Abstract
PurposeTo assess the clinical outcomes and fertility of young women with stage I low-grade endometrial stromal sarcoma (ESS) treated with fertility-sparing surgery.ResultsSeventeen patients with stage I low-grade ESS (stage IA, n = 6; stage IB, n = 11) were entered into this study. Adjuvant hormone therapy was administered to 15 (88.2%) patients. At a median follow-up of 39 months (range, 4106 months), 10 (58.8%) patients developed recurrence. All 10 patients had stage IB disease; among them, the first recurrence limited to the uterus was observed in 6 patients. All 17 patients were alive and disease-free at the time of last contact. After treatment, five of eight (62.5%) patients who attempted pregnancy conceived. No offspring had congenital anomalies.MethodsPatients with stage I low-grade ESS who underwent fertility-sparing surgery between April 2001 and November 2015 were retrospectively reviewed.ConclusionsFertility-sparing surgery may be considered for young patients with stage IA low-grade ESS who wish to preserve their fertility.
Highlights
Endometrial stromal sarcomas (ESS) are rare malignant tumors comprising approximately 10%15% of all uterine sarcomas and 0.2%-1% of all uterine malignancies [1, 2]
Fertility-sparing surgery may be considered for young patients with stage IA low-grade ESS who wish to preserve their fertility
A total of 17 patients with stage I low-grade ESS were entered into this study
Summary
Endometrial stromal sarcomas (ESS) are rare malignant tumors comprising approximately 10%15% of all uterine sarcomas and 0.2%-1% of all uterine malignancies [1, 2]. The 2014 WHO classification divides these malignant tumors into three categories based on pathologic features: low-grade ESS, high-grade ESS, and undifferentiated endometrial sarcoma [4]. Fertility-sparing management for other gynecological malignancies has been widely studied, it has been rarely reported for low-grade ESS. The mainstay of treatment for early stage low-grade ESS is total hysterectomy and bilateral salpingo-oophorectomy (TH/BSO) [5,6,7,8]. Because of the rarity of this disease, there are only a few reported cases of fertility-sparing surgery for early stage low-grade ESS [9,10,11,12,13,14,15,16,17,18,19,20]
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