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A Retrospective Observational Study on Clinicopathological Features, Optimal Management and Recurrence Patterns in Low-Grade Endometrial Stromal Sarcoma

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Indian Journal of Gynecologic Oncology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the clinicopathological features, the role of neo-adjuvant and adjuvant treatment and recurrence patterns in patients with low-grade endometrial stromal sarcomas (LGESS).

Materials and Methods

Medical records of LGESS patients treated at gynec oncologic referral center between January 1, 2014, and October 31, 2021, were retrospectively reviewed.

Statistical Analysis

Recurrence-free survival (RFS) was calculated using the Kaplan–Meier method. Differences between survival curves were assessed using the log-rank test.

Results

A total of 21 consecutive patients with LGESS were identified. The mean age of presentation was 44.3 years (standard deviation of 10.26). The most common presenting complaint was abnormal uterine bleeding in 10 (47.6%) of 21 patients. Fourteen (67%) of 21 patients belonged to FIGO stage I and II. The mainstay of the treatment was total hysterectomy with bilateral salpingo-oophorectomy in all the 21 patients. Three (14.2%) patients with clinically and radiologically inoperable disease, started on neo-adjuvant hormone treatment for 8 weeks, underwent cytoreductive surgery with no residual disease. Recurrence-free survival (RFS) in the observation group of LGESS following surgery was 28 months while the RFS was 40 months if any adjuvant treatment was offered after surgery.

Conclusion

The cornerstone of management remains total hysterectomy with bilateral salpingo-oophorectomy. The use of neo-adjuvant hormone therapy in LGESS is strongly advocated in cases where it is deemed clinically and radiologically inoperable.

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Authors and Affiliations

  1. Department of Gynaec Oncology, Gynaec Onco Unit II, The Gujarat Cancer and Research Institute, M P Shah Cancer Hospital Campus, New Civil Hospital Road, Asarwa, Ahmedabad, Gujarat, 380016, India

    Remi Abdul Shukur, Bijal M. Patel & Pariseema Dave

  2. Gynaec Oncology Unit I, Department of Gynaecologic Oncology, The Gujarat Cancer and Research Institute, Ahmedabad, India

    Shilpa M. Patel

Authors
  1. Remi Abdul Shukur
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  2. Bijal M. Patel
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  3. Pariseema Dave
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  4. Shilpa M. Patel
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Contributions

RAS contributed to data collection, manuscript writing and literature reviewing. BMP, PD contributed to data collection, manuscript writing and proof reading. SMP contributed to data collection.

Corresponding author

Correspondence to Bijal M. Patel.

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Conflict of interest

On behalf of all authors the corresponding author declares there is no conflict of interest.

Ethical Approval

The need for ethical approval was waived due to retrospective nature of analysis. All data were anonymized before analysis. The study was performed in accordance with ethical standards laid down in 1964 Declaration of Helsinki and its latter amendments. Institutional Review Committee (IRC) has approved the article for journal submission. The (IRC) number for this submission is IRC/2023/P-46.

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Abdul Shukur, R., Patel, B.M., Dave, P. et al. A Retrospective Observational Study on Clinicopathological Features, Optimal Management and Recurrence Patterns in Low-Grade Endometrial Stromal Sarcoma. Indian J Gynecol Oncolog 21, 77 (2023). https://doi.org/10.1007/s40944-023-00759-9

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  • DOI: https://doi.org/10.1007/s40944-023-00759-9

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