Fertility-sparing surgery for patients with low-grade endometrial stromal sarcoma

PURPOSE To assess the clinical outcomes and fertility of young women with stage I low-grade endometrial stromal sarcoma (ESS) treated with fertility-sparing surgery. RESULTS Seventeen patients with stage I low-grade ESS (stage IA, n = 6; stage IB, n = 11) were entered into this study. Adjuvant hormone therapy was administered to 15 (88.2%) patients. At a median follow-up of 39 months (range, 4-106 months), 10 (58.8%) patients developed recurrence. All 10 patients had stage IB disease; among them, the first recurrence limited to the uterus was observed in 6 patients. All 17 patients were alive and disease-free at the time of last contact. After treatment, five of eight (62.5%) patients who attempted pregnancy conceived. No offspring had congenital anomalies. METHODS Patients with stage I low-grade ESS who underwent fertility-sparing surgery between April 2001 and November 2015 were retrospectively reviewed. CONCLUSIONS Fertility-sparing surgery may be considered for young patients with stage IA low-grade ESS who wish to preserve their fertility.