Purpose The purpose of this study was to judge the behavior of endometrial stromal sarcomas (ESSs) with regards to their clinical and pathogenic features, also to determine the perfect treatment strategy. (53.8%). Hormone therapy with progesterone, chemotherapy, and/or radiotherapy didn’t influence general survival. Nevertheless, the postoperative adjuvant therapy group, of the procedure modality irrespective, was connected with fairly increased general survival in comparison with the surgery just group (p=0.054). Conclusions The preoperative differential analysis of ESSs from additional benign gynecologic illnesses is usually difficult. We suggest adjuvant therapy become given after hysterectomy in individuals with ESS to avoid recurrence or faraway metastasis. Keywords: Endometrial, Stromal, Sarcoma, Radiotherapy, Chemotherapy, Treatment result Intro Endometrial stromal sarcomas (ESSs) have become uncommon, malignant uterine tumors, composed of <1% of most uterine malignancies (1). Regularly, ESSs are recognized by chance during diagnostic dilatation and curettage (D&C), myomectomy, or hysterectomy for presumed harmless uterine disease. Due to the nonspecific features of ESSs, small is known concerning the pathogenesis, risk elements, ideal therapy, or results. The following features have been proven to possess prognostic significance for ESSs: tumor size, FIGO stage, quality, age group, and menopausal position (2). The most dependable known prognostic elements are the quality of Ombrabulin tumor as well as the degree of disease (3). ESSs could be split into low- and high-grade ESSs predicated on a mitotic depend of less or even more than 10 mitoses/10 high power areas and seen as a a proliferation cellular material with endometrial stromal differentiation (4). Low-grade ESS has an indolent medical program, whereas high-grade ESS behaves in a more aggressive manner having a poorer overall prognosis. Accordingly, it has been suggested that high-grade ESS should be regarded as a different disease entity completely (5). However, some authors are of the opinion that mitotic count number is not indicative of Ombrabulin tumor recurrence or tumor-related deaths (6). The fundamental treatment for ESSs consists of total hysterectomy with bilateral salpingo-oophorectomy. However, Li Ombrabulin et al(7) recently exhibited that ovarian preservation could be a safe option for surgical treatment in stage I, low-grade ESS. The importance of surgical staging, including lymphadenectomy, is still unknown (3). Due to the high recurrence risk, even with localized tumors, many clinicians advocate the use of adjuvant therapy (2); however, no prospective studies have been carried out concerning the merits of adjuvant radiation and/or chemotherapy or hormonal treatment. Of notice, the overall survival does not appear to improve with adjuvant therapy (8,9). The aim of this study was to evaluate the behavior of ESSs in relation to its medical and pathogenic features and to determine the optimal treatment strategy. MATERIALS AND METHODS This study included 28 individuals with histologic-proven ESS treated between 1987 and 2006 in the Division of Obstetrics and Gynecology of Yonsei University College of Medicine. Data were retrospectively examined and included age at the time of analysis, patient demographics, medical presentation, degree of surgical treatment performed, adjuvant therapy, individual end result, recurrence patterns, and follow-up status. Twenty-two instances of low-grade ESS and 5 instances of H3F3A high-grade ESS were recognized. One case was not classified as either low- or high-grade ESS due to diagnostic ambiguity. Surgical staging was based retrospectively within the 1988 FIGO recommendations for cancer of the uterine corpus (10). Total hysterectomy and removal of as much tumor as you possibly can was performed like a surgical methods. With respect to the individuals who composed the current study, the decision to perform adjuvant therapy was remaining to the individual physician, therefore the adjuvant and non-adjuvant organizations were not necessarily similar. The adjuvant group was administered chemotherapy, radiotherapy, or hormonal therapy. Some individuals experienced a combination of the treatments. Megestrol acetate (120~320 mg/day time for 6~12 weeks) was used as hormonal therapy. Chemotherapeutic regimens were variable; however, primarily consisted of a combination of ifosfamide, adriamycin, and platinum based-agents. Survival analysis was used to compare individuals with or without specific clinicopathologic parameters in terms of progression-free and overall survival. The Kaplan-Meier method was used to estimate survival curves, and.