Clinicopathological features and risk factors of type 1 and type 2 endometrial cancer: A retrospective single-centre analysis.

Abstract

e17616 Background: Endometrial cancer (EC) is the most common gynecological malignancy globally and the fourth most prevalent cancer among females. EC is categorized into two distinct subtypes: Type 1 (endometrioid carcinoma) and Type 2 (serous or clear cell carcinoma), each exhibiting unique clinical, morphological, and histopathological features. Objective: This study aims to evaluate the frequency, clinicopathological characteristics, and risk factors associated with EC subtypes, underscoring the need for tailored diagnostic and therapeutic strategies due to their differing etiologies and outcomes. Methods: A retrospective observational study was conducted from January 2022 to June 2024, involving 198 patients diagnosed with EC at a tertiary care medical center. Data on demographic characteristics, comorbidities, and lifestyle factors were analyzed using SPSS version 27. Ethical approval was obtained from the Institutional Review Board (IRB/2024/1438/SIMS). Results: Among the 198 patients, 139 (70.2%) were diagnosed with Type 1 EC, and 59 (29.8%) with Type 2 EC. The overall mean age at diagnosis was 51.6 years (SD ±6.55), with Type 1 EC patients averaging 50.2 years (SD ±6.52) and Type 2 EC patients averaging 54.9 years (SD ±5.27). Hypertension (58.6%), polycystic ovary syndrome (PCOS) (49.5%), and diabetes mellitus (42.9%) were the most prevalent comorbidities. Significant associations were identified between EC subtypes and risk factors, including oral contraceptive use (p = 0.032), diabetes mellitus (p = 0.015), genetic predisposition (p < 0.001), PCOS (p < 0.001), tamoxifen use (p < 0.001), and smoking (p = 0.031). Type 1 EC demonstrated strong correlations with body mass index and PCOS, while Type 2 EC was more frequently associated with advanced age and tamoxifen use. Conclusions: This study highlights the distinct clinicopathological features and risk factors associated with Type 1 and Type 2 EC. Type 1 EC is predominantly linked to metabolic disorders, whereas Type 2 EC shows a marked association with age and tamoxifen use. Notably, a trend of earlier onset of EC was observed compared to prior studies, emphasizing the need for enhanced preventive strategies and early diagnostic interventions. These findings provide a foundation for future research aimed at optimizing patient outcomes through personalized management approaches.