Purpose: The purpose of this study was to compare the short- and long-term outcomes of laparoscopic surgery in elderly and middle-aged patients with clinical stage I endometrial cancer.
Methods: The clinical and follow-up data of 173 patients who were admitted to our hospital due to clinical stage I endometrial cancer and underwent laparoscopic surgery between January 2010 and December 2017 were retrospectively analyzed. The short- and long-term outcomes (including tumor recurrence, disease-free survival rate, and overall survival rate) of the elderly group (≥ 70 years, 69 patients) and the middle-aged group (50-69 years, 104 patients) were compared.
Results: In terms of preoperative general data comparison, only the Charlson comorbidity index and American Society of Anesthesiologists (ASA) score were higher in the elderly group than in the middle-aged group; differences in the remaining preoperative data were not statistically significant. Differences in general data, such as the operation time, proportion of patients that underwent lymphadenectomy, intraoperative blood loss, incidence and severity of postoperative 30-day complications, and pathological results were not statistically significant between the two groups. Long-term follow-up results showed that the two groups had similar tumor recurrence rates, as well as similar overall and disease-free survival rates. Multivariate analysis indicated that age was not an independent predictor for either overall or disease-free survival.
Conclusions: The use of laparoscopic surgery for elderly patients with clinical stage I endometrial cancer can achieve short- and long-term outcomes similar to those of middle-aged patients. Advanced age is not a contraindication to laparoscopic surgery.