Introduction/Background To investigate the feasibility, safety, and short-term outcomes for very elderly patients, age ≥75 years undergoing robotic surgery for intermediate and high risk endometrial cancer.
Methodology Retrospective cohort study of all patients ≥75 years old that underwent robotic surgery for the treatment of endometrial cancer in our centre between July 2014 and April 2019.
Results 84 patients identified with a mean age of 79 (75–91) years old. All of them underwent total hysterectomy + bilateral salpingo-oophorectomy and 70 of them underwent also pelvic Lymphadenectomy with a mean count of 17.0. 72% of them had cardiovascular disease and 28% of them chronic obstructive pulmonary disease. 50% of them had previous abdominal surgery and 17% of them had a performance status (ECOG) ≥2. Compared to the younger group of our patients (mean age 63.4, range 32–74 years old), mean length hospital stay was slightly longer 2.7 days vs 2.1 (p<0.05). There were 8.3% grade I–II (Clavien-Dindo) post-operative complications vs 7.4% (p>0.05) and 4.7% grade III–IV vs 3.2% (p<0.05). The difference was observed to complications related to chest infection and postoperative arrhythmia (AF). There were no deaths.
Conclusion Robotic surgery is feasible and safe in very elderly women with type 2 endometrial cancer. We observed a longer hospital length of stay and greater likelihood of postoperative arrhythmia in comparison to patients ≤75 years old. Patients should not be considered too old for robotic surgery. Pre and perioperative care should take into account their comorbidities and tailored accordingly.
Disclosure The Christie is an accredited training centre for robotic surgery in Gynaecological oncology.
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