Overview
Endometrial stromal sarcoma (ESS) is a rare malignant tumor arising from the endometrial stroma. Metastatic disease can occur in various sites, including the lungs, liver, and bone.Diagnosis
Diagnosis is typically made by histopathologic examination of tissue obtained via biopsy or surgical resection 1.
Molecular tumor profiling may influence adjuvant therapy decisions 1.Management
Adjuvant radiation therapy (RT) may be indicated based on clinical-pathologic risk factors to reduce the risk of vaginal and/or pelvic recurrence 1.
RT techniques include vaginal brachytherapy or external beam RT 1.
Systemic therapy may be utilized in the adjuvant setting 1.
The sequencing of systemic therapy with RT should be considered 1.Key Recommendations
Radiation therapy (vaginal brachytherapy or external beam RT) should be administered based on patient's clinical-pathologic risk factors to decrease the risk of vaginal and/or pelvic recurrence 1. (Evidence: Strong)
External beam RT, when delivered, should utilize intensity-modulated RT 1. (Evidence: Strong)
Adjuvant systemic therapies should be considered, with attention to their utilization and sequencing relative to RT 1. (Evidence: Strong)References
1 Harkenrider MM, Abu-Rustum N, Albuquerque K, Bradfield L, Bradley K, Dolinar E et al.. Radiation Therapy for Endometrial Cancer: An American Society for Radiation Oncology Clinical Practice Guideline. Practical radiation oncology 2023. link