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9. Kim WY, Lee JW, Choi CH, Kang H, Kim TJ, Kim BG, Lee JH, Bae DS: Low-grade endometrial stromal sarcoma: a single center's experience with 22 cases. Int J Gynecol Cancer; 2008 Sep-Oct;18(5):1084-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Low-grade endometrial stromal sarcoma: a single center's experience with 22 cases.
  • The aim of this retrospective study was to evaluate the clinical behavior and management outcome of low-grade endometrial stromal sarcoma (LGESS).
  • Six patients had adjuvant therapy after the hysterectomy.
  • Recurrent disease was treated with surgery (one case), surgery plus chemotherapy (five cases), chemotherapy (two cases), and surgery plus radiotherapy (two cases).
  • Treatment with a bilateral salpingo-oophorectomy or adjuvant chemoradiation did not affect the disease-free interval.
  • Surgery is the primary treatment for recurrent endometrial stromal sarcoma when feasible.
  • Adjuvant treatment (radiotherapy, chemotherapy, or both) had no effect on the prognosis of patients with stage I disease.
  • [MeSH-major] Sarcoma, Endometrial Stromal / pathology

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  • (PMID = 18179547.001).
  • [ISSN] 1525-1438
  • [Journal-full-title] International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
  • [ISO-abbreviation] Int. J. Gynecol. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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10. Paillocher N, Lortholary A, Abadie-Lacourtoisie S, Morand C, Verriele V, Catala L, Descamps P: [Low-grade endometrial stromal sarcoma: contribution of hormone therapy and etoposide]. J Gynecol Obstet Biol Reprod (Paris); 2005 Feb;34(1 Pt 1):41-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Low-grade endometrial stromal sarcoma: contribution of hormone therapy and etoposide].
  • [Transliterated title] Sarcome du chorion cytogène de bas grade. Mise au point sur l'intérêt de l'hormonothérapie et de l'étoposide à partir de 4 cas.
  • Endometrial stromal sarcoma is a rare malignant uterine tumor.
  • We report 4 cases of low-grade endometrial stromal sarcoma, corresponding to the form with a mitotic index at less than 10 mitoses per 10 high power fields (HPF), from which we carried out a review of the literature and defined the potential interest of hormone therapy and chemotherapy by etoposide.
  • The initial treatment is mainly based open surgery, generally total hysterectomy with annexectomy.
  • There is no effective adjuvant treatment.
  • The potential of reccurences remains around 50% with a 34-month median.
  • Several therapeutic options are possible after recurrence but no standard treatment has been established.
  • Chemotherapy by oral etoposide offers easy administration, good compliance and acceptable toxicity with median 20-month remission in 3 patients before progression.
  • Hormone therapy with progestogens (hormone receptor expression of the tumor is 71% for estrogens and 95% for progesterone) is widely studied in the literature with a 46% response rate and 46% rate of disease stabilization.
  • Hormone therapy with an anti-aromatase appears to be a promising treatment according to the bibliographic references on this subject.
  • Overall, prognosis of low-grade endometrial sarcoma is relatively good with 100% survival at 5 years.
  • [MeSH-major] Antineoplastic Agents, Phytogenic / therapeutic use. Endometrial Neoplasms / drug therapy. Etoposide / therapeutic use. Progestins / therapeutic use. Sarcoma / drug therapy

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  • (PMID = 15767916.001).
  • [ISSN] 0368-2315
  • [Journal-full-title] Journal de gynécologie, obstétrique et biologie de la reproduction
  • [ISO-abbreviation] J Gynecol Obstet Biol Reprod (Paris)
  • [Language] fre
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 0 / Progestins; 6PLQ3CP4P3 / Etoposide
  • [Number-of-references] 23
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11. Reich O, Regauer S: Hormonal therapy of endometrial stromal sarcoma. Curr Opin Oncol; 2007 Jul;19(4):347-52
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Hormonal therapy of endometrial stromal sarcoma.
  • PURPOSE OF REVIEW: Low-grade endometrial stromal sarcomas are steroid receptor positive tumors with slow tumor progression and high recurrence rates, which lack established treatment protocols.
  • We present an update on hormonal therapy options.
  • RECENT FINDINGS: In the past, hormonal therapy consisted of progestins for advanced/recurrent/metastatic low-grade endometrial stromal sarcomas.
  • Aromatase inhibitors and gonadotropin-releasing hormone analogues have become new effective alternatives for first and second line treatment.
  • The high recurrence rates after short disease free intervals in low-grade endometrial stromal sarcoma patients were partly due to inadvertent growth stimulation during estrogen-containing hormone replacement therapy and tamoxifen treatment, which - according to current knowledge - are contraindicated.
  • Recently, hormonal therapy has been introduced for the prevention of recurrences.
  • Aromatase inhibitors are becoming the treatment of choice, since progestins are poorly tolerated due to side effects.
  • The effective duration of preventive hormonal therapy is still undetermined.
  • SUMMARY: Hormonal therapy with progestins, aromatase inhibitors and gonadotropin-releasing hormone analogues has become an effective treatment alternative to radiation and chemotherapy for low-grade endometrial stromal sarcoma patients.
  • Preventive hormonal therapy is of particular interest in the setting of concomitant endometriosis.
  • [MeSH-major] Antineoplastic Agents, Hormonal / therapeutic use. Endometrial Neoplasms / drug therapy. Gonadotropin-Releasing Hormone / analogs & derivatives. Gonadotropin-Releasing Hormone / therapeutic use. Sarcoma, Endometrial Stromal / drug therapy
  • [MeSH-minor] Aromatase Inhibitors / therapeutic use. Female. Goserelin. Humans. Neoplasm Recurrence, Local

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  • (PMID = 17545798.001).
  • [ISSN] 1040-8746
  • [Journal-full-title] Current opinion in oncology
  • [ISO-abbreviation] Curr Opin Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Aromatase Inhibitors; 0F65R8P09N / Goserelin; 33515-09-2 / Gonadotropin-Releasing Hormone
  • [Number-of-references] 50
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12. Yokoyama Y, Ono Y, Sakamoto T, Fukuda I, Mizunuma H: Asymptomatic intracardiac metastasis from a low-grade endometrial stromal sarcoma with successful surgical resection. Gynecol Oncol; 2004 Mar;92(3):999-1001
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Asymptomatic intracardiac metastasis from a low-grade endometrial stromal sarcoma with successful surgical resection.
  • BACKGROUND: The endometrial stromal sarcoma (ESS) is a rare neoplasm of the uterine origin.
  • Intracardiac metastasis from the low-grade ESS is an extremely rare event.
  • A case of a patient who successfully underwent surgical extraction of metastatic tumors of the low-grade ESS in the right ventricle is described in the present report.
  • CASE: A 48-year-old woman was considered recurrence of the low-grade ESS 4 years after the initial operation for this disease.
  • The chemotherapy was effective against the recurrent tumors except for intracardiac site.
  • Pathological examination confirmed intracardiac recurrent low-grade ESS.
  • CONCLUSION: Surgical approach to intracardiac metastasis of the low-grade ESS is considered viable because of an excellent long-term prognosis in this disease and the likelihood of fatal heart failure or sudden death in untreated cases.
  • [MeSH-major] Endometrial Neoplasms / pathology. Heart Neoplasms / secondary. Heart Neoplasms / surgery. Sarcoma, Endometrial Stromal / secondary. Sarcoma, Endometrial Stromal / surgery

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  • (PMID = 14984976.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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13. Lim MC, Lee S, Seo SS: Megestrol acetate therapy for advanced low-grade endometrial stromal sarcoma. Onkologie; 2010;33(5):260-2
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Megestrol acetate therapy for advanced low-grade endometrial stromal sarcoma.
  • BACKGROUND: Pulmonary metastases as an initial presentation of primary uterine low-grade endometrial stromal sarcoma (LGESS) are extremely rare.
  • Optimal treatment for such LGESS has not been established.
  • Chest computed tomography (CT) revealed 11 pulmonary metastases measuring up to 2.8 cm.
  • The pulmonary metastases of LGESS began to regress with megestrol acetate treatment and almost completely disappeared 17 months after surgery.
  • At this unexpected and satisfactory response to hormonal treatment, the remaining left ovary was also surgically removed.
  • Since the surgery, the patient has been alive without symptomatic pulmonary metastases over 5 years on intermittent treatment of 200 mg megestrol acetate.
  • CONCLUSION: Megestrol acetate could be suitable as the first-line hormonal treatment for pulmonary metastases from LGESS.
  • [MeSH-major] Antineoplastic Agents, Hormonal / therapeutic use. Endometrial Neoplasms / drug therapy. Lung Neoplasms / drug therapy. Lung Neoplasms / secondary. Megestrol Acetate / therapeutic use. Sarcoma, Endometrial Stromal / drug therapy. Sarcoma, Endometrial Stromal / secondary
  • [MeSH-minor] Adult. Chemotherapy, Adjuvant. Combined Modality Therapy. Disease-Free Survival. Drug Administration Schedule. Fallopian Tubes / surgery. Female. Humans. Neoplasm Staging. Omentum / surgery. Ovariectomy. Palliative Care

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  • [Copyright] Copyright 2010 S. Karger AG, Basel.
  • (PMID = 20502061.001).
  • [ISSN] 1423-0240
  • [Journal-full-title] Onkologie
  • [ISO-abbreviation] Onkologie
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; TJ2M0FR8ES / Megestrol Acetate
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4. Dahhan T, Fons G, Buist MR, Ten Kate FJ, van der Velden J: The efficacy of hormonal treatment for residual or recurrent low-grade endometrial stromal sarcoma. A retrospective study. Eur J Obstet Gynecol Reprod Biol; 2009 May;144(1):80-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The efficacy of hormonal treatment for residual or recurrent low-grade endometrial stromal sarcoma. A retrospective study.
  • OBJECTIVE: Low-grade endometrial stromal sarcoma (EES) is a rare tumour with a high recurrence rate but a very good prognosis.
  • Responses to hormonal treatment of these recurrences have been published in case reports.
  • The aim of this study was to determine the objective response rate and response duration of hormonal treatment for recurrent or residual low-grade ESS in a consecutive series of patients.
  • The following data were collected: age, date of primary diagnosis, type of primary treatment, the presence and localization of residual or recurrent disease, type of treatment, response, duration of response and survival.
  • RESULTS: After hormonal treatment 9 (82%) patients showed an objective response (4 complete response; 5 partial response), one showed stable disease (26+ months) and one progressive disease.
  • CONCLUSION: Hormonal treatment for measurable residual or recurrent low-grade ESS has a high response rate and should be considered as the treatment of choice for patients in which recurrent disease cannot easily be resected.
  • [MeSH-major] Aromatase Inhibitors / therapeutic use. Endometrial Neoplasms / drug therapy. Megestrol Acetate / therapeutic use. Nitriles / therapeutic use. Progestins / therapeutic use. Sarcoma, Endometrial Stromal / drug therapy. Triazoles / therapeutic use
  • [MeSH-minor] Adult. Aged, 80 and over. Combined Modality Therapy. Dose-Response Relationship, Drug. Female. Humans. Hysterectomy. Middle Aged. Retrospective Studies. Secondary Prevention. Treatment Outcome

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  • (PMID = 19269732.001).
  • [ISSN] 1872-7654
  • [Journal-full-title] European journal of obstetrics, gynecology, and reproductive biology
  • [ISO-abbreviation] Eur. J. Obstet. Gynecol. Reprod. Biol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Ireland
  • [Chemical-registry-number] 0 / Aromatase Inhibitors; 0 / Nitriles; 0 / Progestins; 0 / Triazoles; 7LKK855W8I / letrozole; TJ2M0FR8ES / Megestrol Acetate
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15. Mesia AF, Demopoulos RI: Effects of leuprolide acetate on low-grade endometrial stromal sarcoma. Am J Obstet Gynecol; 2000 May;182(5):1140-1
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  • [Title] Effects of leuprolide acetate on low-grade endometrial stromal sarcoma.
  • We describe a low-grade endometrial stromal sarcoma coexistent with leiomyoma and adenomyosis treated with leuprolide acetate.
  • [MeSH-major] Endometrial Neoplasms / drug therapy. Leuprolide / therapeutic use. Sarcoma / drug therapy
  • [MeSH-minor] Adult. Endometriosis / pathology. Female. Humans. Leiomyoma / drug therapy. Leiomyoma / pathology. Leiomyoma / surgery. Neoplasms, Multiple Primary / drug therapy. Neoplasms, Multiple Primary / pathology

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  • (PMID = 10819848.001).
  • [ISSN] 0002-9378
  • [Journal-full-title] American journal of obstetrics and gynecology
  • [ISO-abbreviation] Am. J. Obstet. Gynecol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] EFY6W0M8TG / Leuprolide
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16. Bosincu L, Massarelli G, Cossu Rocca P, Isaac MA, Nogales FF: Rectal endometrial stromal sarcoma arising in endometriosis: report of a case. Dis Colon Rectum; 2001 Jun;44(6):890-2
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Rectal endometrial stromal sarcoma arising in endometriosis: report of a case.
  • PURPOSE: Endometriosis of the rectovaginal septum can harbor different types of secondary tumors that may involve the rectal wall and protrude into its lumen, thus making diagnosis difficult.
  • Extrauterine low-grade endometrial stromal sarcoma may rarely arise in endometriosis.
  • Histopathologically, primary endometriotic foci were found in close relationship with an endometrial stromal sarcoma which invaded the rectal wall.
  • The patient was treated by surgery and subsequent chemotherapy and was alive and well 20 months later.
  • CONCLUSIONS: Endometriosis and its possible malignant changes should be taken into account in the differential endoscopic diagnosis of rectal masses in females.
  • [MeSH-major] Endometrial Neoplasms / etiology. Endometriosis / complications. Sarcoma / etiology
  • [MeSH-minor] Abdominal Pain / etiology. Adult. Female. Fever / etiology. Humans. Stromal Cells / pathology


17. Nakayama K, Ishikawa M, Nagai Y, Yaegashi N, Aoki Y, Miyazaki K: Prolonged long-term survival of low-grade endometrial stromal sarcoma patients with lung metastasis following treatment with medroxyprogesterone acetate. Int J Clin Oncol; 2010 Apr;15(2):179-83
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Prolonged long-term survival of low-grade endometrial stromal sarcoma patients with lung metastasis following treatment with medroxyprogesterone acetate.
  • BACKGROUND: The aim of this study was to investigate the usefulness of medroxyprogesterone acetate (MPA) therapy for patients with metastatic low-grade endometrial stromal sarcoma (LGESS).
  • METHODS: A retrospective review was performed of five patients with metastatic LGESS lesions in whom MPA therapy prolonged survival.
  • Three of the five patients received several types of chemotherapy, and all of these patients received the same MPA (200-600 mg/day) hormonal therapy.
  • The median overall survival from the time of recurrence was 41 months (range, 9-163 months).
  • CONCLUSION: The patients in this study demonstrate that MPA treatment may extend the survival of patients with LGESS that is metastatic to the lung.
  • [MeSH-major] Antineoplastic Agents, Hormonal / therapeutic use. Endometrial Neoplasms / drug therapy. Lung Neoplasms / drug therapy. Medroxyprogesterone Acetate / therapeutic use. Sarcoma, Endometrial Stromal / drug therapy
  • [MeSH-minor] Adult. Chemotherapy, Adjuvant. Disease-Free Survival. Female. Humans. Hysterectomy. Middle Aged. Neoplasm Staging. Ovariectomy. Retrospective Studies. Survival Analysis. Time Factors. Treatment Outcome

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  • (PMID = 20217451.001).
  • [ISSN] 1437-7772
  • [Journal-full-title] International journal of clinical oncology
  • [ISO-abbreviation] Int. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; C2QI4IOI2G / Medroxyprogesterone Acetate
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18. Garavaglia E, Pella F, Montoli S, Voci C, Taccagni G, Mangili G: Treatment of recurrent or metastatic low-grade endometrial stromal sarcoma: three case reports. Int J Gynecol Cancer; 2010 Oct;20(7):1197-200
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Treatment of recurrent or metastatic low-grade endometrial stromal sarcoma: three case reports.
  • BACKGROUND: The treatment of recurrent or metastatic low-grade endometrial stromal sarcoma (LG-ESS) is still controversial.
  • Responses to hormonal therapy have been reported, because of the presence of estrogen and progestin receptors.
  • Also chemotherapy has been used, but the percentage of response is low.
  • The second patient developed pelvic and abdominal recurrences, managed by surgery, 33 months after primary treatment and a subsequent lung recurrence 11 years later.
  • CONCLUSIONS: In LG-ESS, the combined treatment of surgery and progestin therapy is effective in achieving both local and distant disease control.
  • Metastatic lesions, especially pulmonary lesions, seem to benefit from surgical removal, followed by progestin therapy.
  • Hormonal therapy should be maintained for an indefinite period.
  • On account of the long period existing between primary tumor and recurrent disease, a long-term follow-up is always recommended after the primary treatment.
  • [MeSH-major] Endometrial Neoplasms / surgery. Endometrial Stromal Tumors / surgery. Hysterectomy. Neoplasm Recurrence, Local / surgery. Sarcoma, Endometrial Stromal / surgery
  • [MeSH-minor] Adult. Female. Humans. Middle Aged. Survival Rate. Treatment Outcome

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  • (PMID = 21495227.001).
  • [ISSN] 1525-1438
  • [Journal-full-title] International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
  • [ISO-abbreviation] Int. J. Gynecol. Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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