Introduction/Background Endometrial cancer (EC) is the most common malignancy of the female genital tract in developed countries and is normally treated by surgery. Frail EC patients should be identified preoperatively to reduce their risk of adverse surgical outcomes. These are the first results of a systematic, preoperative frailty screening of EC patients regarding perioperative complication rates.
Methodology All EC patients with a standardized surgical treatment, regardless of their actual cancer stage and previous treatments, were screened preoperatively with the G8 geriatric screening tool. If a patient was considered to be G8-frail, multiple geriatric assessment tools followed. The main outcome measures were the relationship between perioperative laboratory results, intraoperative surgical parameters and the incidence of immediate postoperative in-hospital complications with the preoperative frailty status.
Results 42 patients with EC were included at the University Medical Centre Mainz between May 2020 and April 2023. 23.8% (n=10) of the patients were classified as G8-frail. Mean age was 67.6 (± 7.9) years. The G8-frail cohort was slightly older (71 years; p=0.43). Polypharmacy (≥ 5 medication) was found more often in the G8-frail cohort (60 vs 18.8%; p=0.02). The G8-frail cohort showed a numerically but not statistically significant higher Clavien-Dindo-Score than the G8-non-frail cohort (grade ≤2 (70 vs. 87.5%), grade ≥3 (30 vs 12.6%); p=0.29). The G8-frail cohort seemed to have a longer mean hospital stay than the G8-non-frail cohort (27.9 (± 48.3) vs. 5.8 (±5.4) days; p=0.06). The surgical revision rate seemed to be comparable between these two cohorts. One patient in the G8-frail cohort died during the hospital stay.
Conclusion Our first interim-analysis implies that preoperative frailty assessment with the G8 geriatric screening tool for elderly patients with EC might be associated with more severe postoperative complications and a longer hospital stay. Further results will be expected in the near future.
Disclosures The authors have no conflicts of interest to declare that are relevant to the content of this article.
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