Introduction/Background Although grade 1 and 2 endometrioid endometrial carcinomas commonly present at early stage, are hormone dependent and have a favourable clinical course, grade 3 endometrioid cancers (G3EC) are a more mixed entity and have a less favourable prognosis.

Methodology Retrospective study conducted at Rajiv Gandhi Cancer Institute from January 2010 to December 2016.using electronic medical records, clinicopathological factors and survival outcome analysed.Recurrence free survival (RFS) and Overall survival (OS) was calculated. Independent prognostic variables were identified using multivariate analysis.

Results A total of 52 women with G3EC met the inclusion criteria. Median age at presentation was 62 years. Median BMI was 29.7 kg/m2. Bleeding per vaginum was the most common presenting symptom, for 38 (76.9%) patients. A complete surgical staging with total or radical hysterectomy and bilateral salpingo-oophorectomy with pelvic lymph node dissection and omentectomy, with or without RPLNS was done in 45 (86.5%) patients. Majority of patients in both the groups presented in Stage I, i.e. 37 patients(71.1%). Pelvic Lymph node dissection was performed in 48 (92.3%) patients amongst which 8 (16.7%) were positive. Para aortic lymph node dissection was performed in 24 (46.1%) cases. 37 out of 52 (71.1%) received one or more modalities of adjuvant treatment. A total of 24 (47%) patients had recurrence. Mean RFS was 67 months (95% CI 53.8- 80.2). The 3 and 5 year OS was 59.6% and 53.8%. On multivariate analysis, advanced stage at presentation (stage III and IV) (p=0.01) and myometrial invasion more than 50% (p=0.033) were found to be independent unfavourable prognostic factors

Conclusion Grade 3 endometroid endometrial cancers are a heterogenous entity with aggressive nature, but complete surgical staging and adjuvant therapy confer a good survival.