Pattern of high-risk histopathological features among surgically treated endometrial cancer patients in Bangladesh

Background: Endometrial cancer shows heterogeneous biological behavior, and postoperative risk stratification depends strongly on histopathological findings. Conventional features such as International Federation of Gynecology and Obstetrics (FIGO) stage, tumor grade, histological subtype, tumor size, deep myometrial invasion, lymphovascular space invasion, and lymph node metastasis remain clinically important, particularly in settings where molecular classification is not routinely available. The aim of this study was to describe the pattern of high-risk histopathological features among surgically treated endometrial cancer patients at a tertiary cancer center in Bangladesh. Methods: This observational cross-sectional study included 31 histologically confirmed endometrial cancer patients who underwent primary surgical treatment at the Department of Gynecological Oncology, National Institute of Cancer Research and Hospital, Dhaka, Bangladesh, between January and December 2020. Results: The mean age of the patients was 58.6±9.8 years, and 27 patients (87.1%) were postmenopausal. Stage I disease was the most frequent individual stage, present in 18 patients (58.1%); however, advanced-stage disease, FIGO stage III–IV, was present in 12 patients (38.7%). The most frequent high-risk feature was tumor size >2 cm, observed in 21 patients (67.7%), followed by deep myometrial invasion in 16 patients (51.6%). Lymph node metastasis was present in 12 patients (38.7%), grade 3 tumor in 11 patients (35.5%), papillary serous adenocarcinoma in 11 patients (35.5%), and lymphovascular space invasion in 9 patients (29.0%). Conclusions: High-risk histopathological features were common in this cohort, emphasizing the importance of detailed histopathological assessment for postoperative risk stratification in surgically treated endometrial cancer.