Endometrial stromal sarcoma: French Guidelines from the French Sarcoma Group and the Rare Malignant Gynecologic Tumors Group
Bull Cancer. 2023 Mar 27:S0007-4551(23)00141-8. doi: 10.1016/j.bulcan.2023.03.003. Online ahead of print.ABSTRACTLow-grade endometrial stromal sarcoma (LG-ESS) accounts for approximately 15% of all uterine sarcomas. Median age of patients is around 50 years and half of the patients are premenopausal. In all, 60% of cases present with FIGO stage I disease. Preoperatively radiologic findings of ESS are not specific. Pathological diagnosis remains essential. This review aimed to present the French guidelines for low grade ESS treatment within the Groupe sarcome français - Groupe d'étude des tumeurs osseuse (GSF-GETO)/NETSARC+ and tumeur maligne rare gynécologique (TMRG) networks. Treatments should be validated in multidisciplinary team involved in sarcomas or rare gynecologic tumors. Hysterectomy is the cornerstone of treatment for localized ESS, and morcellation should be avoided. Systematic lymphadenectomy in ESS does not improve the outcome and is not recommended. Leaving the ovaries in situ in stage I tumors could be discussed for young women. Adjuvant hormonal treatment could be considered, for two years for stage I with morcellation or stage II and livelong for stages III or IV. Nevertheless, several questions remain, such as optimal doses, regimens (progestins or aromatase inhibitors) and duration of therapy. Tamoxifen is contraindicated. Secondary cytoreductive surgery if feasible for recurrent disease, appears to be an acceptable approach. Systemic treatment for recu...
Source: Bulletin du Cancer - Category: Cancer & Oncology Authors: Coriolan Lebreton Pierre Meeus Catherine Genestie Sabrina Croce Fr édéric Guyon Carmen Llacer Moscardo Sophie Taieb Jean-Yves Blay Sylvie Bonvalot Emmanuelle Bompas Christine Chevreau Fabrice L écuru L éa Rossi Florence Joly Maria Rios Lo ïc Chaignea Source Type: research
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