OBJECTIVES: Uterine cancer is the 7th most common cancer in women, with endometrial cancer (EC) responsible for 90% of such cases. Adult EC mortality has increased from 2010 to 2021, with a current average rate of 1.64 per 100,000 women in Brazil. This study was designed to investigate EC mortality rates by tumor characteristics at a Brazilian reference women healthcare public hospital.

METHODS: This retrospective EC mortality study used data from the public reference center. Included patients were aged ≥18 years and treated between 2010 and 2021 with the ICD-10 code for EC (C54.1). Patients with inconsistent treatment data were excluded. Mortality rate was calculated within each tumor characteristic subgroup (histology, tumor staging, tumor type, and relapse site) and body mass index (BMI) by dividing the number of deaths by the total number of patients with the studied characteristic.

RESULTS: In total, 583 EC cases were registered (ethnicity: 63% White, 24% Brown, 8% Black, 2% Asian, 2% unreported) and 121 patients died, representing a mortality rate of 21%. The average age at diagnosis was 64 years, average time from diagnosis to death was 2 years, and 69% of patients who died were overweight or obese in relation to BMI. The major histological type was epithelial (84% of deaths), with 58.5% representing endometrioid subtype. The highest mortality rate by staging was stage III (24.1%), accounting for 45% of deaths. Tumors that evolved beyond the endometrium and patients who had multiple recurrences demonstrated a higher mortality rate.

CONCLUSIONS: This database analysis suggests that EC prognosis depends on combined tumor characteristics. Tumor stage III, tumors that evolved beyond the endometrium and multiple recurrences presented a higher mortality rate. This highlights the importance of early diagnosis and the need to improve treatment options for advanced-stage patients.