Spectrum of uterine malignancies and their oncological outcomes: a single centre experience

Abstract

Background: Endometrial carcinoma is a significant contributor to the global female cancer burden. Its incidence in India is rising because of increasing life expectancy and metabolic risk factors, although Indian outcome data remain limited. This study aimed to evaluate the spectrum of uterine malignancies and assess their oncological outcomes in an Indian cohort. Methods: This prospective observational study was conducted at a tertiary care centre over a five-year period (2020–2025). Seventy (70) women were included following histopathological confirmation of uterine malignancy. Data on clinical presentation, histological subtype, staging, treatment, and outcomes were recorded and analysed using descriptive statistics. Results: The mean age was in the sixth decade, with 88.6% of patients being postmenopausal. Endometrioid adenocarcinoma was the most common histological subtype (75.7%), followed by serous carcinoma (7.1%), carcinosarcoma (4.3%), and clear cell carcinoma (4.3%). Most patients presented at FIGO Stage I (61.5%) and underwent primary surgical management. Adjuvant therapy was administered in 32.9% of cases based on stage and risk factors. At a median follow-up, 72.9% of patients were alive and recurrence was observed in only 1.4%. Binary logistic regression showed that none of the individual pathological factor’s tumour grade, histology, LVSI, myometrial invasion, or cervical stromal involvement significantly predicted lymph node involvement. Conclusion: Endometrioid carcinoma remains the predominant uterine malignancy in Indian women, typically presenting in postmenopausal women at an early stage with favourable outcomes. Given the inability of conventional pathological risk factors to reliably predict nodal involvement, comprehensive surgical staging using sentinel lymph node mapping or systematic lymphadenectomy should be considered in all cases, irrespective of initial stage.