Treatment of Uterine Sarcoma in Low-Grade Endometrial Stromal Sarcoma (LG-ESS)

Low-grade endometrial stromal sarcoma (LG-ESS) is a recognised subtype of uterine sarcoma with distinct clinical behaviour. It accounts for approximately 20% of all uterine sarcomas and is typically diagnosed around age 50. Management follows a specific evidence-based pathway tailored to this subtype, particularly in recurrent or metastatic disease.

Clinical scenario: Uterine sarcoma in the setting of low-grade endometrial stromal sarcoma — a subtype that warrants a specific treatment approach different from other uterine sarcoma histologies.

Treatment approach

For recurrent or metastatic LG-ESS, second-line endocrine therapy is a recognised treatment direction.

The complete protocol — including the specific agents, selection criteria, and sequencing — is available in the full structured regimen below.

References

LG-ESS account for approximately 20% of all uterine sarcomas, and are diagnosed at a mean age of around 50 years.

Second-line endocrine therapy with an aromatase inhibitor/progestin/GnRH analogs or an estrogen receptor antagonist such as fulvestrant should be offered to patients with recurrent/metastatic LG-ESS with disease progression after first-line endocrine therapy (V, B).

DOI: 10.1136/ijgc-2024-005823

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