Treatment of Uterine Sarcoma in Low-Grade Endometrial Stromal Sarcoma

Low-grade endometrial stromal sarcoma (LG-ESS) is a distinct histologic subtype of uterine sarcoma with specific management considerations, particularly when estrogen and progesterone receptor expression is present.

Clinical Scenario

LG-ESS represents a recognised subtype of uterine sarcoma accounting for approximately one in five cases, typically presenting around age 50. Receptor status is a key factor guiding post-operative management in this population.

Treatment Approach (partial — full protocol below)

In patients with completely resected, estrogen/progesterone receptor-positive LG-ESS, post-operative endocrine therapy is the recommended approach — with specific agent selection, contraindications, and staging criteria defined in the full structured protocol.

Full regimen details, including agent selection and contraindications →

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References

LG-ESS account for approximately 20% of all uterine sarcomas, and are diagnosed at a mean age of around 50 years.
Post-operative endocrine therapy can be considered in patients with stage II, III–IV completely resected estrogen receptor/progesterone receptor positive uterine LG-ESS (IV, C).
Endocrine therapy recommended regimens (IV, C): Progestins (megestrol acetate, medroxyprogesterone acetate) — Aromatase inhibitors (anastrazole, letrozole, exemestane).

DOI: 10.1136/ijgc-2024-005823

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