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

Research output: Contribution to journalArticle

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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
StatePublished - Dec 2005

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Endometrial Stromal Tumors
Ovariectomy
Progesterone Receptors
Estrogen Receptors
Disease-Free Survival
Survival
Recurrence
Kaplan-Meier Estimate
Pelvis
Abdomen
Case-Control Studies
Students

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Li, A. J., Giuntoli, R. L., Drake, R., Byun, S. Y., Rojas, F., Barbuto, D., ... Karlan, B. Y. (2005). Ovarian preservation in stage I low-grade endometrial stromal sarcomas. Obstetrics and Gynecology, 106(6), 1304-1308.

Ovarian preservation in stage I low-grade endometrial stromal sarcomas. / Li, Andrew J.; Giuntoli, Robert L.; Drake, Richard; Byun, Sharon Young; Rojas, Francisco; Barbuto, Denise; Klipfel, Nancy; Edmonds, Pamela; Miller, David S.; Karlan, Beth Y.

In: Obstetrics and Gynecology, Vol. 106, No. 6, 12.2005, p. 1304-1308.

Research output: Contribution to journalArticle

Li, AJ, Giuntoli, RL, Drake, R, Byun, SY, Rojas, F, Barbuto, D, Klipfel, N, Edmonds, P, Miller, DS & Karlan, BY 2005, 'Ovarian preservation in stage I low-grade endometrial stromal sarcomas', Obstetrics and Gynecology, vol. 106, no. 6, pp. 1304-1308.
Li AJ, Giuntoli RL, Drake R, Byun SY, Rojas F, Barbuto D et al. Ovarian preservation in stage I low-grade endometrial stromal sarcomas. Obstetrics and Gynecology. 2005 Dec;106(6):1304-1308.
Li, Andrew J. ; Giuntoli, Robert L. ; Drake, Richard ; Byun, Sharon Young ; Rojas, Francisco ; Barbuto, Denise ; Klipfel, Nancy ; Edmonds, Pamela ; Miller, David S. ; Karlan, Beth Y. / Ovarian preservation in stage I low-grade endometrial stromal sarcomas. In: Obstetrics and Gynecology. 2005 ; Vol. 106, No. 6. pp. 1304-1308.
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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.",
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AU - Giuntoli, Robert L.

AU - Drake, Richard

AU - Byun, Sharon Young

AU - Rojas, Francisco

AU - Barbuto, Denise

AU - Klipfel, Nancy

AU - Edmonds, Pamela

AU - Miller, David S.

AU - Karlan, Beth Y.

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N2 - 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.

AB - 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.

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