Clinicopathological and molecular markers associated with prognosis and treatment effectiveness of endometrial stromal sarcoma: a retrospective study in China

Li, He; Li, Jun Dong; Xiong, Ying; Huang, Xin; Huang, Long; Ji, Lin; Zhou, Yun; Zheng, Min

doi:10.1007/s00404-013-2987-5

Cited by 14 publications

(14 citation statements)

References 25 publications

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“…Because of its rarity and heterogeneous morphological appearance, low-grade ESS (LG-ESS) is often misdiagnosed as a different uterine neoplasm. [ 2 – 4 ] Accurate diagnoses are not established in some cases until the disease relapse. [ 3 , 5 ] Although immunohistochemistry (IHC) often plays an adjunct role in the differential diagnosis of different uterine mesenchymal lesions, [ 6 ] sensitive and specific IHC markers have not been identified for LG-ESS, and valid data are lacking.…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological characteristics and treatment strategies for patients with low-grade endometrial stromal sarcoma

et al. 2017

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To investigate and evaluate the clinicopathological characteristics and treatment strategies for patients with low-grade endometrial stromal sarcoma (LG-ESS).The medical records of LG-ESS patients who were treated at 2 cancer referral centers from January 2005 to December 2015 were retrospectively reviewed.Twenty patients with LG-ESS met the inclusion criteria and were included in this analysis. Hysterectomy with bilateral salpingo-oophorectomy was the mainstay of surgery. Lymphadenectomy was performed in 12 (60%) cases, and no positive nodes were identified. CD10 was the most commonly used immunohistochemistry marker, followed by smooth muscle actin (SMA), estrogen receptor (ER), desmin, progesterone receptor (PR), and S-100; the positivity rates of these markers were 88.2%, 66.7%, 75.0%, 16.7%, 88.9%, and 0, respectively. Postoperative chemotherapy, radiotherapy, and hormonal treatment were provided alone or in combination in 10 (50%) patients, 4 (20%) patients, and 1 (5%) patient, respectively. One patient developed lung metastasis at initial diagnosis, and 2 (10%) patients had recurrence with distant metastasis. They all underwent complete or incomplete resection followed by hormonal treatment. The overall survival time of these patients was 66, 89, and 109 months at last contact, respectively. The 5-year and 10-year disease-free survival rates for the entire cohort were 90% and 72%, respectively. No patients died of the disease.CD10+/SMA+/ER+/PR+ in combination with desmin−/S-100− might improve the diagnostic accuracy. Surgical resection is the foremost treatment for LG-ESS patients with recurrence or distant metastasis. Hormonal treatment may be beneficial for unresectable or residual tumors.

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Section: Introductionmentioning

confidence: 99%

Clinicopathological characteristics and treatment strategies for patients with low-grade endometrial stromal sarcoma

et al. 2017

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“…One meta-analysis suggest that lymphadenectomy bore little prognostic or therapeutic benefit in patients with uterine sarcoma [16]. However, another study showed total hysterectomy with BSO followed by pelvic lymphadenectomy was associated with an improved outcome [17]. Our data found that lymphadenectomy had no effect on both disease free survival (p=0.246) and overall survival (p=0.652).…”

Section: Discussionmentioning

confidence: 55%

Article Evaluation of treatment strategies and prognostic factors of 135 patients with low-grade endometrial stromal sarcoma

Wang

Liang

Zhang

et al. 2019

Preprint

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Background: To evaluate the influence of treatment modalities and prognostic factors on the survival of patients with low-grade endometrial stromal sarcoma (LGESS). Methods: One hundred and thirty-five LGESS patients in Fudan University Shanghai Cancer Center from January 2006 to December 2018 were retrospectively reviewed. Results: Two patients received fertility-sparing surgery while 133 patients received hysterectomy. The median follow-up duration was 52 months (3–342 months). One hundred and nine (80.7%) patients received ovariectomy, 73 (54.1%) patients had lymphadenectomy, 83 (61.5%) patients received adjuvant therapy. The 5-year and 10-year disease free survival rates were 72.0% and 61.0%, respectively. The 5-year and 10-year overall survival rates were 88.0% and 79.8%, respectively. Surgery for recurrence was associated with improved overall survival although the complication rate was about 27.6%. Multivariate analysis showed that lymphovascular invasion was associated with disease free survival (hazard ratio, 0.473; 95 % confidence interval, 0.235–0.952; p=0.036) and menopausal status was related to overall survival (hazard ratio, 5.561; 95 % confidence interval, 1.400–22.084; p=0.015). Conclusions: There was no effect of lymphadenectomy, ovariectomy, or adjuvant therapy on patients’ recurrence and survival. Hysterectomy may be proposed as the standard treatment for LGESS. Surgery for replase was an acceptable method to improve overall survival. Lymphovascular invasion was a significant independent factor for disease free survival. Postmenopause was the poor prognostic factor for overall survival.

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“…Often, routine imaging (TVS, MRI) seems unable to discriminate between leiomyoma and ESS; for this reason, preoperative diagnosis is not easy. 6 , 17 This neoplasm can be diagnosed preoperatively through hysteroscopic biopsies or through endometrial curettage. 7 , 18 Intraoperative frozen section seems to have an intermediate diagnostic accuracy; only definitive histopathology examination achieves a good accuracy, thanks to the invaluable contribution of immunohistochemistry investigations.…”

Section: Discussionmentioning

confidence: 99%

“…In particular, this last parameter represents the single most important oncological prognostic factor. 4 , 5 , 7 , 17 …”

Section: Discussionmentioning

confidence: 99%

“…Recently, the expression of the immunohistochemical marker CD10 on ESS cell surface has been suggested as a positive prognostic marker. 17 Different authors suggest that ovary-sparing surgery may represent a safe option for patients characterized by early stage disease (FIGO I–II), small primary tumor, and free resection margins. 4 , 7 According to the evidence stated, we can suppose that these strict criteria could be a useful starting point to define the feasibility and efficacy of a conservative management for ESS.…”

Section: Discussionmentioning

confidence: 99%

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Fertility sparing surgery in young women affected by endometrial stromal sarcoma: an oncologic dilemma or a reliable option? review of literature starting from a peculiar case

Noventa¹,

Gizzo²,

Conte³

et al. 2014

OTT

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BackgroundEndometrial stromal sarcoma (ESS) is a term used to define a rare neoplasm that accounts for approximately 0.2%–1% of all uterine malignancies; it is, however, implicated in an estimated 10%–15% of those malignancies with a mesenchymal component. Recent evidence suggests that while the preservation of the ovaries may be considered appropriate in premenopausal women, hysterectomy and bilateral salpingo-oophorectomy remains the recommended treatment in postmenopausal women. Currently, only a few case series reporting the treatment of ESS in young women with a desire to preserve fertility and thus subjected to a fertility-sparing surgery are available in the literature.Case presentationWe report a peculiar case of early stage ESS treated by laparoscopic fertility-sparing surgery and a strict follow-up program (every 3 months) of imaging and clinical evaluation. The patient remained disease free 1 year after primary treatment. Three months after completing oncological follow-up, the patient conceived spontaneously and is, to date, pregnant at 11 weeks of gestation without evidence of recurrent disease or obstetric complications.ConclusionBased on our case report and in accordance with the data available, we suggest that in young patients affected by early stage ESS who wish to preserve reproductive function, fertility-sparing surgery could represent a valid option, though strict oncological follow-up remains mandatory.

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Clinicopathological and molecular markers associated with prognosis and treatment effectiveness of endometrial stromal sarcoma: a retrospective study in China

Cited by 14 publications

References 25 publications

Clinicopathological characteristics and treatment strategies for patients with low-grade endometrial stromal sarcoma

Clinicopathological characteristics and treatment strategies for patients with low-grade endometrial stromal sarcoma

Article Evaluation of treatment strategies and prognostic factors of 135 patients with low-grade endometrial stromal sarcoma

Fertility sparing surgery in young women affected by endometrial stromal sarcoma: an oncologic dilemma or a reliable option? review of literature starting from a peculiar case

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