Outcome and Prognostic Factors in Endometrial Stromal Tumors: A Rare Cancer Network Study
- Department of Radiation Oncology, University Hospital, Geneva (Switzerland)
- Department of Radiation Oncology, Ege University Hospital, Izmir (Turkey)
- Department of Radiation Oncology, Antoine Lacassagne Center, Nice (France)
- Department of Radiation Oncology, Rambam Medical Center, Haifa (Israel)
- Department of Radiation Oncology, Metropolitan Hospital, Istanbul (Turkey)
- Department of Radiation Oncology, Marmara University Hospital, Istanbul (Turkey)
- Department of Radiation Oncology, University Hospital, Bern (Switzerland)
- Department of Radiation Oncology, Dueren Hospital, Dueren (Germany)
- Department of Radiation Oncology, William Buckland Radiotherapy Centre, Melbourne (Australia)
- Department of Radiation Oncology, Rene Huguenin Center, Saint-Cloud (France)
Purpose: To provide further understanding regarding outcome and prognostic factors of endometrial stromal tumors (EST). Methods and Materials: A retrospective analysis was performed on the records of 59 women diagnosed with EST and treated with curative intent between 1983 and 2007 in the framework of the Rare Cancer Network. Results: Endometrial stromal sarcomas (ESS) were found in 44% and undifferentiated ESS (UES) in 49% of the cases. In 7% the grading was unclear. Of the total number of patients, 33 had Stage I, 4 Stage II, 20 Stage III, and 1 presented with Stage IVB disease. Adjuvant chemotherapy was administered to 12 patients, all with UES. External-beam radiotherapy (RT) was administered postoperatively to 48 women. The median follow-up was 41.4 months. The 5-year overall survival (OS) rate was 96.2% and 64.8% for ESS and UES, respectively, with a corresponding 5-year disease-free survival (DFS) rate of 49.4% and 43.4%, respectively. On multivariate analysis, adjuvant RT was an independent prognostic factor for OS (p = 0.007) and DFS (p = 0.013). Locoregional control, DFS, and OS were significantly associated with age ({<=}60 vs. >60 years), grade (ESS vs. UES), and International Federation of Gynecology and Obstetrics stage (I-II vs. III-IV). Positive lymph node staging had an impact on OS (p < 0.001). Conclusion: The prognosis of ESS differed from that of UES. Endometrial stromal sarcomas had an excellent 5-year OS, whereas the OS in UES was rather low. However, half of ESS patients had a relapse. For this reason, adjuvant treatment such as RT should be considered even in low-grade tumors. Multicenter randomized studies are still warranted to establish clear guidelines.
- OSTI ID:
- 22056247
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 82, Issue 5; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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