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treatment of endometrial stromal sarcoma

Saki Sato, Yojiro Ojima, Masatoshi Kanda, Tomohiko Kizaki, Noriyuki Ohara
Endometrial stromal sarcoma (ESS) is a rare malignant tumor of the uterus. We report an uncommon case of ESS composed of both low-grade ESS and high-grade ESS arising from an endometrial polyp. On the findings of magnetic resonance imaging and contrast computed tomography, a patient was suspected of having uterine malignant tumor. She underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. Macroscopically, the tumor was a polypoid lesion in the uterine cavity. The tumor was an endometrial polyp with ESS components...
September 11, 2018: Kobe Journal of Medical Sciences
Falk C Thiel, Sonja Halmen
Like other uterine sarcomas, low-grade endometrial stromal sarcomas (LG-ESS) are a very rare tumor entity. In the past, research studies therefore discussed the various different types of the disease in combination. In addition, the classification of endometrial stromal tumors presented difficulties for quite some time so that in earlier studies it was not always possible to precisely distinguish between LG-ESS, high-grade endometrial stromal sarcoma, and undifferentiated uterine sarcoma. For LG-ESS, surgery with hysterectomy and adnexectomy is the first-line treatment...
2018: Oncology Research and Treatment
Hiroshi Tsubamoto, Tomoko Ueda, Kayo Inoue, Roze Isono-Nakata, Shinichiro Saeki, Yu Kato, Hiroaki Shibahara
AIM: To investigate the effects of leuprorelin using a self-administered quality-of-life (QOL) questionnaire in patients with recurrent gynecological cancer. METHODS: Records of patients who received 3.75 mg leuprorelin every 4 weeks for the treatment of recurrent gynecological cancer were retrospectively reviewed. The physical domain of the QOL questionnaire, Care Notebook, was used to assess physical symptoms. Symptom deterioration was defined as a ≥10-point increase in baseline score; otherwise, symptoms were defined as controlled...
August 16, 2018: Journal of Obstetrics and Gynaecology Research
Vanessa L Nieto, Yongmei Huang, June Y Hou, Ana I Tergas, Caryn M St Clair, Cande V Ananth, Alfred I Neugut, Dawn L Hershman, Jason D Wright
BACKGROUND: Minimally invasive hysterectomy is now used routinely for women with uterine cancer. Most studies of minimally invasive surgery for endometrial cancer have focused on low-risk endometrioid tumors, with few reports of the safety of the procedure for women with higher risk histologic subtypes. OBJECTIVE: The purpose of this study was to examine the use of and survival associated with minimally invasive hysterectomy for women with uterine cancer and high-risk histologic subtypes...
November 2018: American Journal of Obstetrics and Gynecology
Teresa P Díaz-Montes, Farah El-Sharkawy, Sarah Lynam, Amy Harper, Michelle Sittig, Ryan MacDonald, Vadim Gushchin, Armando Sardi
OBJECTIVE: Uterine sarcomas (USs) are characterized by poor response to systemic chemotherapy and high recurrence rates. This study evaluates whether the use of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) confers survival benefit in comparison with conventional treatment modalities in patients with recurrent US. METHODS/MATERIALS: A retrospective analysis of patients with recurrent US at a single institution for an 11-year study period was performed...
July 2018: International Journal of Gynecological Cancer
Tzu-Hsuan Chin, Gigin Lin, Ren-Chin Wu, Chyong-Huey Lai
Considering the characteristics of low-grade endometrial stromal sarcoma (ESS), such as relative indolent course, younger age at diagnosis and favorable prognosis, the fertility-preserving management of low-grade ESS has been described by several authors. We report a 34-year-old female with stage IB low-grade ESS who developed recurrence 7 years after neoadjuvant high-dose progestin therapy followed by fertility-preserving surgery and postoperative progestin therapy. The patient stopped progestin therapy and was disease free for 4 years after diagnosis but experienced recurrence with peritoneal dissemination at 7 years...
July 5, 2018: Journal of Obstetrics and Gynaecology Research
J Michael Straughn, Teresa Boitano, Haller J Smith, Sarah E Dilley, Margaret I Liang, Lea Novak
A 32 year-old nulligravid woman with a uterine mass underwent exploratory laparotomy with myomectomy. Final pathology revealed a low-grade endometrial stromal sarcoma (ESS) with positive margins. She subsequently underwent definitive robotic hysterectomy and bilateral salpingectomy with ovarian preservation. She was diagnosed with a stage IB low-grade ESS. She is currently undergoing observation. Discussion of classification, surgical options, and adjuvant therapy is presented.
October 2018: Gynecologic Oncology
Jeong-Yeol Park, Min-Hyun Baek, Yangsoon Park, Young-Tak Kim, Joo-Hyun Nam
To evaluate the immunohistochemical (IHC) expression of hormone receptors and analyze the prognostic implication of these receptors in patients with endometrial stromal sarcoma (ESS). Fifty-one patients with ESS whose paraffin blocks and pathologic slides, which were obtained after hysterectomy, were available and included in this study. Clinicopathologic data were gathered from patients' medical records, and IHC staining of hormone receptors was performed using tissue microarrays. Estrogen receptor (ER)-alpha was expressed in 37 patients (72...
July 2018: Virchows Archiv: An International Journal of Pathology
Justine Gantzer, Isabelle Ray-Coquard
PURPOSE OF REVIEW: In this article, we focus on recent published data (2017) on the management of gynecologic sarcomas. RECENT FINDINGS: The most significant data published in 2017 develop definition of a new molecular subtype of high grade endometrial stromal sarcoma (ESS) using molecular technics added to histological analysis. The identification of a new translocation on presumed uterine leiomyosarcoma (LMS) points to refinement of nosological classification, with fragmentation of even rare tumors into distinct molecular entities: gynecologic sarcomas are now distinguished into distinct entities from a heterogeneous group of tumors...
July 2018: Current Opinion in Oncology
Uma Deshmukh, Jonathan Black, Javier Perez-Irizarry, Rachel Passarelli, Karen Levy, Amanda Rostkowski, Pei Hui, Thomas J Rutherford, Alessandro D Santin, Masoud Azodi, Dan-Arin Silasi, Elena Ratner, Babak Litkouhi, Peter E Schwartz
OBJECTIVE: To compare aromatase inhibitors (AIs) with progestins as adjuvant hormonal therapy(AHT) for low-grade endometrial stromal sarcomas (LGESSs). METHODS: We reviewed cases with LGESS at our institution from 1984 to 2017. Disease recurrence and recurrence-free survival (RFS) were assessed among patients who received AI, progestins, or no AHT. RESULTS: Among 39 patients with LGESS, 18 received progestins, 13 received AI, and 8 received no AHT...
January 1, 2018: Reproductive Sciences
Hiroyuki Kanao, Tsuyoshi Hisa, Makiko Omi, Minoru Nagashima, Shuhei Okamoto, Yoichi Aoki, Terumi Tanigawa, Maki Matoda, Sanshiro Okamoto, Hidetaka Nomura, Kohei Omatsu, Kazuyoshi Kato, Kuniko Utsugi, Nobuhiro Takeshima
STUDY OBJECTIVE: To show total laparoscopic complete resection of a recurrent low-grade endometrial sarcoma. DESIGN: Step-by-step demonstration of the technique of laparoscopic anterior pelvic exenteration with super radical parametrectomy, including the explanation of detailed pelvic anatomy (Canadian Task Force classification III). SETTING: Low-grade endometrial stromal sarcoma (LGESS) is a rare malignancy that makes up around 0.2% of all uterine malignancies [1]...
April 3, 2018: Journal of Minimally Invasive Gynecology
Kenichi Nakamura, Hiroaki Kajiyama, Fumi Utsumi, Shiro Suzuki, Kaoru Niimi, Ryuichiro Sekiya, Jun Sakata, Eiko Yamamoto, Kiyosumi Shibata, Fumitaka Kikkawa
Uterine sarcomas are some of the most malignant and aggressive tumor types among the gynecologic malignancies, and they are associated with a high rate of recurrence and a poor prognosis. Due to their rarity and diversity, the optimal treatment for recurrent uterine sarcomas has not yet been elucidated. The aim of the present study was to investigate the potential of secondary cytoreductive surgery (SCS) for patients with recurrent uterine sarcomas. A total of 18 patients with recurrent uterine sarcomas were retrospectively identified at the Department of Obstetrics and Gynecology, Nagoya University (Nagoya, Japan) between January 2002 and December 2015...
March 2018: Molecular and Clinical Oncology
L E Stewart, T L Beck, N V Giannakopoulos, M H Rendi, C Isacson, B A Goff
OBJECTIVES: Low grade endometrial stromal sarcoma (LG-ESS) is a rare cancer with an indolent course. We aimed to assess the effectiveness of adjuvant hormonal suppression (HT) with or without oophorectomy (BSO) in prolonging progression free survival (PFS) and overall survival (OS) in patients with LG-ESS. METHODS: We performed a multi-institutional retrospective review of patients treated for low grade LG-ESS from 1985 to 2014. Demographics, treatment and recurrence data were abstracted from medical records...
May 2018: Gynecologic Oncology
I M E Desar, P B Ottevanger, C Benson, W T A van der Graaf
Uterine sarcomas (US) are rare mesenchymal tumours of the uterus and are divided mainly into uterine leiomyosarcoma (uLMS), low grade endometrial stromal sarcoma (LG-ESS), high grade endometrial stromal sarcoma (HG-ESS), adenosarcomas and high grade undifferentiated sarcoma (HGUS). US are often high-grade tumours with a high local recurrence rate and metastatic risk. We here discuss the current standard of care and knowledge of systemic therapy for adult uterine sarcomas, in particular uLMS, LG-ESS, HG-ESS and HGUS, in both the adjuvant as well as the metastatic setting...
February 2018: Critical Reviews in Oncology/hematology
Arie J Verschoor, Fabiënne A R M Warmerdam, Tjalling Bosse, Judith V M G Bovée, Hans Gelderblom
BACKGROUND: Pazopanib is an oral tyrosine kinase inhibitor registered for metastatic renal cell carcinoma and soft tissue sarcoma. Liver toxicity is a common side effect for this class of agents. The current opinion is that in case of severe liver toxicity pazopanib should be interrupted and restarted at a lower dose after returning to Common Terminology Criteria for Adverse Events (CTCAE) grade 1. After recurrence of liver toxicity at the lower dose it is advised to permanently stop pazopanib...
January 22, 2018: BMC Cancer
Erina Yuasa-Shibasaki, Sumiyasu Ishii, Shunichi Matsumoto, Takuya Tomaru, Kazuhiko Horiguchi, Aya Osaki, Atsushi Ozawa, Nobuyuki Shibusawa, Tetsurou Satoh, Masanobu Yamada
A 39-year-old woman was admitted to our hospital with symptoms of general fatigue, nausea, and vomiting that appeared three months after she stopped seven years of medroxyprogesterone acetate (MPA) medication for endometrial stromal sarcoma. Laboratory tests demonstrated moderate hypercalcemia. Several tests demonstrated that she was suffering from adrenal insufficiency. Glucocorticoid supplementation decreased her calcium level to a normal range, indicating that hypercalcemia was induced by adrenal insufficiency...
February 15, 2018: Internal Medicine
Ghada A Abu Jamea, Ammar C Al Rikabi, Khalid Akkour
Endometrial stromal sarcoma rarely occurs as an extrauterine neoplasm and it is even more unlikely to be found in the vagina. To the best of our knowledge, only six cases of primary vaginal endometrial stromal sarcoma without association with endometriosis have been published to this day. We describe a case of a 58-year-old female with a history of vaginal heaviness caused by a mass lesion. After a biopsy was taken, the histopathological findings and immunohistochemical stains were consistent with low-grade endometrial stromal sarcoma...
November 2017: Journal of Surgical Case Reports
Hyun Jun Kim, Youjin Kim, Su Jin Lee, Jeeyun Lee, Se Hoon Park
OBJECTIVE: In the treatment of metastatic soft tissue sarcoma (STS), pazopanib is considered a standard treatment after failure of chemotherapy. We retrospectively investigated outcomes of pazopanib in patients with metastatic uterine STS. METHODS: A retrospective study was performed on 35 consecutive patients with uterine STS treated with oral pazopanib 800 mg daily as salvage therapy for metastatic disease between September 2013 and December 2015. Endpoints included response rate, survival, and safety...
January 2018: Journal of Gynecologic Oncology
Armando Sardi, Arkadii Sipok, Dario Baratti, Marcello Deraco, Paul Sugarbaker, George Salti, Yutaka Yonemura, Paolo Sammartino, Olivier Glehen, Naoual Bakrin, Teresa P Díaz-Montes, Vadim Gushchin
OBJECTIVE: Uterine sarcoma (US) is a rare tumor representing 1% of female genital tract malignancies. Peritoneal sarcomatosis (PS) after US, diminishes median overall survival (OS) and progression-free survival (PFS) with cytoreductive surgery (CRS) alone, with or without systemic chemotherapy is <1 year and 6 months, respectively. A multi-institutional review of PS from US was conducted to evaluate CRS and hyperthermic intraperitoneal chemotherapy (HIPEC) and effects on survival outcomes...
November 2017: European Journal of Surgical Oncology
Charlotte Benson, Aisha B Miah
Uterine sarcomas comprise a group of rare tumors with differing tumor biology, natural history and response to treatment. Diagnosis is often made following surgery for presumed benign disease. Currently, preoperative imaging does not reliably distinguish between benign leiomyomas and other malignant pathology. Uterine leiomyosarcoma is the most common sarcoma, but other subtypes include endometrial stromal sarcoma (low grade and high grade), undifferentiated uterine sarcoma and adenosarcoma. Clinical trials have shown no definite survival benefit of adjuvant radiotherapy or chemotherapy and have been hampered by the rarity and heterogeneity of these disease types...
2017: International Journal of Women's Health
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