Abstract
Objective
This study aims to evaluate the different surgical approaches, perioperative morbidity
and surgical staging according to age in patients with endometrial cancer.
Methods
Multicentre retrospective study. Cancer characteristics and perioperative data were
collected for patients surgically treated for endometrial cancer. The patients were
divided into 2 groups according to their age: younger or older than 75 years.
Results
Surgery was performed on 270 women <75 years old and on 74 ≥ 75 years old. Minimally
invasive surgery was performed less often in the elderly compared with their younger
counterparts (58.2% vs. 74.8%; p = 0.006). Independently of the surgical approach,
the rate of pelvic and para-aortic lymphadenectomy was lower in women older than 75
years old than their younger counterparts (52.7% vs. 74.8%; p < 0.001; 8.1% vs. 21.8%;
p = 0.007 respectively). According to the guidelines, more frequent surgical understaging
was seen in the elderly compared with the younger (37% vs. 15.2%; p = 0.002). In the
comparison of complications for each surgical approach, there was no statistical difference
in the ≥75-year-old age group in terms of intra- or postoperative complications between
the laparotomy, laparoscopy or robotic surgery group. We found a shorter length of
hospital stay for the women who underwent laparoscopy or robotic surgery compared
with laparotomy (p < 0.0001).
Conclusion
Elderly women with endometrial cancer are often surgically understaged whereas there
is no evidence of greater perioperative complications than for their younger counterparts.
They should benefit from minimally invasive surgery and optimal surgical staging to
the same extent as younger women.
Keywords
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Article info
Publication history
Published online: November 26, 2016
Accepted:
October 24,
2016
Identification
Copyright
© 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
