The usefulness of geriatric assessment of older patients with Endometrial Cancer: our institutional study

Background Older patients with cancer are at an increased risk of treatment-related complications and poor survival. However, evidence of the usefulness of geriatric assessment (GA) in gynecological oncology remains limited. We aimed to investigate the relationship between GA and treatment-related complications and prognosis in older patients with endometrial cancer at our institution. Methods We retrospectively analyzed 41 patients aged ≥ 65 years with endometrial cancer who underwent surgery at our institution between July 2020 and April 2024. Preoperative GA included the G8 score, Instrumental Activities of Daily Living, Charlson Comorbidity Index, residential status, and Mini-Cog test. We also evaluated preoperative anemia, undernutrition, postoperative complications, delirium, and survival outcomes. Results Abnormal G8 scores and cognitive decline were observed in 39% and 15% of patients, respectively. Postoperative complications occurred more frequently in patients with cognitive impairment than in those without (p = 0.027). Progression-free survival was significantly shorter in patients with abnormal G8 scores (p = 0.029), cognitive impairment (p = 0.015), and anemia (p = 0.015) than in those without. Overall survival was significantly shorter in patients with anemia (p = 0.016) and undernutrition (p = 0.043) than in those without. Conclusion GA was significantly associated with postoperative complications and survival outcomes in older patients with endometrial cancer. Abnormal G8 scores, cognitive impairment, preoperative anemia, and undernutrition are useful prognostic factors. Incorporating GA into routine preoperative evaluations could help to identify high-risk patients and guide personalized treatment strategies in gynecological oncology.