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2022-RA-1511-ESGO Endometrial stromal sarcomas – a 12 year single centre experience
  1. Dimitrios Giannoulopoulos,
  2. Sofia Lekka,
  3. Kalliopi Kokkali,
  4. Dimitrios Korfias,
  5. Eugenia Karavioti,
  6. Christos Iavazzo and
  7. George Vorgias
  1. Gynaecological Oncology Department, Metaxa Cancer Hospital, Piraeus, Greece


Introduction/Background Endometrial stromal tumors (EST) represent less than 1% of all uterine malignant neoplasms. Those include endometrial stromal nodule (ESN), low-grade stromal sarcoma (LGESS), high-grade stromal sarcoma (HGESS), undifferentiated uterine sarcoma (UUS), uterine adenosarcoma (ADENOSA) and uterine tumor resembling ovarian sex cord tumor (UTROSCT). Treatment typically includes a combination of surgery and chemotherapy. Radiotherapy may be also used for local control. Herein we present a case series of 14 patients.

Methodology We found a total of 14 patients (median age 60.4). 7 patients had stage I disease, 2 stage II, 1 stage III and 5 stage IV. Early stage patients were mostly managed with surgery with/without adjuvant endocrine therapy and chemotherapy. Advanced disease patients received endocrine therapy and/or chemotherapy.

Results 2 ADENOSA patients are still in remission 3 years after surgery alone and 2 UTROSCT patients are in remission 1 and 3 years after surgery alone. 1 stage I UUS patient is free of disease 5 years after surgery and adjuvant chemotherapy. 1 patient with stage I LGESS, 1 patient with stage II LGESS and 1 patient with stage IV LGESS were lost to the follow up. 1 patient with LGESS stage I experienced distant relapse 3 months postoperatively and has been receiving multiple regimens of chemotherapy for 3 years eversince, with rapidly progressive disease nonetheless. 1 patient with stage II LGESS experienced pelvic recurrence 2 months post surgery, she was managed with chemoradiation and has developed upper abdominal disease 3 years postoperatively. 2 patients with extensive metastatic disease stage IVb were referred to palliative care. 2 patients with stage IVb LGESS and HGESS were managed with endocrine therapy and chemotherapy; however, they died at the one year mark.

Conclusion Endometrial stromal tumors are rare neoplasms; a combination of surgical cytoreduction, endocrine therapy and chemotherapy is the standard treatment approach.

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