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

Oncotarget. 2017 Feb 7;8(6):10602-10608. doi: 10.18632/oncotarget.12491.

Abstract

Purpose: To assess the clinical outcomes and fertility of young women with stage I low-grade endometrial stromal sarcoma (ESS) treated with fertility-sparing surgery.

Results: Seventeen 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, 4-106 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.

Methods: Patients with stage I low-grade ESS who underwent fertility-sparing surgery between April 2001 and November 2015 were retrospectively reviewed.

Conclusions: Fertility-sparing surgery may be considered for young patients with stage IA low-grade ESS who wish to preserve their fertility.

Keywords: endometrial stromal sarcoma; fertility-sparing surgery; low-grade; pregnancy; recurrence.

MeSH terms

  • Adolescent
  • Adult
  • Disease-Free Survival
  • Endometrial Neoplasms / pathology
  • Endometrial Neoplasms / surgery*
  • Female
  • Fertility Agents / administration & dosage
  • Fertility Preservation / adverse effects
  • Fertility Preservation / methods*
  • Fertility* / drug effects
  • Humans
  • Hysteroscopy* / adverse effects
  • Laparoscopy* / adverse effects
  • Live Birth
  • Neoplasm Grading
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Organ Sparing Treatments* / adverse effects
  • Pregnancy
  • Pregnancy Rate
  • Retrospective Studies
  • Sarcoma, Endometrial Stromal / pathology
  • Sarcoma, Endometrial Stromal / surgery*
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Fertility Agents