Prognostic factors and treatment for patients with uterine endometrial stromal sarcomas

Surgery is the main treatment method for patients with endometrial stromal sarcomas (ESS).The standard surgery for low grade ESS includes the extended uterine extirpation with adnexa. Combination of surgery with radiation therapy results in increase in the 5-and 10-year survival rates by 10%. Addition of chemotherapy demonstrates improved long-term treatment results only for patients with non-differentiated ESS. For patients with non-differentiated uterine sarcomas, it is advisable to perform extended uterine extirpation with adnexa and complete removal of the great omentum. Chemoradiation therapy in postoperative period results in 2-fold increase in life span of these patients. The main factors of unfavorable prognosis are the following: non-differentiated tumor, extrauterine involvement, deep myometrial invasion, evidence of necrosis in the tumor and age over 50 years.