Young women diagnosed with endometrial cancer (EC) tend to experience favorable outcomes, with traditional tumor characteristics remaining the strongest predictors of survival, according to a study published recently in Cureus.
For patients, this means that the type and behavior of their cancer, rather than their age alone, will guide treatment decisions and long-term expectations.
Researchers in central Tunisia reviewed 24 cases in women 40 years or younger treated between 2010 and 2022, representing 6.3% of all 381 EC diagnoses at their institution. The average age was 34 years. Most patients presented with symptoms related to infertility, pelvic pain, or abnormal bleeding. Nearly 80 percent had a history of infertility and more than half were obese, reflecting well-known risk factors.
Endometrioid adenocarcinoma accounted for 66.7 percent of cases, while more aggressive types such as endometrial sarcoma and clear cell carcinoma made up roughly one third. Imaging showed that most tumors were limited to the uterus, with 55 percent staged as FIGO IA. These features contributed to generally good outcomes, although deeper myometrial invasion, nodal involvement, and distant spread were linked with lower survival.
Read more about the prognosis of EC
“Individualized strategies that balance oncologic safety with fertility preservation remain a cornerstone for this unique patient population,” explained this study’s authors.
Five women received fertility-sparing treatment using high-dose progestins and levonorgestrel-releasing intrauterine devices, an option that may help preserve the chance of future pregnancy. However, three of the five ultimately required definitive surgery, signalling that conservative therapy must be offered carefully and followed closely. Overall, 19 women underwent surgery and nearly half received adjuvant radiotherapy, chemotherapy, or both.
After an average follow-up of 20 months, 14 patients were alive in complete remission. Recurrences and metastases were uncommon but more likely in those with advanced stage disease or non-endometrioid histology. Survival was excellent for endometrioid cancers, reaching 100 percent, compared with 71.1 percent for sarcomas. Tumors invading half or more of the uterine muscle carried a markedly poorer outlook.
For patients, these findings reinforce that early diagnosis, accurate staging, and awareness of tumor type play central roles in guiding care. Although young women often fare well, those with aggressive or advanced disease need vigilant monitoring and tailored treatment plans.
Sign up here to get the latest news, perspectives, and information about EC sent directly to your inbox. Registration is free and only takes a minute.
