Kim W Y, Lee J-W, Choi C H, Kang H, Kim T-J, Kim B-G, Lee J-H, Bae D-S
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Int J Gynecol Cancer. 2008 Sep-Oct;18(5):1084-9. doi: 10.1111/j.1525-1438.2007.01159.x. Epub 2007 Dec 27.
The aim of this retrospective study was to evaluate the clinical behavior and management outcome of low-grade endometrial stromal sarcoma (LGESS). From September 1994, to March 2007, 22 patients with histologically proven stage I LGESS were included in this study. Clinicopathologic variables, recurrence, and management outcomes were reviewed retrospectively. The median age of the 22 patients was 43 years. The most common presenting symptom was abnormal vaginal bleeding. All patients underwent a hysterectomy and had stage I disease. Six patients had adjuvant therapy after the hysterectomy. The median follow-up period was 77 months (range 12-202 months). Ten patients had disease recurrence. The median disease-free survival period was 111 months (range 6-182 months). The pelvis (eight cases) was the most common site of recurrence followed by the lung (four cases) and the liver (one case). Recurrent disease was treated with surgery (one case), surgery plus chemotherapy (five cases), chemotherapy (two cases), and surgery plus radiotherapy (two cases). Two patients died after 25 and 54 months after disease recurrence. Treatment with a bilateral salpingo-oophorectomy or adjuvant chemoradiation did not affect the disease-free interval. LGESS is usually a slow-growing neoplasm with an indolent clinical course. Surgery is the primary treatment for recurrent endometrial stromal sarcoma when feasible. Adjuvant treatment (radiotherapy, chemotherapy, or both) had no effect on the prognosis of patients with stage I disease.
本回顾性研究的目的是评估低级别子宫内膜间质肉瘤（LGESS）的临床行为和治疗结果。从1994年9月至2007年3月，本研究纳入了22例经组织学证实为I期LGESS的患者。对临床病理变量、复发情况和治疗结果进行了回顾性分析。22例患者的中位年龄为43岁。最常见的症状是异常阴道出血。所有患者均接受了子宫切除术，且均为I期疾病。6例患者在子宫切除术后接受了辅助治疗。中位随访期为77个月（范围12 - 202个月）。10例患者出现疾病复发。中位无病生存期为111个月（范围6 - 182个月）。盆腔（8例）是最常见的复发部位，其次是肺（4例）和肝（1例）。复发性疾病的治疗方法包括手术（1例）、手术加化疗（5例）、化疗（2例）和手术加放疗（2例）。2例患者在疾病复发后25个月和54个月死亡。双侧输卵管卵巢切除术或辅助放化疗对无病间期无影响。LGESS通常是一种生长缓慢的肿瘤，临床病程较为惰性。可行时，手术是复发性子宫内膜间质肉瘤的主要治疗方法。辅助治疗（放疗、化疗或两者联合）对I期疾病患者的预后无影响。
