Characteristics of patients with endometrial stromal sarcoma

Abstract

5145 Background: Endometrial stromal sarcoma (ESS) is by definition a low grade sarcoma, accounting for less than 1% of all tumor malignancies. The prevalence is approximately 2 per million women. By comparison, the prevalence of endometrial cancer is 700 per million women. Because of its rarity, the natural history of the disease and the optimal therapy have not been well established. Methods: After IRB approval, the charts of 78 patients diagnosed for the first time with ESS and treated at the University of Texas MDACC were reviewed, with emphasis on patient demographics, therapies, recurrence, and survival. Patients with stromal nodule, high grade ESS (undifferentiated sarcoma), or other sarcomas were excluded. Results: The median age of 78 patients was 43 (range 20–78), 85% were Caucasian, and 37% had received exogenous hormones before diagnosis. Endometrial FIGO stage was I in 52%, II in 6%, III in 30%, and IV in 12%. The primary site was uterus in 87% and extra-uterine in 13%. The median parity was 2. Among 68 patients, 78% were postmenopausal. The two-year recurrence rate was 25% and the five year recurrence rate was 51%. The five-year survival rate was 81%. Conclusions: Our study represents 36 years of collected data from MDACC. The demographic data has been recorded and tabled. The median age of onset is younger than the one of endometrial cancer, but interestingly about 75% are postmenopausal at diagnosis. The prognosis is usually good. Various treatments including hormonal therapy, chemotherapy, radiation therapy, and hysterectomy with oophorectomy have been used, and we plan to study their impact on this disease, to present at the annual meeting. No significant financial relationships to disclose.