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This study evaluated the prognostic value of frailty and frailty-related scores in predicting perioperative morbidity and survival in EMCA patients undergoing minimally invasive surgery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This retrospective cohort study included 289 patients from the Sentinel Database treated for EMCA at Bern University Hospital (2012\u20132020). Patients underwent minimally invasive hysterectomy with sentinel lymph node dissection (39%) or additional radical lymphadenectomy (61%). Frailty was assessed using the Age-Adjusted Charlson Comorbidity Index (ACCI), modified Frailty Index (mFI), 5-item mFI (mFI-5), American Society of Anesthesiologists (ASA) scores, and independent parameters. Primary outcomes included perioperative complications, hospital stay, recurrence-free survival (RFS), and overall survival (OS).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Median age was 65 years (range 26\u201394) and median follow-up was 41 months (0\u2013105). ACCI &gt;\u00a04 (23.2%) was the strongest predictor of postoperative complications (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.025), prolonged hospitalization (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.03), and reduced OS (hazard ratio [HR] 2.57, 95% confidence interval [CI] 1.18\u20135.60; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.018). Multivariable analysis confirmed ACCI &gt;\u00a04 (HR 2.24, 95% CI 1.02\u20134.90; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.044), European Society for Medical Oncology (ESMO) risk group (HR 1.61, 95% CI 1.24\u20132.07; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), hemoglobin (HR 1.03, 95% CI 1.00\u20131.05; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.033), and congestive heart failure (HR 6.29, 95% CI 1.35\u201329.27; <jats:italic>p<\/jats:italic>\u00a0=0.019) were significant predictors of OS. Radical lymphadenectomy (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), ACCI &gt;\u00a04 (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.025), and age &gt;\u00a070\u00a0years (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.034) increased complication risks.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>ACCI &gt;\u00a04 is a practical tool for preoperative risk assessment and predicting surgical tolerance and survival, and is therefore applicable for guiding surgical decisions and personalized care in patients with EMCA.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1245\/s10434-025-17376-9","type":"journal-article","created":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T20:11:07Z","timestamp":1747426267000},"page":"5603-5615","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Usefulness of Geriatric Parameters in Preoperative Evaluation of Patients Undergoing Minimally Invasive Surgery for Endometrial Cancer: A Retrospective Cohort Study"],"prefix":"10.1245","volume":"32","author":[{"given":"Jonas Jean Mathieu","family":"Vibert","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franziska","family":"Siegenthaler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flurina A. 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