Introduction/Background Endometrial cancer is the most common gynaecological malignancy and is treated primarily surgically. An increasing body of evidence suggests frailty is an important predictor of postoperative morbidity. Yet, data on pre-operative assessment tool use to assist surgical decision making is limited. This study sought to assess different surgical decision making tools for assessing the impact of frailty on short-term postoperative outcomes.

Methodology A patient record review was performed for patients diagnosed and primarily surgically treated between January 2015 and December 2016 for endometrial cancer at the University Medical Centre Maribor, Slovenia. Records of patients were evaluated through the use of different frailty indexes; the modified Frailty Index-5 (mFI-5), 11-factor modified frailty index (mFI-11), frailty deficit index (FDI) and Memorial Sloan Kettering Frailty Index (MSK-FI). Scores were recorded and correlated with short-term patient outcomes as well as patient characteristics. Primary outcomes were 45-day Clavien-Dindo rated complications, length of postoperative stay (LOS) and 45-day emergency services visits (ER).

Results Seventy-three women, median age 65 years (min 41 years – max 87 years) were included. Median LOS was 4 (min 1 – max 21) days. 24 women (33%) had post-operative complications resulting in a deviation from standard early postoperative care. Amongst those, experiencing complications within 45 days after surgery, 7 (10%) had stage I complications, 16 (22%) stage II complications and 2 (3%) stage III complications. Older women (above 60 years) had significanlty higher BMI (p<.001), but age was not a significant determinant of LOS. All evaluated frailty scales showed significant increases in women above 60 as well as 70 years of age. No specific cut-off was found to be significant for predicting short-term post-operative complications.

Conclusion Different additional tools should be further evaluated to determine most appropriate assessment methods to assist surgical decision-making in identifying and preparing frail patients for treatment.