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Year : 2020  |  Volume : 3  |  Issue : 3  |  Page : 489-494

Endometrial stromal sarcoma: Retrospective analysis of a tertiary care experience from India

Department of Radiation and Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Correspondence Address:
Bhavana Rai
Department of Radiation Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/CRST.CRST_70_20

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Background: Endometrial stromal tumors are rare tumors of mesenchymal origin, conventionally classified as low-grade and high-grade tumors based on the mitotic count. Objective: In this study, our objective was to analyze the clinical characteristics and outcomes of patients with endometrial stromal sarcomas (ESS) treated at our institute. Materials and Methods: Records of histologically proven cases of ESS treated at out institute between January 2011 and July 2015 were studied. The data were reviewed to ascertain the patient and disease characteristics and the treatment received before and after coming to the tertiary care hospital. Overall survival (OS) was assessed using the Kaplan–Meier method, and the differences were evaluated using the log-rank test. Results: A total of 25 patients with ESS were identified, and the data for 23 of these were analyzed; 15 (65%) patients had low-grade tumors, and eight (35%) had high-grade tumors. About 53% of the patients with low-grade ESS (LG-ESS) had early stage disease, and 75% of those with high-grade ESS had Stage III/IV disease. All patients underwent at least a total abdominal hysterectomy. Adjuvant radiation and chemotherapy were given to 11 and 7 with LG-ESS and HG-ESS patients, respectively. Nine (39.1%) patients received hormonal therapy. Fifteen (65%) patients received some form of treatment before reporting at our institute. At the median follow-up of 22 months (range, 5–62 months), four patients died because of disease progression. The median OS for patients with high-grade tumors was 25 months; it was not reached for patients with low-grade tumors. Conclusions: LG-ESS present at an earlier stage and have a better outcome than high-grade ESS, which receive more aggressive treatment. However, the general lack of awareness among practitioners has led to many patients not receiving standard treatment and counseling. Therefore, the treating oncologists must properly assess the risk management strategies before instituting treatment.

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