title: Fertility-sparing treatment of low-grade endometrial stromal sarcoma.
abstract: Low-grade endometrial stromal sarcoma (ESS) is a kind of uterine malignancy. Total hysterectomy and bilateral salpingo-oophorectomy was the main treatment. We evaluate the feasibility of fertility-sparing management in five patients with low-grade ESS who desired for childbearing. The patients aged 28-36 years old presented with symptoms of menometrorrhagia or without symptom. Ultrasound examinations demonstrated leiomyomas (with the diameter of 3.5-6 cm respectively). All the patients received conservative surgeries of local resection of the mass with uterine reconstruction. Then the adjuvant endocrine therapy was given to them with megestrol acetate (160-320 mg/day) or triptorelin (3.75 mg/28 days) for 5-6 months. The follow-up lasted 21-55 months. All the patients survived. Three of them underwent an uncomplicated pregnancy, and received cesarean delivery of a liveborn neonate. One of them is alive without disease recurrence. The other one found disease recurred during the megestrol acetate treatment, and received hysterectomy. We consider that fertility-sparing treatment is suitable in selected in young low-grade ESS patients especially for those whose lesion was with a clear borderline. Adjuvant endocrine therapy is recommended for about 6 months after operation.
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Jin
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China.
authors.forename: Cheng-Yan
authors.initials: CY
authors.lastname: Deng
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China.
authors.forename: Qin-Jie
authors.initials: QJ
authors.lastname: Tian
authors.affiliation: Quanzhou Women's and Children's Hospital Quanzhou, Fujian, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China.
authors.forename: Ling-Ya
authors.initials: LY
authors.lastname: Pan
keywords: Endometrial stromal sarcoma; endocrine therapy; fertility-conservative