Low-grade endometrial stromal sarcoma (LG-ESS) is a distinct subtype of uterine sarcoma. When disease is unresectable, recurrent, or metastatic, a specific first-line approach is recommended by evidence-based guidelines.
LG-ESS accounts for approximately 20% of all uterine sarcomas and is diagnosed at a mean age of around 50 years. This protocol applies to patients with unresectable recurrent or metastatic LG-ESS who require first-line systemic management.
First-line management in this setting is built around endocrine-based therapy, with agent selection guided by menopausal status and ovarian function — the complete options, eligibility criteria, and sequencing are detailed in the full protocol.
The aim is to achieve sufficient tumor response on reassessment after an adequate course of neoadjuvant endocrine therapy, to determine whether debulking surgery becomes a viable next step.
DOI: 10.1136/ijgc-2024-005823
LG-ESS account for approximately 20% of all uterine sarcomas, and are diagnosed at a mean age of around 50 years.
Endocrine therapy is recommended for unresectable recurrent tumors (V, C).
Reassessment after at least 3 months of neoadjuvant endocrine therapy may identify a subset of patients with sufficient tumor response to consider debulking surgery (V, C).
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