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Systemic therapy for endometrial stromal sarcomas: current treatment options
Krystyna Serkies1, Ewa Pawłowska, Jacek Jassem
1Department of Oncology and Radiotherapy, Medical University of Gdansk, Poland. kserkies@gumed.edu.pl.
Ginekologia Polska
|September 16, 2016
Summary
Endometrial stromal sarcomas are rare, aggressive cancers. While surgery is primary, hormonal therapies show promise for advanced low-grade types, and chemotherapy for high-grade, despite toxicities.
Area of Science:
- Gynecologic Oncology
- Oncology
- Pathology
Background:
- Endometrial stromal sarcomas (ESS), including low-grade (LG-ESS) and high-grade (HG-ESS)/undifferentiated (UES), are rare and aggressive uterine malignancies.
- Most LG-ESS cases express steroid receptors, influencing treatment strategies.
- These cancers exhibit relative resistance to radiation and conventional chemotherapy.
Purpose of the Study:
- To review current therapeutic strategies for endometrial stromal sarcomas.
- To evaluate the efficacy and toxicity of various treatment modalities.
- To highlight the role of hormonal therapy and chemotherapy in advanced or recurrent ESS.
Main Methods:
- Review of existing literature on endometrial stromal sarcoma treatment.
- Analysis of surgical, hormonal, chemotherapeutic, and emerging targeted therapy approaches.
- Assessment of treatment outcomes, including survival and toxicity profiles.
Main Results:
- Surgery is the primary treatment for all ESS.
- Hormonal therapy (progestins, aromatase inhibitors) is effective in advanced steroid receptor-positive LG-ESS, offering long-term survival with good tolerance.
- Gemcitabine and docetaxel combination is the most effective chemotherapy for advanced HG-ESS/UES, but associated with significant toxicity.
Conclusions:
- Surgical management is crucial for all ESS.
- Hormonal therapy represents a viable and well-tolerated option for advanced LG-ESS.
- Effective chemotherapy regimens for advanced HG-ESS/UES exist but require careful toxicity management; the role of molecular-targeted therapies is still under investigation.
