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 chi analytis 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.