Endometrial stromal sarcoma: Analysis of recurrence following adjuvant treatment

Beck, Tiffany L.; Singhal, Pankaj; Ehrenberg, Hugh M.; Rose, Peter G.; Lele, Shashikant; Krivak, Thomas C.; McBee, William C.

doi:10.1016/j.ygyno.2011.10.010

Cited by 45 publications

(31 citation statements)

References 16 publications

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“…Our results demonstrate poor overall survival (11.8 months) regardless of stage or residual disease status following primary surgery. This overall survival rate compares unfavorably with survival rates for more common high grade uterine sarcomas such as leiomyosarcoma and carcinosarcoma [14][15][16]. This is also on the lower end of survival rates reported for patients previously classified as high grade endometrial stromal sarcoma and HGUS.…”

Section: Discussionmentioning

confidence: 65%

High grade undifferentiated uterine sarcoma: Surgery, treatment, and survival outcomes

Tanner

Garg

Leitao

et al. 2012

Gynecologic Oncology

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Section: Discussionmentioning

confidence: 65%

High grade undifferentiated uterine sarcoma: Surgery, treatment, and survival outcomes

Tanner

Garg

Leitao

et al. 2012

Gynecologic Oncology

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“…ESS is a relatively indolent disease which responds to hormonal treatment, as the majority of tumors express estrogen and progesterone receptors. However, adnexal and lymph node metastases, as well as metastases outside the pelvis, are found in some patients at diagnosis, and recurrences, especially within the abdominal cavity or in the lungs, are frequent [4,17–20]. In the present cohort, 1 of the 7 tumors recurred to date, a figure which may increase in view of the short follow-up period for some of the patients.…”

Section: Discussionmentioning

confidence: 65%

Gene expression signatures differentiate uterine endometrial stromal sarcoma from leiomyosarcoma

Davidson

Abeler

Hellesylt

et al. 2013

Gynecologic Oncology

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Objective Endometrial stromal sarcoma (ESS) and leiomyosarcoma (LMS) are the two most common uterine sarcomas, but both are rare tumors. The aim of the present study was to compare the global gene expression patterns of ESS and LMS. Methods Gene expression profiles of 7 ESS and 13 LMS were analyzed using the HumanRef-8 BeadChip from Illumina. Differentially expressed candidate genes were validated using quantitative real-time PCR and immunohistochemistry. Results Unsupervised hierarchical clustering using all 54,675 genes in the array separated ESS from LMS samples. We identified 549 unique probes that were significantly differentially expressed in the two malignancies by greater than 2-fold with 1% FDR cutoff using one-way ANOVA with Benjamini–Hochberg correction, of which 336 and 213 were overexpressed in ESS and LMS, respectively. Genes overexpressed in ESS included SLC7A10, EFNB3, CCND2, ECEL1, ITM2A, NPW, PLAG1 and GCGR. Genes overexpressed in LMS included CDKN2A, FABP3, TAGLN, JPH2, GEM, NAV2 and RAB23. The top 100 genes overexpressed in LMS included those coding for myosin light chain and caldesmon, but not the genes coding for desmin or actin. CD10 was not overexpressed in ESS. Results for selected genes were validated by quantitative real-time PCR and immunohistochemistry. Conclusions We present the first study in which gene expression profiling was shown to distinguish between ESS and LMS. The molecular signatures unique to each of these malignancies may aid in expanding the diagnostic battery for their differentiation, and may provide a molecular basis for prognostic studies and therapeutic target discovery.

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“…Malouf et al did not observe any recurrence in a group of 10 women with early stage low-grade endometrial stromal sarcoma who received adjuvant hormonal treatment 13. In addition, Beck et al observed a trend towards a decreased recurrence rate among women (n=42) with early stage low-grade endometrial stromal sarcoma who received adjuvant hormonal therapy (14.3% vs 38.5%, p=0.26) 8. Similarly, Chu et al reported a lower recurrence rate among women (n=22) who received adjuvant progestin therapy (31% vs 67%) 11.…”

Section: Discussionmentioning

confidence: 97%

Ovarian preservation for low-grade endometrial stromal sarcoma: a systematic review of the literature and meta-analysis

Nasioudis

Kolovos³

et al. 2019

Int J Gynecol Cancer

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ObjectiveTo evaluate the effect of ovarian preservation on oncologic outcomes for women with low-grade endometrial stromal sarcoma of the uterus.MethodsA systematic search of the Medline, Embase, Cohrane, and Web of Science databases was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Studies including patients with low-grade endometrial stromal sarcoma who had hysterectomy were identified. Data on tumor recurrence and death rate were pooled using a random effects model.ResultsA total of 17 studies met the inclusion criteria and reported on 786 patients. Based on available information, ovarian preservation was noted in 190 patients while 501 had bilateral salpingo-oophorectomy. A significantly increased tumor recurrence rate was observed in the ovarian preservation group (89/190, 46.8%) compared with the bilateral salpingo-oophorectomy group (121/501, 24.2%) (OR 2.70, 95% CI 1.39 to 5.28). Based on data from 162 patients, no difference in death rate was noted between the ovarian preservation (2/34, 5.9%) and bilateral salpingo-oophorectomy (9/128, 7%) groups (OR 0.80, 95% CI 0.18 to 3.47).ConclusionsApproximately one-quarter of patients with low-grade endometrial stromal sarcoma were managed with ovarian preservation. These women experienced a higher recurrence rate. Hormone exposure may be responsible for this elevated risk. Given the apparent high salvage rate, however, ovarian preservation may be an option only in a well-informed patient population.

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Endometrial stromal sarcoma: Analysis of recurrence following adjuvant treatment

Cited by 45 publications

References 16 publications

High grade undifferentiated uterine sarcoma: Surgery, treatment, and survival outcomes

High grade undifferentiated uterine sarcoma: Surgery, treatment, and survival outcomes

Gene expression signatures differentiate uterine endometrial stromal sarcoma from leiomyosarcoma

Ovarian preservation for low-grade endometrial stromal sarcoma: a systematic review of the literature and meta-analysis

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