旨在评估低度子宫内膜间质肉瘤 (LG-ESS) 患者的病程，并比较原发性疾病和复发性疾病中激素治疗相关的肿瘤学结果。这是一项对 2000 年 1 月期间接受积极治疗的 LG-ESS 患者的回顾性研究2023 年 7 月。使用 Kaplan-Meier 乘积极限估计器估计无复发生存期 (RFS) 和总生存期 (OS)，并通过 Cox 比例风险回归建模。总共纳入 221 名患者； 58% (91/157) 的患者处于 I 期，12% (19/157) 处于 II 期，13% (20/157) 处于 III 期，17% (27/157) 处于 IV 期。手术是 98% (213/218) 的主要治疗方法。只有 79 名患者接受激素辅助治疗，其中 58% (46/79) Megace、24% (19/79) 来曲唑和 18% (14/79) 接受其他激素治疗。接受 Megace 与来曲唑作为辅助治疗的患者之间，RFS (p = 0.159) 和 OS (p = 0.167) 没有显着差异。首次复发时，接受 Megace 治疗的患者与接受来曲唑治疗的患者具有相似的 RFS（p = 0.302），但 OS 更好（27 个月与 10 个月，p = 0.018）。  雌激素、平​​滑肌肌动蛋白和结蛋白的阴性状态与较低的 RFS（分别为 p = 0.039、p = 0.002 和 p = 0.015）和 OS（分别为 p = 0.008、p = 0.012 和 p = 0.013）相关。 。淋巴血管侵犯与较低的 RFS 相关（p = 0.033），孕酮阴性状态与较低的 OS 相关（p = 0.003）。在接受 LG-ESS 辅助治疗的患者中，Megace 和来曲唑之间的肿瘤学结果没有差异。 Megace可能在复发性疾病中具有潜在的生存优势。需要进一步研究以确定治疗 LG-ESS 的最有效药物及其顺序。版权所有 © 2024。由 Elsevier Inc. 出版。

To evaluate the disease course of patients with low grade endometrial stromal sarcoma (LG-ESS) and compare oncologic outcomes associated with hormonal therapy in primary and recurrent disease.This is a retrospective study of patients with LG-ESS who underwent active treatment between January 2000 and July 2023. Recurrence-free survival (RFS) and overall survival (OS) were estimated using the Kaplan-Meier product-limit estimator and modeled via Cox proportional hazards regression.A total of 221 patients were included; 58 % of patients (91/157) were stage I, 12 % (19/157) stage II, 13 % (20/157) stage III, and 17 % (27/157) stage IV. Surgery was the primary treatment for 98 % (213/218). Only 79 patients received hormonal adjuvant therapy, 58 % (46/79) Megace, 24 % (19/79) Letrozole, and 18 % (14/79) received other hormonal therapy. There was no significant difference in RFS (p = 0.159) and OS (p = 0.167) between patients receiving Megace versus Letrozole as adjuvant therapy. At first recurrence, patients given Megace had a similar RFS to those on Letrozole (p = 0.302), but a better OS (27 vs 10 months, p = 0.018).  Negative status of estrogen, smooth muscle actin, and desmin were associated with lower RFS (p = 0.039, p = 0.002, and p = 0.015, respectively) and OS (p = 0.008, p = 0.012, and p = 0.013, respectively). Lymphovascular invasion was associated with lower RFS (p = 0.033), and negative status of progesterone was associated with lower OS (p = 0.003).There was no difference in oncologic outcomes between Megace and Letrozole in patients who received adjuvant therapy for LG-ESS. Megace may have potential survival advantage in recurrent disease. Further study is warranted to determine the most effective agents and their sequence in the treatment of LG-ESS.Copyright © 2024. Published by Elsevier Inc.