Minimally Invasive Surgery With Sentinel Lymph Node Mapping in Elderly Patients With Early-Stage Endometrial Cancer: A Subgroup Analysis of a Prospective Cohort Study.

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.