Togami Shinichi, Furuzono Nozomi, Tsuruzono Hitomi, Fukuda Mika, Kobayashi Hiroaki
Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University, Kagoshima, JPN.
Cureus. 2025 Jul 2;17(7):e87200. doi: 10.7759/cureus.87200. eCollection 2025 Jul.
Objective The objective of this study is to evaluate the surgical safety and oncological outcomes of minimally invasive surgery (MIS) with sentinel lymph node (SN) mapping in older adults (≥70 years) with early-stage endometrial cancer, as part of a prospective cohort study. Methods This study is a subgroup analysis of a prospective cohort comprising 204 patients with International Federation of Gynecology and Obstetrics stage IA endometrial cancer who underwent MIS with SN mapping at a single tertiary center between December 2016 and April 2022. Patients were categorized into two groups based on age: <70 years and ≥70 years. Perioperative outcomes, SN detection rates, and survival outcomes were compared between the two groups. Results Of the total cohort, 29 patients were aged ≥70 years. Non-endometrioid histology (6.9% vs. 1.1%, P = 0.039) and deep myometrial invasion (27.6% vs. 11.4%, P = 0.019) were more common in the older adults group. Although bilateral SN detection was lower in elderly patients (72.4% vs. 91.4%, P = 0.011), no intraoperative complications occurred in this group. Postoperative complication rates and recurrence-free survival (93% vs. 97.1%, P = 0.29) were comparable across groups. Conclusion MIS with SN mapping is a safe and feasible approach for older adults with early-stage endometrial cancer. Despite higher-risk pathological features, older patients had equivalent surgical and oncological outcomes. Age alone should not preclude surgical treatment; instead, decisions should be based on functional status and preoperative evaluation.
目的 本研究的目的是评估前哨淋巴结（SN）定位的微创手术（MIS）在老年（≥70岁）早期子宫内膜癌患者中的手术安全性和肿瘤学结局，作为一项前瞻性队列研究的一部分。方法 本研究是一项前瞻性队列的亚组分析，该队列包括204例国际妇产科联盟IA期子宫内膜癌患者，于2016年12月至2022年4月在单一三级中心接受了SN定位的MIS。根据年龄将患者分为两组：<70岁和≥70岁。比较两组的围手术期结局、SN检测率和生存结局。结果 在整个队列中，29例患者年龄≥70岁。非子宫内膜样组织学（6.9%对1.1%，P = 0.039）和肌层深层浸润（27.6%对11.4%，P = 0.019）在老年组中更为常见。尽管老年患者双侧SN检测率较低（72.4%对91.4%，P = 0.011），但该组未发生术中并发症。各组术后并发症发生率和无复发生存率（93%对97.1%，P = 0.29）相当。结论 SN定位的MIS对于老年早期子宫内膜癌患者是一种安全可行的方法。尽管存在较高风险的病理特征，但老年患者的手术和肿瘤学结局相当。不应仅因年龄而排除手术治疗；相反，决策应基于功能状态和术前评估。
