[Treatment and prognosis of low-grade malignant endometrial stromal sarcoma].
OBJECTIVE
To review the experience in the treatment of low-grade malignant endometrial stromal sarcoma.


METHODS
The data of 41 patients with low-grade malignant endometrial stromal sarcoma surgically treated between 1982 and 2004 were reviewed. Statistical analysis was carried out using chi(2) and Kaplan-Meier life table.


RESULTS
Of these 41 patients, 24 suffered from irregular vaginal bleeding, and 30 had been diagnosed to have leiomyoma before treatment. Thirty patients but 11 underwent surgical management with uterus removed. Thirty-three patients received postoperative adjuvant therapy including radiation and/or chemotherapy. The 5-year and 10-year actuarial survival was 87. 5% and 77. 8%, respectively. Eighteen patients (43. 9%) developed recurrent disease, most of which in the pelvis. The mean time to recurrence was 31 months (range 6 to 78 months) with the median time of 26 months. The recurrent rate was 66.7% for patients whose ovarian function was reserved versus 37. 5% for those without reservation. Patients who received adjuvant therapy had a lower recurrent rate (30. 3%) than those who did not (87. 5%). The recurrent rate of the patients treated with postoperative adjuvant radiation was 32. 3% (10/31) versus 80% (8/10) for those patients without. The 5-year actuarial survival rate of patients with recurrent disease was 71. 8%.


CONCLUSIONS
Low-grade malignant endometrial stromal sarcoma has a good prognoses though dwarfed by higher late recurrence after initial treatment. Postoperative adjuvant radiation is helpful to reduce local recurrence. Endometrial stromal sarcoma;
Ma
Shao-kang
SK
Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China. mskd2@sina.com
Zhang
Hong-tu
HT
Wu
Ling-ying
LY
Liu
Li-ying
LY
Li
Bin
B
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001918:Brachytherapy / Q000379:methods; D002588:Cesium Radioisotopes / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant / Q000379:methods; D003131:Combined Modality Therapy; D016889:Endometrial Neoplasms / Q000473:pathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000556:secondary / Q000628:therapy*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D018714:Radiotherapy, Adjuvant / Q000379:methods; D012189:Retrospective Studies; D018203:Sarcoma, Endometrial Stromal / Q000556:secondary / Q000628:therapy*
D002588:Cesium Radioisotopes