Endometrial stromal sarcoma: A clinicopathologic study of 29 patients

OBJECTIVE: To analyze clinicopathological characteristics, treatment, and survival in patients with endometrial stromal sarcoma (ESS). STUDY DESIGN: Patients with ESS were identified from the tumor registry of the two participating institutions. Categorical variables were evaluated by χ² analysis or Fisher’s exact test. Survival estimates were plotted utilizing the Kaplan–Meier method. The log-rank test was utilized to quantify survival differences on univariate analysis. RESULTS: A total of 29 patients with ESS were included: 14 (48%) patients with stage I, 1 (3.4%) with stage II, 5 (17%) with stage III, and 9 (31%) with stage IV disease. Median age was 44 (range, 25–62). Most patients were treated by hysterectomy and salpingooophorectomy. Sixteen patients (55%) received adjuvant therapy after surgery. The most common type of adjuvant therapy was hormonal treatment. Median follow-up was 84 months (range, 1–382 months). Four patients with stage I (36%), 2 with stage III (18%), and 5 (46%) with stage IV developed disease recurrences. In 8 cases (73%) the recurrence site was the abdomen and pelvis, and in 3 cases (27%) the recurrence site was the lung. CONCLUSION: ESS is an indolent tumor with propensity for late recurrence. Age, early tumor stage (stage I), lymph node dissection, and adjuvant therapy did not affect disease-free or overall survival.