Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey.
Department of Biostatistics, Ankara University, Ankara, Turkey.
J Chin Med Assoc. 2019 May;82(5):385-389. doi: 10.1097/JCMA.0000000000000039.
Low-grade endometrial stromal sarcoma (LGESS) is, in most cases, a slow-growing malignancy; however, it is related with high recurrence rates. The aim of this study is to determine which factors may be associated with the recurrence rate of LGESS.
The clinicopathological features and treatment options in 37 patients with LGESS were evaluated.
All patients underwent the hysterectomy and bilateral salpingo-oophorectomy. Additionally, lymphadenectomy was performed in 56.8% (n = 21) of the patients. Among the patients who underwent lymphadenectomy, 14.3% (n = 3) had lymph node metastasis. The disease was limited to the uterus in 75.7% of patients. Treatment following surgery was radiotherapy in three patients, chemotherapy in seven patients, hormone therapy in 12 patients, and chemotherapy plus hormone therapy in one patient. Megestrol acetate was used in all patients who received hormone therapy. Median follow-up time was 96 months. The 5-year disease-free survival and disease-specific survival were 72% and 97%, respectively. The recurrence rate was 27%. Only hormone therapy following surgery was significantly associated with a lower recurrence rate, even in patients with stage 1 disease. None of the patients treated with hormone therapy following surgery had recurrence, whereas recurrence occurred in 38.5% of the patients who underwent surgery only (p = 0.039).
Hormone therapy after surgery should be considered a viable option for decreasing the LGESS recurrence rate, regardless of the disease stage.
低度子宫内膜间质肉瘤（LGESS）在大多数情况下是一种生长缓慢的恶性肿瘤，但它与高复发率有关。本研究旨在确定哪些因素可能与 LGESS 的复发率相关。
评估了 37 例 LGESS 患者的临床病理特征和治疗选择。
所有患者均接受了子宫切除术和双侧输卵管卵巢切除术。此外，56.8%（n=21）的患者进行了淋巴结切除术。在接受淋巴结切除术的患者中，有 14.3%（n=3）发生淋巴结转移。75.7%的患者疾病局限于子宫。手术后的治疗包括 3 例放疗、7 例化疗、12 例激素治疗和 1 例化疗加激素治疗。所有接受激素治疗的患者均使用醋酸甲地孕酮。中位随访时间为 96 个月。5 年无病生存率和疾病特异性生存率分别为 72%和 97%。复发率为 27%。仅手术后的激素治疗与较低的复发率显著相关，即使在 1 期疾病患者中也是如此。手术后接受激素治疗的患者均无复发，而仅接受手术治疗的患者中有 38.5%复发（p=0.039）。
无论疾病阶段如何，手术后的激素治疗都应被视为降低 LGESS 复发率的可行选择。
