[Designation, classification and treatment of endometrial stromal sarcoma--a report of 9 cases]

From 1958 to 1984, 13 cases were diagnosed as endometrial stromal sarcoma in our hospital, 9 of whom having complete data and been followed for over 5 years were analysed. The results indicated that degree of cellular atypia was a major factor related to prognosis. According to the degree of cellular atypia with consideration of cellular mitotic rate, the tumors were divided into two types: low and high grade malignancies. The former was likely to develop recurrence in the pelvis whereas the latter was prone to distant metastasis. There was no definite relation between the time and initial site of recurrence or metastasis and the stage of the lesion. Operation is the treatment of choice for primary as well as recurrent lesions. The operation should be total hysterectomy and bilateral salpingo-oophorectomy with removal of all visible tumor tissues. In this series, 5 patients received prophylactic postoperative pelvic radiation, none developed local recurrence and 3 of them have survived for 13-19 years free of tumor. Two of 3 treated with postoperative chemotherapy developed recurrence and died 3 months and 4 years after chemotherapy, respectively.