Adjuvant Hormonal Therapy for Low-Grade Endometrial Stromal Sarcoma

Area of Science:

• Gynecologic Oncology
• Endocrine Therapy
• Sarcoma Research

Background:

• Low-grade endometrial stromal sarcoma (LGESS) is a rare gynecologic malignancy.
• Adjuvant hormonal therapy (AHT) plays a role in managing LGESS.
• Comparing treatment efficacy and tolerability of different AHT options is crucial.

Purpose of the Study:

• To compare aromatase inhibitors (AIs) with progestins as adjuvant hormonal therapy (AHT) for LGESS.
• To evaluate disease recurrence and recurrence-free survival (RFS) in LGESS patients treated with AIs, progestins, or no AHT.

Main Methods:

• Retrospective review of LGESS cases from 1984 to 2017.
• Assessment of disease recurrence and RFS based on AHT received (AI, progestins, or none).
• Analysis of patient demographics, disease stage, and treatment outcomes.

Main Results:

• Aromatase inhibitors (AIs) and progestins significantly reduced recurrence in stage I LGESS compared to no AHT.
• Patients receiving progestins had the longest RFS (306.2 months) in stage I, followed by AI (153.1 months).
• Aromatase inhibitors (AIs) showed better tolerability, with no early treatment discontinuation due to side effects, unlike progestins (69% discontinuation).

Conclusions:

• Aromatase inhibitors (AIs) are associated with longer RFS in advanced LGESS.
• AIs are better tolerated than progestins.
• Aromatase inhibitors (AIs) can be considered a primary adjuvant hormonal therapy for LGESS.