Low Grade Endometrial Stromal Sarcoma of Uterine: Review of 17 Cases
-
Nadereh Behtash
,
Setareh Akhavan
,
Mitra Modares Gilani
,
Azamsadat Mousavi
,
Fatemeh Ghaemmaghami
,
Marjan Moradi Mazhari
Abstract
Endometrial stromal sarcomas (ESS) are the second most common uterine sarcomas. Endometrial stromal sarcomas account for 0.25% of all uterine malignancies. Uterine sarcomas most often affect postmenopausal women. The aim of this retrospective study was to review the experience in the treatment and clinical outcome of low grade malignant endometrial stromal sarcoma. Seventeen patients with histologically proven low grade ESS in department of Gynecologic Oncology of the Vali-e-Asr Hospital, Tehran-Iran, between 1999 and 2008 were included in the analysis. Demographics, pathology, treatment, time to recurrence, salvage therapy and survival information was collected. The median age of our patients was 45.35±6.8 (range 36-61). The median parity of the patients was 5 (range 0-8). Most patients were diagnosed at FIGO stage I. The mean survival for patients with stage I and II was 73.5±35.09 and 57.6±5.37 months, respectively, with mortality rate of 5.9% through a median follow-up time of 68.82±30 months. Of 17 patients, seven cases (35.29%) were disease free at 6 years after hysterectomy. Radiotherapy was administered to four patients (23.53%). Only one patient recurred at 10th month after surgery. Surgeries not preserving ovarian function were helpful to decrease the risk of recurrence compared with those sparing ovarian function.
Garg G, Shah JP, Toy EP, Bryant CS, Kumar S, Morris RT. Stage IA vs. IB endometrial stromal sarcoma: does the new staging system predict survival? Gynecol Oncol 2010;118(1):8-13.
Boardman CH, Webb MJ, Jefferies JA. Low-grade endometrial stromal sarcoma of the ectocervix after therapy for breast cancer. Gynecol Oncol 2000;79(1):120-3.
Pink D, Lindner T, Mrozek A, Kretzschmar A, Thuss- Patience PC, Dörken B, Reichardt P. Harm or benefit of hormonal treatment in metastatic low-grade endometrial stromal sarcoma: single center experience with 10 cases and review of the literature. Gynecol Oncol 2006;101(3):464-9.
Ashraf-Ganjoei T, Behtash N, Shariat M, Mosavi A. Low grade endometrial stromal sarcoma of uterine corpus, a clinico-pathological and survey study in 14 cases. World J Surg Oncol 2006;4:50.
Demopoulos RI, Mesia AF. Effects of leuprolide acetate on treatment of leiomyomata: clues to mechanisms of action. Adv Anat Pathol 1998;5(2):129-36.
El Husseiny G, Al Bareedy N, Mourad WA, Mohamed G, Shoukri M, Subhi J, Ezzat A. Prognostic factors and treatment modalities in uterine sarcoma. Am J Clin Oncol 2002;25(3):256-60.
Pekindil G, Tuncyurek O, Orguc S, Inceboz U, Kandiloglu AR, Caglar H. A case of endometrial stromal sarcoma with curvilinear calcification. Gynecol Oncol 2005;98(2):318-21.
Zemlyak A, Hwang S, Chalas E, Pameijer CR. Primary extrauterine endometrial stromal cell sarcoma: a case and review. J Gastrointest Cancer 2008;39(1-4):104-6.
Feeley KM, Burton JL, Wells M. A diagnostic approach to endometrial biopsies: selected topics. Curr Diagn Pathol 2000;6(1):13-20.
Geller MA, Argenta P, Bradley W, Dusenbery KE, Brooker D, Downs LS Jr, Judson PL, Carson LF, Boente MP. Treatment and recurrence patterns in endometrial stromal sarcomas and the relation to c-kit expression. Gynecol Oncol 2004;95(3):632-6.
Bodner K, Bodner-Adler B, Obermair A, Windbichler G, Petru E, Mayerhofer S, Czerwenka K, Leodolter S, Kainz C, Mayerhofer K. Prognostic parameters in endometrial stromal sarcoma: a clinicopathologic study in 31 patients. Gynecol Oncol 2001;81(2):160-5.
Mansi J, Ramachandra S, Wiltshaw E, Fisher C. Case report: endometrial stromal sarcoma. Gynecol Oncol 1990;36(1):113 8.
Katz L, Merino MJ, Sakamoto H, Schwartz PE. Endometrial stromal sarcoma: a clinicopathologic study of 11 cases with determination of estrogen andprogestin receptor levels in three tumors. Gynecol Oncol 1987;26(1):87-97.
Sutton GP, Stehman FB, Michael H, Young PC, Ehrlich CE. Estrogen and progesterone receptors in uterine sarcomas. Obstet Gynecol 1986;68(5):709-14.
Scribner DR Jr, Walker JL. Low-grade endometrial stromal sarcoma preoperative treatment with Depo- Lupron and Megace. Gynecol Oncol 1998;71(3):458-60.
Nordal RR, Kristensen GB, Kaern J, Stenwig AE, Pettersen EO, Tropé CG. The prognostic significance of surgery, tumor size, malignancy grade, menopausal status, and DNA ploidy in endometrial stromal sarcoma. Gynecol Oncol 1996;62(2):254-9.
Liokumovich P, Goldberg I, Davidson B, Gotlieb WH, Zahavi T, Ben-Baruch G, Reder I, Kopolovic J. Expression of metalloproteinases endometrial stromal sarcoma: immunohistochemical study using image analysis. J Clin Pathol 1999;52(3):198-202.
Spano JP, Soria JC, Kambouchner M, Piperno- Neuman S, Morin F, Morere JF, Martin A, Breau JL.Long-term survival of patients given hormonal therapyfor metastatic endometrial stromal sarcoma. MedOncol 2003;20(1):87-93.
Michalas S, Creatsas G, Deligeoroglou E, Markaki S.High-grade endometrial stromal sarcoma in a 16-yearoldgirl. Gynecol Oncol 1994;54(1):95-8.
Li N, Wu LY, Zhang HT, An JS, Li XG, Ma SK. Treatment options in stage I endometrial stromal sarcoma: a retrospective analysis of 53 cases. Gynecol Oncol 2008;108(2):306-11.
Sato T, Maeda H, Suzuki A, Shibuya H, Sakata A, Shirai W. Endometrial stromal sarcoma with smooth muscle and glandular differentiation of the felineuterus. Vet Pathol 2007;44(3):379-82.
Fadare O, McCalip B, Mariappan MR, Hileeto D, Parkash V. An endometrial stromal tumor with osteoclast-like giant cells. Ann Diagn Pathol 2005;9(3):160-5.
Boardman CH, Webb MJ, Jefferies JA. Low-gradeendometrial stromal sarcoma of the ectocervix after therapy for breast cancer. Gynecol Oncol 2000;79(1):120-3.
Leath CA 3rd, Huh WK, Hyde J Jr, Cohn DE, Resnick KE, Taylor NP, Powell MA, Mutch DG, Bradley WH, Geller MA, Argenta PA, Gold MA. A multiinstitutional review of outcomes of endometrial stromal sarcoma. Gynecol Oncol 2007;105(3):630-4.
Diesing D, Cordes T, Finas D, Löning M, Mayer K,Diedrich K, Friedrich M. Endometrial stromal sarcomas: a retrospective analysis of 11 patients. Anticancer Res 2006;26(1B):655-61.
Pink D, Lindner T, Mrozek A, Kretzschmar A, Thuss- Patience PC, Dörken B, Reichardt P. Harm or benefit of hormonal treatment in metastatic low-grade endometrial stromal sarcoma: single center experience with 10 cases and review of the literature. Gynecol Oncol 2006;101(3):464-9.
Berkowitz RS, Goldstein DP. Uterine cancer. In: Berek JS, Hacker NE, editors. Practical Gynecologic Oncology. 4th ed. Philadelphia: Lippincott Williams and Wilkins; 2005. p. 431-2.
Tavassoli FA, Devilee P, editors. World Health Organisation (WHO) Classification of Tumours: Pathology and Genetics of Tumours of the Breast and Female Genital Organs. Lyon, France: IARC Press; 2003. p. 92, 93, 283, 305.
Kim WY, Lee JW, Choi CH, Kang H, Kim TJ, Kim BG, Lee JH, Bae DS. Low-grade endometrial stromal sarcoma: a single center's experience with 22 cases. Int J Gynecol Cancer 2008;18(5):1084-9.
Sagae S, Yamashita K, Ishioka S, Nishioka Y, Terasawa K, Mori M, Yamashiro K, Kanemoto T, Kudo R. Preoperative diagnosis and treatment results in 106 patients with uterine sarcoma in Hokkaido,Japan. Oncology 2004;67(1):33-9.
Yokoyama Y, Ono Y, Sakamoto T, Fukuda I, Mizunuma H. Asymptomatic intracardiac metastasis from a low-grade endometrial stromal sarcoma with successful surgical resection. Gynecol Oncol 2004;92(3):999-1001.
Ma SK, Zhang HT, Wu LY, Liu LY, Li B. Treatment and prognosis of low-grade malignant endometrial stromal sarcoma. Zhonghua Zhong Liu Za Zhi 2007;29(1):74-8.
Park JY, Kim DY, Suh DS, Kim JH, Kim YM, Kim YT, Nam JH. Prognostic factors and treatmentoutcomes of patients with uterine sarcoma: analysis of 127 patients at a single institution, 1989-2007. J Cancer Res Clin Oncol 2008;134(12):1277-87.
| Files | ||
| Issue | Vol 49, No 9 (2011) | |
| Section | Original Article(s) | |
| Keywords | ||
| Sarcoma Endometrial stromal Outcome assessment Surgery | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
