A multi-institutional review of outcomes of endometrial stromal sarcoma

Leath, Charles A.; Huh, Warner K.; Hyde, Johnny; Cohn, David E.; Resnick, Kimberly; Taylor, Nicholas; Powell, Matthew A.; Mutch, David G.; Bradley, William H.; Geller, Melissa A.; Argenta, Peter A.; Gold, Michael A.

doi:10.1016/j.ygyno.2007.01.031

Cited by 182 publications

(136 citation statements)

References 27 publications

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“…In our analysis, stage I -II patients had a 5-year DSS of 89.3% compared with only 50.3% in stage III -IV disease. Grade has also long been recognized as an important factor in ESS (Norris and Taylor, 1966;Pautier et al, 2000;Haberal et al, 2003;Leath et al, 2007). In over 400 patients with grades 1 and 2 tumors in our study, the 5-year DSS was more than 90% compared with only 42% in those with grade 3 tumors.…”

Section: Discussionmentioning

confidence: 54%

“…These findings clearly support the hypothesis that highgrade ESSs have a distinct biologic behaviour. This has also been demonstrated by others (Gadducci et al, 1996;Leath et al, 2007). In fact, there are some investigators who have recommended a change in the classification of high-grade ESS to undifferentiated endometrial sarcoma, as these tumors have distinct pathologic and clinical properties compared with low-grade ESS.…”

Section: Discussionmentioning

confidence: 64%

“…Given the rarity of ESS, there are limited reports in the literature that have evaluated the prognostic factors of patients with this tumor. On account of significant differences in the clinical behaviour of ESS patients, Norris and Taylor first described the prognostic significance of histologic grade in ESS, and their findings have been subsequently confirmed by others (Norris and Taylor, 1966;Pautier et al, 2000;Leath et al, 2007). Furthermore, as high-grade ESS lack specific differentiation, recent modifications to pathologic classifications of uterine sarcoma have been recommended to rename high-grade ESS as undifferentiated endometrial sarcoma (Jaffe et al, 2001;Moinfar et al, 2007).…”

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confidence: 99%

“…The role of pelvic and para-aortic lymphadenectomy, and adjuvant therapy with radiation therapy, chemotherapy, or hormonal treatment remains controversial. Most of the earlier studies have been limited by a small number of patients from academic institutions with associated biases (Echt et al, 1990;Haberal et al, 2003;Denschlag et al, 2007;Leath et al, 2007). In addition, there are no large studies that have investigated the potential risk of ovarian preservation in young patients with early-stage disease.…”

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confidence: 99%

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Endometrial stromal sarcoma: a population-based analysis

et al. 2008

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To determine independent prognostic factors for the survival of patients with endometrial stromal sarcoma (ESS), data were abstracted from the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute from 1988 to 2003. Kaplan -Meier and Cox proportional hazards models were used for analyses. Of 831 women diagnosed with ESS, the median age was 52 years (range: 17 -96 years). In total, 59.9% had stage I, 5.1% stage II, 14.9% stage III, and 20.1% had stage IV disease. Overall, 13.0, 36.1, and 34.7% presented with grades 1, 2, and 3, respectively. Patients with stage I-II vs III-IV disease had 5 years DSS of 89.3% vs 50.3% (Po0.001) and those with grades 1, 2, and 3 cancers had survivals of 91.4, 95.4, and 42.1% (Po0.001). In multivariate analysis, older patients, black race, advanced stage, higher grade, lack of primary surgery, and nodal metastasis were independent prognostic factors for poorer survival. In younger women (o50 years) with stage I -II disease, ovarian-sparing procedures did not adversely impact survival (91.9 vs 96.2%; P ¼ 0.1). Age, race, primary surgery, stage, and grade are important prognostic factors for ESS. Excellent survival in patients with grade 1 and 2 disease of all stages supports the concept that these tumors are significantly different from grade 3 tumors. Ovarian-sparing surgeries may be considered in younger patients with early-stage disease.

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Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 64%

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confidence: 99%

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Endometrial stromal sarcoma: a population-based analysis

et al. 2008

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“…LG-ESS presents with lymph node metastasis in 9-33% cases (6,7) and displays characteristics that include frequent development as an intravascular tumor with intracardiac extension (ICE). The number of reported cases of LG-ESS with clinically obvious intravascular extension was only 19 over the last 38 years (8,9); however, up to one-third of the cases presented with extrauterine extension, including microscopic worm-like plugs within the vessels (4).…”

Section: Introductionmentioning

confidence: 99%

Intravenous low-grade endometrial stromal sarcoma with intracardiac extension: A CASE OF inaccurate tumor location on contrast-enhanced computed tomography

Nogami

Yamagami

Maki

et al. 2015

Molecular and Clinical Oncology

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Abstract.We herein report a case of low-grade endometrial stromal sarcoma with intracardiac extension in a 58-year-old woman with a uterine tumor with intravascular involvement. The tumor was suspected preoperatively to be an endometrial stromal sarcoma by magnetic resonance imaging. The extent of intravascular involvement was determined to be below the level of the renal veins on preoperative contrast-enhanced computed tomography (CT). However, perioperative echography revealed that the tumor extended to the right atrium. An emergency cardiotomy with extracorporeal circulation was required. The risk of tumor embolism was reduced through transection of the inferior vena cava, but the tumor was difficult to remove completely. Postoperative hormonal therapy reduced the size of the residual tumor and no recurrence was detected for 1 year. The preoperative contrast-enhanced CT was unable to detect the free-floating intravascular tumor. This case illustrates a limitation of CT and indicates that accurate determination of the tumor extent for planning a surgical strategy in similar cases should be performed using multiple imaging methods.

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