Prolonged long-term survival of low-grade endometrial stromal sarcoma patients with lung metastasis following treatment with medroxyprogesterone acetate

Abstract

The aim of this study was to investigate the usefulness of medroxyprogesterone acetate (MPA) therapy for patients with metastatic low-grade endometrial stromal sarcoma (LGESS). A retrospective review was performed of five patients with metastatic LGESS lesions in whom MPA therapy prolonged survival. The diagnosis was established by hysterectomy in all five patients. Three patients had stage I disease and two patients had stage IV. The median follow-up period was 77 months (range, 15-283 months). All five patients had recurrent disease in the lung. The median disease-free interval was 50 months (range, 7-120 months). Three of the five patients received several types of chemotherapy, and all of these patients received the same MPA (200-600 mg/day) hormonal therapy. One patient died 149 months after disease recurrence. Interestingly, after the recurrence in the lung, three patients were alive with persistent pulmonary metastases for more than 120 months. The median overall survival from the time of recurrence was 41 months (range, 9-163 months). The patients in this study demonstrate that MPA treatment may extend the survival of patients with LGESS that is metastatic to the lung.