Clinicopathologic parameters and immunohistochemical study of endometrial stromal sarcomas

Tzu I. Wu, Hung Hsueh Chou, Chi Ju Yeh, Swei Hsueh, Jung Erh Yang, Mei Shan Jao, Ting Chang Chang, Chun-Sen Hsu, Kwang Huei Lin, Chyong Huey Lai

Research output: Contribution to journalArticle

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Abstract

We aimed to investigate the clinicopathologic features, immunohistochemical studies, and prognosis in patients with endometrial stromal sarcoma (ESS). Clinical information was reviewed retrospectively for cases of ESS (1985-2009). A histologic review and immunohistochemical staining for the estrogen receptor, progesterone receptor, c-Kit, CD-10, Ki-67, and m-TOR were performed. Sixty-one patients (median age, 44 y; range, 22-71) were eligible for analysis (1988 International Federation of Gynecology and Obstetrics Stage I, 43; Stage II, 2; Stage III, 11; Sage IV, 4; unstaged, 1). The median follow-up period for survivors was 73 mo. Of those, the patients who underwent an adnexectomy and a pelvic lymphadenectomy, 15% and 13%, respectively, revealed metastasis. There were 20 relapses/persistence, including 13 (65%) in the pelvis and abdomen and 7 (35%) in distant sites. Eight patients died from ESS at a median duration of 14.5 mo (range, 2-50 mo) after relapse. Five- and 10-yr cancer-specific survival (CSS) rates were 88% and 85%, respectively; and 5- and 10-yr progression-free survival rates were 69% and 57%, respectively. Stage, residual disease, and high proliferative index of Ki-67 were significant prognostic factors for both progression-free survival and CSS in a univariate analysis, in addition to mitotic index for CSS. Multivariate analysis selected only residual disease as an independent variable for progression-free survival and stage and residual disease for CSS. Our results support using clinical Stage I, no residual disease, low proliferative index of Ki-67, and estrogen receptor/progesterone receptor overexpression as potential biomarkers to select patients with ESS for fertility-preservation surgery (5 such patients were alive and free).

Original languageEnglish
Pages (from-to)482-492
Number of pages11
JournalInternational Journal of Gynecological Pathology
Volume32
Issue number5
DOIs
Publication statusPublished - Sep 2013

Fingerprint

Endometrial Stromal Sarcoma
Disease-Free Survival
Progesterone Receptors
Estrogen Receptors
Survival
Survival Rate
Fertility Preservation
Recurrence
Neoplasms
Mitotic Index
Residual Neoplasm
Lymph Node Excision
Pelvis
Gynecology
Abdomen
Obstetrics
Survivors
Multivariate Analysis
Biomarkers
Staining and Labeling

Keywords

  • Endometrial stromal sarcoma
  • Immunohistochemistry
  • Prognostic factors
  • Survival

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Obstetrics and Gynaecology
  • Medicine(all)

Cite this

Clinicopathologic parameters and immunohistochemical study of endometrial stromal sarcomas. / Wu, Tzu I.; Chou, Hung Hsueh; Yeh, Chi Ju; Hsueh, Swei; Yang, Jung Erh; Jao, Mei Shan; Chang, Ting Chang; Hsu, Chun-Sen; Lin, Kwang Huei; Lai, Chyong Huey.

In: International Journal of Gynecological Pathology, Vol. 32, No. 5, 09.2013, p. 482-492.

Research output: Contribution to journalArticle

Wu, Tzu I. ; Chou, Hung Hsueh ; Yeh, Chi Ju ; Hsueh, Swei ; Yang, Jung Erh ; Jao, Mei Shan ; Chang, Ting Chang ; Hsu, Chun-Sen ; Lin, Kwang Huei ; Lai, Chyong Huey. / Clinicopathologic parameters and immunohistochemical study of endometrial stromal sarcomas. In: International Journal of Gynecological Pathology. 2013 ; Vol. 32, No. 5. pp. 482-492.
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AU - Yang, Jung Erh

AU - Jao, Mei Shan

AU - Chang, Ting Chang

AU - Hsu, Chun-Sen

AU - Lin, Kwang Huei

AU - Lai, Chyong Huey

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