title: Influence of different treatment modalities on survival of patients with low-grade endometrial stromal sarcoma: A retrospective cohort study.
abstract: BACKGROUND
  To assess the efficacy of different treatment modalities on the outcome of patients with low-grade endometrial stromal sarcoma (LG-ESS).
  
  
  METHODS
  Patients with LG-ESS who received hysterectomy from March 1991 to December 2013 were retrospectively analyzed. The associations between clinicopathologic variables and disease free survival (DFS) were evaluated.
  
  
  RESULTS
  One hundred and fourteen patients met the eligibility requirements. All patients received hysterectomy as the main treatment, 17.5% (20/114) of patients received ovarian preservation, and 62.3% (71/114) of patients received lymphadenectomy. Fifty-six patients received chemotherapy, 36 patients received radiotherapy, and 11 patients received endocrine therapy. The median follow-up duration was 40 months. The 5-year and 10-year DFS rates were 91.8% and 77.4%, respectively. The 5-year and 10-year overall survival rates were 96.7% and 96.7%, respectively. Univariate analyses showed that there were no risk factors associated with DFS. Lymphadenectomy, lymph node status, ovarian preservation, chemotherapy, radiotherapy, and endocrine therapy had no significant effect on DFS.
  
  
  CONCLUSIONS
  Hysterectomy has been the mainstay of treatment for LG-ESS. The optimal treatment strategy in LG-ESS remains to be determined.
authors.affiliation: Xiamen Cancer Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China.
authors.forename: Juan
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Xiamen Cancer Center, Department of Radiation Oncology, The First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China.
authors.forename: Hua
authors.initials: H
authors.lastname: Zheng
authors.affiliation: Xiamen Cancer Center, Department of Radiation Oncology, The First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China.
authors.forename: San-Gang
authors.initials: SG
authors.lastname: Wu
authors.affiliation: Sun Yat-sen University Cancer Center, Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, People's Republic of China.
authors.forename: Zhen-Yu
authors.initials: ZY
authors.lastname: He
authors.affiliation: Sun Yat-sen University Cancer Center, Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, People's Republic of China.
authors.forename: Feng-Yan
authors.initials: FY
authors.lastname: Li
authors.affiliation: Department of Gastrointestinal Surgery Ward 3 Areas of Cancer Center, The First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China. Electronic address: suguoqiang66@163.com.
authors.forename: Guo-Qiang
authors.initials: GQ
authors.lastname: Su
authors.affiliation: Sun Yat-sen University Cancer Center, Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, People's Republic of China. Electronic address: sunjy@sysucc.org.cn.
authors.forename: Jia-Yuan
authors.initials: JY
authors.lastname: Sun
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007857:Leadership; D008197:Lymph Node Excision; D008875:Middle Aged; D059351:Organ Sparing Treatments / Q000379:methods; D011878:Radiotherapy; D012189:Retrospective Studies; D018203:Sarcoma, Endometrial Stromal / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal
keywords: Low-grade endometrial stromal sarcoma; Lymphadenectomy; Ovarian preservation; Prognosis; Treatment