Ovarian preservation in stage I low-grade endometrial stromal sarcomas

Andrew J. Li, Robert L. Giuntoli, Richard Drake, Sharon Young Byun, Francisco Rojas, Denise Barbuto, Nancy Klipfel, Pamela Edmonds, David S. Miller, Beth Y. Karlan

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Abstract

OBJECTIVE: To examine the impact of ovarian preservation in a case-control study of women with stage I low-grade endometrial stromal sarcomas. METHODS: Patients with low-grade endometrial stromal sarcomas were identified at 5 institutions from 1976 to 2002. Cases were defined as patients who retained ovarian function; each case was matched to 2 control patients who underwent bilateral salpingo-oophorectomy (BSO). Immunostaining for estrogen and progesterone receptors was performed. Data were examined with Student t, χ2, Cox regression, and Kaplan-Meier analyses. RESULTS: Twelve premenopausal patients with low-grade endometrial stromal sarcomas who did not undergo BSO were matched to 24 controls. Of the 36 patients in the entire cohort, disease recurred in 14 (39%). Recurrences were identified in the pelvis, abdomen, lung, or lymphatics in both cases and controls. Disease recurred in 4/12 (33%) case patients, compared with 10/24 (42%) control patients (P = .63). When case patients were compared with controls, no differences in progression-free (91.3 months versus 68.6 months, P = .44) or overall survival (median survival not yet reached versus 406 months, P = .82) were identified. This study had 13% power to detect the observed difference in median disease-free survival. After controlling for use of adjuvant therapy and BSO, older age remained the only independent poor prognostic factor for progression-free survival (P = .008). Twenty-two available tumors demonstrated positivity for both estrogen and progesterone receptors. CONCLUSION: Bilateral salpingo-oophorectomy did not appear to affect time to recurrence or overall survival. Retention of ovarian function may be an option for premenopausal women with low-grade endometrial stromal sarcomas.

Original languageEnglish (US)
Pages (from-to)1304-1308
Number of pages5
JournalObstetrics and gynecology
Volume106
Issue number6
DOIs
StatePublished - Dec 2005

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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    Li, A. J., Giuntoli, R. L., Drake, R., Byun, S. Y., Rojas, F., Barbuto, D., Klipfel, N., Edmonds, P., Miller, D. S., & Karlan, B. Y. (2005). Ovarian preservation in stage I low-grade endometrial stromal sarcomas. Obstetrics and gynecology, 106(6), 1304-1308. https://doi.org/10.1097/01.AOG.0000185511.91694.1e