Objectives Endometrial stromal sarcoma(ESS) is a rare gynaecological malignancy accounting only.2percent of uterine neoplasm.According to WHO, one third of the ESS recurs.But there is no protocol to treat recurrent ESS. This study is to find out a standard protocol of treatment incase of recurrent endometrial stromal sarcoma.

Methods Its a retrospective study of nineteen patients of ESS attending NICRH.All had hysterectomy outside our hospital and came with histopathology report of ESS.Time period was three years (2016–2018).

Results The recurrence rate of nineteen cases were42.1percent.The median age of diagnosis was47.55 years and median time of first relapse was9 months.The number of recurrance ranges from 1 to 5.Incase of first relapse,second surgery was done in eight patients but three had third relapse.out of eleven patients who received adjuvant chemotherapy,six had relapse and out of seven patients who had adjuvant radiation,five had recurrance.As all primary histopathology was done outside NICRH,grade was undetermined in eleven patients.Out of four high grade patients,three had relapse.Incase of four low grade, two received aeromatase inhibitor and they remain relapse free.

Conclusions In our study,it is clear that neither secondary cytoreduction nor adjuvant chemoradiation can prevent recurrence.There is limited data of immuno or target therapy.So long term multicentric study should be performed to set up a standard guideline of treatment in case of recurrent endometrial stromal sarcoma.