Reproductive outcome after uterine-sparing surgery for endometrial stromal sarcoma

Sánchez-Ferrer, María Luisa; Machado-Linde, Francisco; Ferri-Ñíguez, Belén; Parrilla-Paricio, J.J.

doi:10.1016/j.gynor.2012.10.001

Cited by 12 publications

(13 citation statements)

References 10 publications

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“…These data suggest that stage IA patients may be candidates for fertility-sparing surgery. Although the recurrence rate for 7 stage IB patients from seven other studies [ 9 , 11 , 12 , 14 – 17 ] was relatively low (28.6%), we observed a higher recurrence rate (90.9%) for our 11 stage IB patients who underwent fertility-sparing surgery. This difference may be partly explained by the relatively short follow-up periods of the previous studies.…”

Section: Discussioncontrasting

confidence: 65%

Fertility-sparing surgery for patients with low-grade endometrial stromal sarcoma

et al. 2016

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PurposeTo assess the clinical outcomes and fertility of young women with stage I low-grade endometrial stromal sarcoma (ESS) treated with fertility-sparing surgery.ResultsSeventeen patients with stage I low-grade ESS (stage IA, n = 6; stage IB, n = 11) were entered into this study. Adjuvant hormone therapy was administered to 15 (88.2%) patients. At a median follow-up of 39 months (range, 4106 months), 10 (58.8%) patients developed recurrence. All 10 patients had stage IB disease; among them, the first recurrence limited to the uterus was observed in 6 patients. All 17 patients were alive and disease-free at the time of last contact. After treatment, five of eight (62.5%) patients who attempted pregnancy conceived. No offspring had congenital anomalies.MethodsPatients with stage I low-grade ESS who underwent fertility-sparing surgery between April 2001 and November 2015 were retrospectively reviewed.ConclusionsFertility-sparing surgery may be considered for young patients with stage IA low-grade ESS who wish to preserve their fertility.

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Section: Discussioncontrasting

confidence: 65%

Fertility-sparing surgery for patients with low-grade endometrial stromal sarcoma

et al. 2016

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“…LGESS is a rare disease. Several case reports describing pregnancy after contracting this disease have been published [ 4 – 6 ]. In our present report, we describe a case of childbirth amid repeated tumor resections.…”

Section: Discussionmentioning

confidence: 99%

Long-term survival in low-grade endometrial stromal sarcoma with childbirth and multidisciplinary treatment: a case report

et al. 2015

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IntroductionLow-grade endometrial stromal sarcoma is very rare and difficult to diagnose in the early stage. A standard treatment has not been established. In this case report of a patient with long-term survival, we describe an effective treatment for advanced low-grade endometrial stromal sarcoma.Case presentationA 24-year-old Japanese woman who presented with prolonged menstruation was diagnosed with leiomyoma on the basis of a specimen resected transvaginally. She underwent ten resections in 10 years without a malignancy diagnosis. During this period, she gave birth. At age 34 years, she visited our hospital, complaining of lower abdominal pain. A 10cm tumor was detected behind her uterus. The disease was diagnosed as an advanced malignant ovarian tumor before surgery. A laparotomy was performed, with many remnants left in the abdominal cavity. The final diagnosis was advanced low-grade endometrial stromal sarcoma. After 12 cycles of gemcitabine and docetaxel combination chemotherapy, the tumor disappeared completely. A retrospective pathological review of the specimens resected transvaginally showed that the tumors included low-grade endometrial stromal sarcoma elements. When the patient was age 42 years, the sarcoma recurred. It was detected around the right diaphragm and liver. Despite administration of gemcitabine and docetaxel, ascites and pleural effusion accumulated. Administration of medroxyprogesterone acetate, leuprorelin acetate, and anastrozole gradually reduced the ascites and pleural effusion. In addition to the three hormone drugs, 18 cycles of paclitaxel and carboplatin were administered. The patient recovered from her critically ill state and is currently alive with reduced tumor at age 45 years.ConclusionsOur patient with low-grade endometrial stromal sarcoma whose disease began in her youth gave birth and experienced long-term survival with surgery, chemotherapy, and hormone therapy.

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“…Considering relative indolent course and better prognosis of low‐grade ESS, fertility‐preserving treatment might be possible. Fertility‐sparing surgery for young women with ESS has been reported in a few case reports . Some achieved successful pregnancies, while others ended up recurrences.…”

Section: Introductionmentioning

confidence: 99%

“…Fertility-sparing surgery for young women with ESS has been reported in a few case reports. [7][8][9][10][11][12][13][14][15][16] Some achieved successful pregnancies, while others ended up recurrences. Experiences of conservative management in low-grade ESS are still limited.…”

Section: Introductionmentioning

confidence: 99%

Recurrence after fertility‐preserving surgery for low‐grade endometrial stromal sarcoma

Chin

Lin

et al. 2018

J of Obstet and Gynaecol

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Considering the characteristics of low-grade endometrial stromal sarcoma (ESS), such as relative indolent course, younger age at diagnosis and favorable prognosis, the fertility-preserving management of low-grade ESS has been described by several authors. We report a 34-year-old female with stage IB low-grade ESS who developed recurrence 7 years after neoadjuvant high-dose progestin therapy followed by fertility-preserving surgery and postoperative progestin therapy. The patient stopped progestin therapy and was disease free for 4 years after diagnosis but experienced recurrence with peritoneal dissemination at 7 years. Considering the tendency of late recurrence, long-term surveillance is necessary to ensure timely action. Long-term progestin treatment might be considered after complete remission even beyond 5 years. We performed a literature review and found that many of the cases did not meet solid pathological criteria of low-grade ESS. The diagnostic criteria of low-grade ESS (vs endometrial stromal nodule) should be deliberately documented for future studies of this rare disease.

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Reproductive outcome after uterine-sparing surgery for endometrial stromal sarcoma

Abstract: ► This is the second report of pregnancy following endometrial stromal sarcoma (ESS). ► The role of adnexectomy is controversial in stage I ESS. ► Adnexectomy does not appear to affect survival in stage I ESS.

Cited by 12 publications

References 10 publications

Fertility-sparing surgery for patients with low-grade endometrial stromal sarcoma

Fertility-sparing surgery for patients with low-grade endometrial stromal sarcoma

Long-term survival in low-grade endometrial stromal sarcoma with childbirth and multidisciplinary treatment: a case report

Recurrence after fertility‐preserving surgery for low‐grade endometrial stromal sarcoma

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