview

Journal J Gynecol Oncol

Specialties Gynecology & Obstetrics
Oncology

Date 2024 May 10

PMID 38725236

Authors

Chenlian Quan

Zhong Zheng

Siyu Cao

Yong Wu

Wei Zhang

Yan Huang

Affiliations

Soon will be listed here.

Abstract

Objective: As an indolent malignant tumor, the long-term management of low-grade endometrial stromal sarcoma (LGESS) patients required awareness, especially the management of recurrences. Unfortunately, few studies focused on the treatment of recurrent LGESS. Our study aimed to investigate the prognostic factors and the value of recurrent surgery on recurrent LGESS.

Methods: This retrospective study consecutively recruited patients with pathologically diagnosed recurrent LGESS at our center from April 1, 2004 to April 1, 2020.

Results: After a median follow-up of 137.0 months (95% confidence interval=85.4-188.6), the 5-year cumulative survival rate of the cohort of 38 patients with recurrent LGESS was 71.1%. The median overall survival (OS) and post-recurrence survival (PRS) was 156 and 89.0 months. Survival analysis showed that patients with younger age, positive estrogen receptor (ER) and optimal abdominopelvic debulking in the first recurrent surgery had better prognosis (p<0.05). Multivariate analysis showed that optimal abdominopelvic debulking in the first recurrent surgery was the only independent prognostic factor for OS and PRS (OS=216.0/35.0 months, hazard ratio [HR]=5.319, p=0.034; PRS=not reached/4.0 months, HR=10.900, p=0.006). There was no significant difference in OS and PRS between patients recurred only once and those recurred at least twice (p>0.05).

Conclusions: The prognosis of recurrent LGESS was favorable. Optimal debulking of no residual tumor in abdominal and pelvic cavity should be the first choice of treatment for recurrent patients, while preservation of ovary or fertility should not be recommended.

Citing Articles

Recurrent Low-grade endometrial stromal sarcoma metastasized to the common iliac veins, extending into the inferior vena cava and right atrium after 12 years: A case report.

Naaman N, Alyafi M, Albeshri H, Jamjoom A, AlTurkistany S, Al-Maghrabi H Gynecol Oncol Rep. 2024; 56:101543.

PMID: 39737433 PMC: 11683952. DOI: 10.1016/j.gore.2024.101543.

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