Laparoscopic vs. open treatment of endometrial cancer in the elderly and very elderly: An age-stratified multicenter study on 1606 women

Impact of age on surgical staging and approaches (laparotomy, laparoscopy and robotic surgery) in endometrial cancer management

“…But, elderly women are surgically understaged. Yet despite significantly higher comorbidity rates consistent with literature findings (12)(13)(14)(15), our study showed no more intra-or postoperative complications in the older group. .…”

“…Women over 65 years old account for almost two-thirds of new cancer diagnoses and threequarters of all cancer-related deaths(12) (13). Despite this trend, data focused on practice with elderly populations in the context of endometrial carcinoma (the most common gynaecological cancer in developed countries) remains scarce(11) (14)(15)(16)(17)(18)(19).The majority of elderly patients are treated with traditional open surgery and a smaller percentage with vaginal or laparoscopic surgery. Despite the high rate of minimally invasive surgery in patients over 75 years old in this study (58%) because of our well-trained teams, we still observed a lower rate of minimally invasive surgery in the elderly when compared with younger patients.…”

Management and Survival of Elderly and Very Elderly Patients with Endometrial Cancer: An Age-Stratified Study of 1228 Women from the FRANCOGYN Group

“…One of the limitations of the present study was its retrospective nature, which led to missing data; however, the present cohort was very large, one of the most important published to date 19 , and the patients were managed in tertiary centers, which used well documented electronic charts. Secondly, the median follow-up for recurrence was relatively short.…”

“…The standard of care for endometrial cancer remains controversial, but it mostly includes comprehensive surgical staging as recommended by the International Federation of Gynecology and Obstetrics (FIGO) 12 . This can involve complex procedures such as pelvic and para-aortic lymphadenectomy and omentectomy, especially for high-risk endometrial cancer [12][13][14][15][16][17] , and the biological aggressiveness of endometrial cancer increases with age [17][18][19] . The benefit of applying these complex procedures to elderly patients remains unclear.…”

Lymphadenectomy in elderly patients with high-intermediate-risk, high-risk or advanced endometrial cancer: Time to move from personalized cancer medicine to personalized patient medicine!

“…Minimally invasive surgery tends to be underused in older patients, probably due to possible contraindications to laparoscopy (32). (34,35). A minimally invasive approach could lead to a higher rate of pelvic or paraaortic lymphadenectomy in this age group, as one of the reasons for the reluctance to perform lymphadenectomy is the risks associated with xipho-pubic laparotomy.…”