Clinicopathologic Profile and Survival of Patients with Uterine Low Grade Endometrial Stromal Sarcoma

Low-grade uterine endometrial stromal sarcoma (LG-ESS) is a rare tumour characterised by an overall good survival but showing indolent behaviour and a variable risk of recurrence. There is no clear consensus on the optimal management of these tumours and no prognostic or predictive factors have been established. With this study, we evaluated the clinical profile and survival outcome of patients affected by LGESS.

We retrospectively analysed 56 LG-ESS cases, treated from January 1st, 2010 to July 31st, 2019, in our centre. The clinicopathological characteristics, the patterns of recurrence and its treatment and the relationship between various modalities of treatment and the recurrence rate was investigated. Risk of recurrence and disease-free survival (DFS) and overall survival (OS) were estimated by Cox regression and the Kaplan–Meier analysis, respectively.

Of 56 patients with LG-ESS, five experienced recurrence (9%). The median time to recurrence was 24 months. Majority of the recurrences were locoregional. The 3 year overall survival (OS) from this study was 100% with a median follow up period of 86 months (range 26–168 months). The three year disease free survival (DFS) was 96.5% with a standard error (SE) of 2.4%.

This study concludes that LG-ESS has an overall excellent prognosis. Recurrences are late, but salvageable. The role of various adjuvant modalities of treatment needs to be defined with more research.