Analysis of Clinical Presentation, Radiological Features, Management, and Oncological Outcome of Endometrial Stromal...

This retrospective study was conducted to assess the clinicopathological and radiological features, management, and oncological outcome of endometrial stromal sarcoma (ESS). Data were collected from all cases of ESS treated at Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) from 2012 to 2023. The clinical and radiological features and treatment offered were collected, and overall survival rates were analyzed. A total of 18 cases were collected, with 50% being high-grade and 50% being low-grade disease. The mean age was 48 years, with 44% being post-menopausal. The most common presentation was abnormal uterine bleeding. Ultrasound showed leiomyoma in 44.4% of cases and a heterogeneous mass in the endometrium in 22.2%. Pre-operatively, four patients had a diagnosis of endometrial stromal sarcoma. Five patients had disease recurrence; four were high-grade ESS, and one was low-grade ESS. Of the 18 patients, four succumbed to the disease. The median follow-up period (interquartile range IQR) was 24 months (3 to 108 months). The mean survival time was 89.7 months (CI 63.8-115.6; S.E ± 13.2), and the mean progression-free survival time was 75.9 months (CI 43.3-108.5; S.E ± 16.6). Thus, ESS can have a wide range of presentations and should always be suspected in women with symptomatic fibroid and mass in the endometrium, especially in the post-menopausal age group. The patient's age and tumor stage and grade are the most important prognostic factors affecting the overall survival time.