Science & Healthcare

Introduction. Endometrial stromal sarcoma (ESS) takes the third place after leiomyosarcoma and undifferentiated uterine sarcoma; it’s classified as a rare endometrial tumor, accounting for only 15 % of all sarcomas. From 15 to 25 % of patients with uterine endometrial stromal sarcoma die because of the relapsed disease.

The purpose is to analyse a serie of clinical cases of uterine sarcoma patients, who were diagnosed for the first time and underwent treatment between January 1997 and December 2016 in the clinic of Grigoriev Institute for Medical Radiology, NAMS of Ukraine.

Methods: Study design – there were investigated retrospective  treatment results of 33 patients and prospective data of 9 patients with uterine endometrial stromal sarcoma patients stage IA-IVB (T1-3NxM0-1), based on non-progressive survival, relapse-rate at follow-up of 60 month. All the patients underwent surgery, radiotherapy and/or chemotherapy.

All the patients with primary morphologically proved ESS were enrolled into this study.

For indexes, which were measured by the quantitative scale, there were obtained median and mean as a measure of position; the standard deviation and quartiles - as a measure of dispersion; minimal and maximal values - as a measure of the sample’s range.

The statistical data-processing was performed by STATISTICA 6.1 (Russian version). The statistical significance of the differences was verified using the Mann-Whitney U test (in case of the paired independent sets), the Kraskel-Wallis criteria (in case of multiple independent sets), and the analysis of conjugacy tables.

Results: The relapse-rate after the combined or complex treatment in ESS patients stage I–IV was 42.9 ± 7.6 %: loco-regional recurrence was detected in 16.7 ± 5.8 % of patients, distant metastases – in 26.2 ± 6.8 %.

Depending on stage of disease, the relapse was detected in patients with I stage in 22,2 ± 1,0 % cases, with II stage – 50,1 ± 1,7%, with III stage – 66,7 ± 1,7 %, and with IV stage – in 62,5 ± 1,8 % of cases during follow-up of 60 months. Five-years relapse-free survival is 77,8 ± 1,0% in patients stage I, in patients with stage II - 50,0 ± 1,7%, with stage III - 33,3 ± 2,1%, and stage IV  – 0 %.

Conclusions: The progressive disease in term up to 6 months was detected in 80 % of patients with stage II and IV. The 5-year non-progressive survival, without taking into consideration the stage of disease, was revealed in 57.1 % of patients.

The relapse-rate in ESS patients stage I-II, in whom there was conducted adjuvant radiation or chemo-radiation therapy, was  33,3 and 36,4%, respectively; in case of chemotherapy – 0%.