Journal of Gynecology and Reproductive Health
ISSN: 2574-2728 | DOI: 10.64030/2574-2728
SÃÂlvia Serrano, Margarida Bernardino and Ana Francisca Jorge
Introduction: Endometrial cancer (EC) is one of the most common gynecologic malignancies. In elderly patients, treatment decisions are often influenced by comorbidities and presumed surgical risks. However, age alone may not be a sufficient criterion to guide management.
Objectives: To compare clinical characteristics, surgical treatment, perioperative complications, and survival outcomes in patients with EC aged under 70 versus those aged 70 or older. Methods: This retrospective study included 206 patients who underwent surgical treatment for EC at a tertiary center between 2017 and 2018. Patients were divided into two groups: under 70 years (NOP, n=105) and 70 years or older (OP, n=101). Data on demographics, comorbidities, tumor features, surgical approach, complications, and survival were analyzed. Mean follow-up was 50.1 months for NOP and 38.4 months for OP.
Results: Mean age was 62.2 years in NOP and 76.9 years in OP. Cardiovascular disease was more frequent in OP (18.8% vs 8.6%, p<0.05). OP had higher rates of cervical infiltration (38.6% vs 19.0%, p=0.002), lymphovascular invasion (29.7% vs 15.2%, p=0.009), and deep myometrial invasion (64.4% vs 43.8%, p=0.003). Laparotomy was performed in 96.6% of patients. Postoperative complications were not significantly different (29.7% OP vs 21.0% NOP, p=0.154), but hospital stay was longer in OP (p=0.005). Five-year overall and progression-free survival were significantly lower in OP (p<0.001).
Conclusion: Chronological age should not be the sole determinant in EC treatment decisions. Elderly patients did not experience significantly more perioperative complications. Comprehensive geriatric assessment and individualized care planning are essential.