TY - JOUR
T1 - Gynecologic Cancer InterGroup (GCIG) consensus review for endometrial stromal sarcoma
AU - Amant, Frédéric
AU - Floquet, Anne
AU - Friedlander, Michael
AU - Kristensen, Gunnar
AU - Mahner, Sven
AU - Nam, Eun Ji
AU - Powell, Matthew A.
AU - Ray-Coquard, Isabelle
AU - Siddiqui, Nadeem
AU - Sykes, Peter
AU - Westermann, Anneke M.
AU - Seddon, Beatrice
PY - 2014
Y1 - 2014
N2 - Endometrial stromal sarcoma (ESS) accounts for approximately 20% of all uterine sarcomas and presents, at a mean age, around 50 years of age. Half of the patients are premenopausal. ESS often manifests as an endometrial polyp and 60% of cases present with FIGO stage I disease. The natural history is one of slow growing indolent disease. Typical microscopic findings include a uniform population of endometrial stromal-type cells invading the myometrium and myometrial vessels. Imaging studies cannot reliably diagnose ESS preoperatively, so surgical resection for a presumed fibroid is a common scenario. Hysterectomy is the cornerstone of treatment for localized ESS, but morcellation should be avoided. Systematic lymphadenectomy in ESS does not improve the outcome. Leaving the ovaries in situ does not worsen survival and this is of importance especially for young women. The data support the current practice to administer adjuvant hormonal treatment, although several questions remain, such as optimal doses, regimens (progestins or aromatase inhibitors) and duration of therapy. Repeat surgery for recurrent disease that is indolent and hormone sensitive appears to be an acceptable approach. Systemic treatment for recurrent disease is mainly hormonal
AB - Endometrial stromal sarcoma (ESS) accounts for approximately 20% of all uterine sarcomas and presents, at a mean age, around 50 years of age. Half of the patients are premenopausal. ESS often manifests as an endometrial polyp and 60% of cases present with FIGO stage I disease. The natural history is one of slow growing indolent disease. Typical microscopic findings include a uniform population of endometrial stromal-type cells invading the myometrium and myometrial vessels. Imaging studies cannot reliably diagnose ESS preoperatively, so surgical resection for a presumed fibroid is a common scenario. Hysterectomy is the cornerstone of treatment for localized ESS, but morcellation should be avoided. Systematic lymphadenectomy in ESS does not improve the outcome. Leaving the ovaries in situ does not worsen survival and this is of importance especially for young women. The data support the current practice to administer adjuvant hormonal treatment, although several questions remain, such as optimal doses, regimens (progestins or aromatase inhibitors) and duration of therapy. Repeat surgery for recurrent disease that is indolent and hormone sensitive appears to be an acceptable approach. Systemic treatment for recurrent disease is mainly hormonal
U2 - https://doi.org/10.1097/IGC.0000000000000205
DO - https://doi.org/10.1097/IGC.0000000000000205
M3 - Review article
C2 - 25033257
SN - 1048-891X
VL - 24
SP - S67-S72
JO - International journal of gynecological cancer
JF - International journal of gynecological cancer
IS - 9 Suppl 3
ER -