Clinical Report: Analysis of Immunophenotypic Changes in Recurrent LG-ESS

Overview

This study investigates the immunophenotypic changes in recurrent low-grade endometrial stromal sarcoma (LG-ESS) and highlights the stability of core driver gene rearrangements. The findings suggest that while molecular characteristics remain stable, immunophenotypic alterations may influence treatment strategies.

Background

Low-grade endometrial stromal sarcoma (LG-ESS) is a rare tumor that predominantly affects young women and is known for its propensity to recur many years after initial treatment. Understanding the molecular and immunophenotypic characteristics of recurrent LG-ESS is crucial for optimizing treatment strategies, particularly given the potential for resistance to hormonal therapies. This study aims to provide insights into the dynamic evolution of immunophenotypes during recurrence.

Data Highlights

Key Findings

• All cases exhibited stable JAZF1 or PHF1 gene rearrangements in both primary and recurrent tumors.
• Immunophenotypic changes included loss of PR expression and decreased Ki-67 index in one case.
• Another case demonstrated loss of CD10 expression during recurrence.
• All patients remained alive following comprehensive treatment with a median follow-up of 84 months.
• Long-term follow-up is essential due to the characteristic tendency for late recurrence in LG-ESS.

Clinical Implications

The study underscores the importance of re-evaluating hormone receptor status at recurrence, which may guide individualized treatment decisions. Clinicians should be aware of potential immunophenotypic changes that could affect the efficacy of hormonal therapies in recurrent LG-ESS.

Conclusion

The findings indicate that while core genetic rearrangements in LG-ESS remain stable, immunophenotypic evolution may occur, necessitating careful monitoring and potential adjustments in treatment strategies.

Related Resources & Content

1. Molecular Landscape of Endometrial Stromal Tumors, ICGI, 2025 -- Insights into Molecular Stability
2. The value of surgery and the prognostic factors for patients with recurrent low-grade endometrial stromal sarcoma: a retrospective study of 38 patients, JGO, 2024 -- Prognostic Factors in LG-ESS
3. Gastric Cancer — Variability in Predictive Biomarker Expression in Gastric and Esophagogastric Junction Carcinomas Associated with Peritoneal Metastasis
4. Gastric Cancer — Prognostic Significance of Stroma AReactive Invasion Front Areas (SARIFA) in Gastric Carcinoma Linked to Tumor-Adipocyte Interactions and Immune Response Alterations
5. Journal of Gastroenterology — Evaluating the Role of Tumor-Infiltrating Lymphocytes in Predicting Lymph Node Metastasis in Deep Submucosal Invasive Esophageal Squamous Cell Carcinoma: A Retrospective Analysis
6. the pathologist — Advancing MSI Testing in Endometrial Cancer
7. Advancing MSI Testing in Endometrial Cancer
8. 2025 ESGO/EURACAN/GCIG Pocket Guidelines
9. Molecular Landscape of Endometrial Stromal Tumors
10. The value of surgery and the prognostic factors for patients with recurrent low-grade endometrial stromal sarcoma: a retrospective study of 38 patients