title: Long-term medroxyprogesterone acetate therapy for low-grade endometrial stromal sarcoma.
abstract: BACKGROUND
  Low-grade endometrial stromal sarcoma (ESS) is a rare tumor. Endocrine treatment is frequently necessary, but treatment details have not been established.
  
  
  METHODS
  Thirteen consecutive patients with low-grade ESS were examined clinicopathologically. All patients underwent surgery, and six were treated with a uniform regimen of medroxyprogesterone acetate (MPA) against residual or recurrent disease.
  
  
  RESULTS
  Of the 13 patients, 9 were in stage I, whereas the others were in advanced stages. The median follow-up period was 117 months (range 43-170 months). Six patients, including three with residual peritoneal dissemination and three with recurrent tumors, were treated with MPA. Six months after the initiation of treatment, 3 patients demonstrated a partial response, and 3 patients demonstrated stable disease. The median dosing period was 64 months (range 28-92 months). Five of the patients, including 2 patients who are alive with no evidence of disease and 3 patients who are alive with disease, continue with MPA therapy.
  
  
  CONCLUSIONS
  The clinicopathological characteristics of the low-grade ESS in this study are consistent with those reported in previous studies. MPA therapy with residual or recurrent disease achieved excellent disease control over a period of 5 years. These results indicate that MPA therapy might be considered as a therapeutic option for residual or recurrent low-grade ESS and perhaps chosen as a first-line therapy.
authors.affiliation: Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, 466-8550, Japan. mizunomizuno@med.nagoya-u.ac.jp
authors.forename: Mika
authors.initials: M
authors.lastname: Mizuno
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Yatabe
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nawa
authors.forename: Toru
authors.initials: T
authors.lastname: Nakanishi
mesh_terms: D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D012008:Recurrence; D018203:Sarcoma, Endometrial Stromal / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D016019:Survival Analysis; D014594:Uterine Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery
chemical_list: D018931:Antineoplastic Agents, Hormonal; D017258:Medroxyprogesterone Acetate