ArticleAnnals of surgical oncology2025
Usefulness of Geriatric Parameters in Preoperative Evaluation of Patients Undergoing Minimally Invasive Surgery for Endometrial Cancer: A Retrospective Cohort Study.
Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Perioperative Risk Stratification in Surgically Treated Endometrial Cancer: The Impact of Nutritional Status and Comorbidity Burden on Morbidity and Survival.Annals of surgical oncology · 2026Article
- Impact of frailty on perioperative and oncologic outcomes after robotic radical prostatectomy: a multicenter study with competing risk analysis.Journal of robotic surgery · 2026Article
- Exploring the role of patient activity in the clinical decision-making processes of health care practitioners working in hospital care: A qualitative study.Clinical rehabilitation · 2026Article
- Development of a Prognostic Nomogram Model and Establishment of a Risk Stratification System Based on the Naples Prognostic Score for Patients with Oropharyngeal Squamous Cell Carcinoma Who Have Undergone Radical Surgery.Journal of inflammation research · 2026Article
- Hysterectomy for oncological and non-oncological reasons in patients over 70 years of age - comparison of robot-assisted, laparoscopic, and open approaches.Journal of robotic surgery · 2025Article
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Authors and funding
6 authors.
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Abstract
introductionPatients operated for endometrial cancer (EMCA) are typically elderly with multiple comorbidities, potentially impacting surgical outcomes and survival. This study evaluated the prognostic value of frailty and frailty-related scores in predicting perioperative morbidity and survival in EMCA patients undergoing minimally invasive surgery.
methodsThis retrospective cohort study included 289 patients from the Sentinel Database treated for EMCA at Bern University Hospital (2012-2020). Patients underwent minimally invasive hysterectomy with sentinel lymph node dissection (39%) or additional radical lymphadenectomy (61%). Frailty was assessed using the Age-Adjusted Charlson Comorbidity Index (ACCI), modified Frailty Index (mFI), 5-item mFI (mFI-5), American Society of Anesthesiologists (ASA) scores, and independent parameters. Primary outcomes included perioperative complications, hospital stay, recurrence-free survival (RFS), and overall survival (OS).
resultsMedian age was 65 years (range 26-94) and median follow-up was 41 months (0-105). ACCI > 4 (23.2%) was the strongest predictor of postoperative complications (p = 0.025), prolonged hospitalization (p = 0.03), and reduced OS (hazard ratio [HR] 2.57, 95% confidence interval [CI] 1.18-5.60; p = 0.018). Multivariable analysis confirmed ACCI > 4 (HR 2.24, 95% CI 1.02-4.90; p = 0.044), European Society for Medical Oncology (ESMO) risk group (HR 1.61, 95% CI 1.24-2.07; p < 0.001), hemoglobin (HR 1.03, 95% CI 1.00-1.05; p = 0.033), and congestive heart failure (HR 6.29, 95% CI 1.35-29.27; p =0.019) were significant predictors of OS. Radical lymphadenectomy (p < 0.001), ACCI > 4 (p = 0.025), and age > 70 years (p = 0.034) increased complication risks.
conclusionsACCI > 4 is a practical tool for preoperative risk assessment and predicting surgical tolerance and survival, and is therefore applicable for guiding surgical decisions and personalized care in patients with EMCA.
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