Introduction/Background To investigate the feasibility, safety, and short-term outcomes for elderly patients, (age ≥80 years old) undergoing robotic surgery for intermediate and high risk endometrial cancer.

Methodology Prospective data collection, cohort study of all patients ≥80 years old that underwent robotic surgery for the treatment of endometrial cancer (intermediate and high risk) in our centre between 1/1/2015 and 15/03/2022

Results We reviewed 752 cases and identified 82 patients ≥80 years old with a mean age of 83 (80–91) years old. They have significant incidence of comorbidities: 80% cardiovascular disease, 29.1% diabetes, 19% chronic obstructive pulmonary disease. Mean BMI was 30 (range 18–45). 76% of them had previous abdominal surgery and 38.2% of them had a performance status (ECOG) ≥2. 24% of them had been treated for another cancer in the past. All comorbidity characteristics were statistically higher other than BMI, compared to the younger group of our patients in the same period. 60% underwent pelvic Lymphadenectomies and 22% sentinel lymph node biopsy; and 16.4% had positive lymph node identified and upstaged. 33% of them were discharged day 1 post op. Mean and median length of hospital stay was 3 and 2 days respectively. There was no difference in the minor post operative complication rate (9.8% vs 10%, p<0.05), but we observed 4.8% grade III-IV vs 2.8% (p>0.05). There were no 30-day post-operative deaths in none of the groups.

Conclusion Robotic surgery is feasible with acceptable post-operative complication rate in comparison to younger women, ensuring appropriate oncological staging and treatment We observed a longer length of hospital stay and a slightly higher grade III-IV complications of 4.8%. Very elderly women (≥80 y.o) should be considered suitable for robotic surgical staging, and consented appropriately of risks.