Comparative analysis of hormonal therapy in low-grade endometrial stromal sarcoma: A retrospective study

被引:0
作者
Saab, Reem [1 ]
Ratan, Ravin [3 ]
Fellman, Bryan M. [2 ]
Legarreta, Alejandra Flores [1 ]
Meyer, Larissa A. [1 ]
Fleming, Nicole D. [1 ]
Haddad, Elise F. Nassif [3 ]
Frumovitz, Michael [1 ]
Soliman, Pamela T. [1 ]
机构
[1] Univ Texas MD Anderson Canc Ctr, Dept Gynecol Oncol & Reprod Med, Houston, TX USA
[2] Univ Texas MD Anderson Canc Ctr, Dept Biostat, Houston, TX USA
[3] Univ Texas MD Anderson Canc Ctr, Dept Sarcoma Med Oncol, Houston, TX USA
基金
美国国家卫生研究院;
关键词
Endometrial stromal sarcoma; Low-grade ESS; Uterine sarcoma; Hormonal therapy; Megace; Letrozole; PROGNOSTIC-FACTORS; SPACE INVASION; GENE FUSION; CANCER; NEOPLASMS; TUMORS;
D O I
10.1016/j.ygyno.2024.10.008
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Objective. To evaluate the disease course of patients with low grade endometrial stromal sarcoma (LG-ESS) and compare oncologic outcomes associated with hormonal therapy in primary and recurrent disease. Methods. This is a retrospective study of patients with LG-ESS who underwent active treatment between January 2000 and July 2023. Recurrence-free survival (RFS) and overall survival (OS) were estimated using the Kaplan-Meier product-limit estimator and modeled via Cox proportional hazards regression. Results. A total of 221 patients were included; 58 % of patients (91/157) were stage I, 12 % (19/157) stage II, 13 % (20/157) stage III, and 17 % (27/157) stage IV. Surgery was the primary treatment for 98 % (213/218). Only 79 patients received hormonal adjuvant therapy, 58 % (46/79) Megace, 24 % (19/79) Letrozole, and 18 % (14/79) received other hormonal therapy. There was no significant difference in RFS (p = 0.159) and OS (p = 0.167) between patients receiving Megace versus Letrozole as adjuvant therapy. At first recurrence, patients given Megace had a similar RFS to those on Letrozole (p = 0.302), but a better OS (27 vs 10 months, p = 0.018). Negative status of estrogen, smooth muscle actin, and desmin were associated with lower RFS (p = 0.039, p = 0.002, and p = 0.015, respectively) and OS (p = 0.008, p = 0.012, and p = 0.013, respectively). Lymphovascular invasion was associated with lower RFS (p = 0.033), and negative status of progesterone was associated with lower OS (p = 0.003). Conclusion. There was no difference in oncologic outcomes between Megace and Letrozole in patients who received adjuvant therapy for LG-ESS. Megace may have potential survival advantage in recurrent disease. Further study is warranted to determine the most effective agents and their sequence in the treatment of LG-ESS. (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
引用
收藏
页码:143 / 149
页数:7
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