TY - JOUR
T1 - Identifying risk factors for postoperative complications following staging surgery for endometrial cancer
AU - Ram, Shai
AU - Lavie, Michael
AU - Assouline, Anna
AU - Gilboa, Itamar
AU - Yacobi, Lihie Maltz
AU - Ariel, Gal
AU - Michaan, Nadav
AU - Grisaru, Dan
AU - Laskov, Ido
N1 - Publisher Copyright:
© 2025 Elsevier Masson SAS
PY - 2025/6
Y1 - 2025/6
N2 - Introduction: Endometrial cancer is the most prevalent gynecologic malignancy, with increasing incidence primarily due to aging, obesity, and diabetes. Surgical staging, a gold standard treatment involving total hysterectomy with bilateral salpingo-oophorectomy and sentinel lymph node biopsy, presents various postoperative complications influencing patient outcomes and healthcare costs. This study aims to identify risk factors associated with short term postoperative complications following staging surgery for endometrial cancer. Methods: A retrospective cohort study conducted at a single university-affiliated medical center from January 2016 to December 2022. Data were extracted from electronic medical records, including patient demographics and comorbidities, surgical data including intraoperative complications, tumor histology and surgical outcomes. A composite adverse post operative outcome was defined, including need for post-operative blood transfusion, antibiotic treatment, Intensive care unit (ICU) admission, prolonged hospitalization, and 30-day readmission rates. Results: Among 495 patients, 34.3 % experienced at least one postoperative complication. Significant factors associated with complications included age over 65, ASA score >2, pathologic grade 3 tumours, and non-minimally invasive surgical approaches. Prolonged operative time (>75th percentile) and intraoperative complications also correlated with increased risk. Conversely, higher preoperative haemoglobin levels were protective against complications. Conclusion: The findings emphasize the importance of recognizing risk factors such as advanced age, elevated ASA scores, and specific tumor characteristics to enhance preoperative assessments and surgical planning. By tailoring surgical approaches and optimizing patient preparation, healthcare providers may improve postoperative outcomes and reduce complications for patients undergoing staging surgery for endometrial cancer.
AB - Introduction: Endometrial cancer is the most prevalent gynecologic malignancy, with increasing incidence primarily due to aging, obesity, and diabetes. Surgical staging, a gold standard treatment involving total hysterectomy with bilateral salpingo-oophorectomy and sentinel lymph node biopsy, presents various postoperative complications influencing patient outcomes and healthcare costs. This study aims to identify risk factors associated with short term postoperative complications following staging surgery for endometrial cancer. Methods: A retrospective cohort study conducted at a single university-affiliated medical center from January 2016 to December 2022. Data were extracted from electronic medical records, including patient demographics and comorbidities, surgical data including intraoperative complications, tumor histology and surgical outcomes. A composite adverse post operative outcome was defined, including need for post-operative blood transfusion, antibiotic treatment, Intensive care unit (ICU) admission, prolonged hospitalization, and 30-day readmission rates. Results: Among 495 patients, 34.3 % experienced at least one postoperative complication. Significant factors associated with complications included age over 65, ASA score >2, pathologic grade 3 tumours, and non-minimally invasive surgical approaches. Prolonged operative time (>75th percentile) and intraoperative complications also correlated with increased risk. Conversely, higher preoperative haemoglobin levels were protective against complications. Conclusion: The findings emphasize the importance of recognizing risk factors such as advanced age, elevated ASA scores, and specific tumor characteristics to enhance preoperative assessments and surgical planning. By tailoring surgical approaches and optimizing patient preparation, healthcare providers may improve postoperative outcomes and reduce complications for patients undergoing staging surgery for endometrial cancer.
KW - Endometrial cancer
KW - Postoperative complications
KW - Risk factors
KW - Staging surgery
UR - https://www.scopus.com/pages/publications/105001998664
U2 - 10.1016/j.jogoh.2025.102949
DO - 10.1016/j.jogoh.2025.102949
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C2 - 40185228
AN - SCOPUS:105001998664
SN - 0368-2315
VL - 54
JO - Journal of Gynecology Obstetrics and Human Reproduction
JF - Journal of Gynecology Obstetrics and Human Reproduction
IS - 6
M1 - 102949
ER -
