Long-term survival of patients with recurrent endometrial stromal sarcoma: a multicenter, observational study.
OBJECTIVE
The aim of this study was to evaluate the clinical behavior and management outcome of recurrent endometrial stromal sarcoma (ESS).


METHODS
A retrospective review of charts of 10 patients with recurrent ESS was performed and relapse-free interval, relapse site, treatment, response to treatment, duration of follow-up and clinical outcome extracted. Survival outcome measures used were post-relapse survival which was defined as the time from first evidence of relapse to death from any cause. Living patients were censored at the date of last follow-up.


RESULTS
The median age and median relapse-free interval at the time of initial relapse were 51.5 years and 66.5 months, respectively. The number of relapses ranged from one to five. Sixteen surgical procedures for recurrent disease included nine (56.0%) complete resections. There was no statistically significant difference between initial recurrent tumors and second/subsequent recurrent tumors in the rate of complete surgery (44.4% vs. 71.4%, respectively, p=0.36). Of the eleven evaluable occasions when hormonal therapy was used for recurrent disease, disease control was achieved in eight (72.7%). There was no difference between initial recurrent tumors and second/subsequent recurrent tumors in disease control rate by hormonal therapy (85.7% vs. 50.0%, respectively, p=0.49). The 10-year post-relapse survival rate was 90.0% and the overall median post-relapse survival 119 months (range, 7 to 216 months).


CONCLUSIONS
Post-relapse survival of patients with ESS can be expected to be >10 years when treated by repeated surgical resection and hormonal therapy or both.
Division of Gynecologic Oncology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan.
Hiroyuki
H
Yamazaki
Division of Gynecologic Oncology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan. yukiharu@sap-cc.go.jp.
Yukiharu
Y
Todo
Division of Obstetrics and Gynecology, Asahikawa Kosei General Hospital, Asahikawa, Japan.
Kenrokuro
K
Mitsube
Division of Obstetrics and Gynecology, Sapporo Municipal Hospital, Sapporo, Japan.
Hitoshi
H
Hareyama
Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Sapporo, Japan.
Chisa
C
Shimada
Division of Gynecologic Oncology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan.
Hidenori
H
Kato
Division of Pathology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan.
Katsushige
K
Yamashiro
D000328:Adult; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant / Q000401:mortality; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality*; D012189:Retrospective Studies; D018203:Sarcoma, Endometrial Stromal / Q000188:drug therapy / Q000401:mortality* / Q000601:surgery; D016896:Treatment Outcome
D018931:Antineoplastic Agents, Hormonal
Aromatase Inhibitors; Gonadotropin-Releasing Hormone; Retrospective Studies; Sarcoma, Endometrial Stromal; Survival Rate