Background: UBC is 2nd common gynecological malignancy after cervix. It increases worldwide due to prolongation of life & obesity.
Two main types exist (I & II); type II is more aggressive, occurs at older age, less common (20%), unrelated to estrogen, poorly
differentiated and deeply invade myometrium. Main presentation is abnormal uterine bleeding, diagnosed by endometrial sampling
either aspiration or blind D&C. LNs affection is most important prognostic factor. Pelvic radiation (RT)+/- brachytherapy is the
recommended adjuvant treatment. Multiagent chemotherapy (CTH) +/- RT improves disease free survival (DFS) & overall survival
(OS) when using platinum/taxanes based regimen. Aims: to study clinicopathological features of all cases of type II UBC, pathological
subtypes, management protocols, surgery, RT & CTH given & outcome 'DFS'& 'OS'. Materials & Methods: A single institution
prospective analysis of all cases presented to NCI-Cairo University with type II UBC candidate for surgery over a period of 4 years
from June 2016 until June 2020; 60 cases were included. Data collected then analyzed. Results: median age was 62 years with
commonest age group was 60-70ys (34 cases, 56.6%). Main presentation was postmenopausal bleeding (52 cases, 86.6%). Dilatation
& curettage (D&C) were done for (56 cases, 93.3%). Carcinosarcomas dominated the pathology (34 cases, 56.6%). Most cases
surgically staged via open approach (54 cases, 90%) with minimal invasive techniques in 6 cases (10%). Only 32 cases (53.3%)
underwent lymphadenectomy with positive LNs encountered in 14 cases (23.3%) and grade III predominate (26 cases, 43.3%). Postoperative
positive margins found in 4 cases (6.6%). 63.3% (38 cases) were FIGO stage II. Adjuvant EBRTH (5000cGY/25Fr) was given
to (36 cases, 60%), Brachytherapy (700cGY/3Fr) to (26 cases, 43.3%). (34 cases, 56.6%) received adjuvant CTH (platinum/taxanes
based) + RT in advanced stage & high-grade tumors. Conclusion: Surgery is the primary treatment for early stages disease. In cases
of irresectable tumors neoadjuvant combined RT/CTH is preferred. In advanced disease surgical debulking is justified. Pelvic RT +/-
brachy therapy combined with multi-agent chemotherapy improves DFS and OS.
Keywords: Type II UBC, Outcome, NCI, EGYPT