The value of surgery and the prognostic factors for patients with recurrent low-grade endometrial stromal sarcoma: a...

Area of Science:

• Gynecologic Oncology
• Surgical Oncology
• Cancer Prognostics

Background:

• Low-grade endometrial stromal sarcoma (LGESS) is an indolent malignancy requiring long-term management, particularly for recurrent disease.
• Limited research exists on the optimal treatment strategies for recurrent LGESS, highlighting a critical gap in clinical knowledge.
• Understanding prognostic factors is essential for improving patient outcomes in recurrent LGESS.

Purpose of the Study:

• To investigate prognostic factors influencing survival in patients with recurrent LGESS.
• To evaluate the therapeutic value and impact of surgical intervention for recurrent LGESS.

Main Methods:

• Retrospective analysis of patients diagnosed with recurrent LGESS between April 2004 and April 2020.
• Inclusion of 38 patients with pathologically confirmed recurrent LGESS.
• Median follow-up duration of 137.0 months.

Main Results:

• The 5-year cumulative survival rate for recurrent LGESS was 71.1%, with a median overall survival (OS) of 156 months and post-recurrence survival (PRS) of 89.0 months.
• Younger age, positive estrogen receptor (ER) status, and optimal abdominopelvic debulking during the first recurrent surgery were associated with better prognosis.
• Optimal abdominopelvic debulking was identified as the sole independent prognostic factor for improved OS and PRS (OS: 216.0 vs. 35.0 months; PRS: not reached vs. 4.0 months).

Conclusions:

• Recurrent LGESS demonstrates a generally favorable prognosis.
• Optimal debulking surgery, aiming for no residual tumor in the abdominal and pelvic cavity, is the recommended primary treatment for recurrent LGESS.
• Ovarian preservation or fertility considerations are not advised for patients with recurrent LGESS.