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Aust N Z J Obstet Gynaecol. 2014 Oct;54(5):453-6. doi: 10.1111/ajo.12245.

Prognostic significance of steroid receptor positivity and adjuvant progestogen use in endometrial stromal sarcoma.

Author information

1
Department of Obstetrics and Gynaecology, Royal Women's Hospital, Parkville, Victoria, Australia.

Abstract

BACKGROUND:

The prognostic significance of oestrogen and progesterone receptors (ER/PR) in endometrial stromal sarcoma (ESS) has conflicting reports in the literature, and the routine use of adjuvant progestogen is of uncertain efficacy.

AIMS:

To examine the prognostic significance of ER/PR positivity and of primary adjuvant progestogen use with outcome in ESS.

MATERIALS AND METHODS:

All women with a diagnosis of ESS in our tertiary institution and associated private practices over the last 23 years were included. Primary variables were ER/PR positivity and adjuvant progestogen use. Other variables included high-grade disease and extrauterine disease. The primary outcome was survival, and the secondary outcome was recurrence-free survival (both overall and at 5 years). Survival was calculated using the Kaplan-Meier method. Univariate analyses were performed with t-test for means and chi-squared test for proportions, and multivariate analysis was used to control for age.

RESULTS:

35 women were included. ER/PR positivity was associated with a survival benefit (OR death 0.22, P = 0.02), but primary adjuvant progestogen was not. High-grade disease (OR 13, P = 0.02) and extrauterine disease (OR 8.7, P = 0.04) were associated with decreased survival. No variable significantly affected recurrence-free survival. Eight of ten cases of recurrence treated with progestogen have survived more than 3 years.

CONCLUSIONS:

ER/PR positivity appears to be useful for prognosis, but routine administration of primary adjuvant progestogen is not supported. There may be a role for progestogen in ER/PR positive tumours with recurrence or incomplete surgical clearance, but further research is required.

KEYWORDS:

endometrial stromal; endometrial stromal tumours; progestins; receptors; sarcoma; steroid

PMID:
25287561
DOI:
10.1111/ajo.12245
[Indexed for MEDLINE]

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