CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2018; 78(11): 1089-1109
DOI: 10.1055/a-0715-2964
GebFra Science
Guideline/Leitlinie
Georg Thieme Verlag KG Stuttgart · New York

Interdisciplinary Diagnosis, Therapy and Follow-up of Patients with Endometrial Cancer. Guideline (S3-Level, AWMF Registry Number 032/034-OL, April 2018) – Part 2 with Recommendations on the Therapy and Follow-up of Endometrial Cancer, Palliative Care, Psycho-oncological/Psychosocial Care/Rehabilitation/Patient Information and Healthcare Facilities

Article in several languages: English | deutsch
Günter Emons
1  Klinik für Gynäkologie und Geburtshilfe, Universitätsmedizin Göttingen, Göttingen, Germany
,
Eric Steiner
2  Frauenklinik, GPR Klinikum Rüsselsheim am Main, Rüsselsheim, Germany
,
Dirk Vordermark
3  Radiotherapy, Universität Halle (Saale), Halle (Saale), Germany
,
Christoph Uleer
4  Facharzt für Frauenheilkunde und Geburtshilfe, Hildesheim, Germany
,
Nina Bock
1  Klinik für Gynäkologie und Geburtshilfe, Universitätsmedizin Göttingen, Göttingen, Germany
,
Kerstin Paradies
5  Konferenz Onkologischer Kranken- und Kinderkrankenpflege, Hamburg, Germany
,
Olaf Ortmann
6  Frauenheilkunde und Geburtshilfe, Universität Regensburg, Regensburg, Germany
,
Stefan Aretz
7  Institut für Humangenetik, Universität Bonn, Zentrum für erbliche Tumorerkrankungen, Universitätsklinikum Bonn, Bonn, Germany
,
Peter Mallmann
8  Frauenheilkunde, Uniklinik Köln, Köln, Germany
,
Christian Kurzeder
9  Frauenklinik, Universitätsspital Basel, Basel, Switzerland
,
Volker Hagen
10  Klinik für Innere Medizin II, St.-Johannes-Hospital Dortmund, Germany
,
Birgitt van Oorschot
11  Interdisziplinäres Zentrum Palliativmedizin, Universitätsklinikum Würzburg, Würzburg, Germany
,
Stefan Höcht
12  Xcare, Praxis für Strahlentherapie, Saarlouis, Germany
,
Petra Feyer
13  Klinik für Strahlentherapie und Radioonkologie, Vivantes Klinikum Neukölln, Berlin, Germany
,
Gerlinde Egerer
14  Zentrum für Innere Medizin, Universitätsklinikum Heidelberg, Heidelberg, Germany
,
Michael Friedrich
15  Frauenklinik, HELIOS-Klinikum Krefeld, Krefeld, Germany
,
Wolfgang Cremer
16  Praxis für Frauenheilkunde Hamburg, Hamburg, Germany
,
Franz-Josef Prott
17  Facharzt für Radiologie und Strahlentherapie, Wiesbaden, Germany
,
Lars-Christian Horn
18  Institut für Pathologie, Universitätsklinikum Leipzig, Leipzig, Germany
,
Heinrich Prömpeler
19  Klinik für Frauenheilkunde, Universitätsklinikum Freiburg, Freiburg, Germany
,
Jan Langrehr
20  Klinik für Allgemein-, Gefäß- und Viszeralchirurgie, Martin-Luther-Krankenhaus, Berlin, Germany
,
Steffen Leinung†
21  Muldentalkliniken, Grimma, Germany
,
Matthias W. Beckmann
22  Dept. of OB/Gyn, University Hospital Erlangen, Erlangen, Germany
,
Rainer Kimmig
23  Womenʼs Department, University Hospital of Essen, Essen, Germany
,
Anne Letsch
24  Medizinische Klinik mit Schwerpunkt Hämatologie und Onkologie, Charité, Campus Benjamin Franklin, Universitätsmedizin Berlin, Berlin, Germany
,
Michael Reinhardt
25  Klinik für Nuklearmedizin, Pius Hospital Oldenburg, Oldenburg, Germany
,
Bernd Alt-Epping
26  Klinik für Palliativmedizin, Universitätsmedizin Göttingen, Göttingen, Germany
,
Ludwig Kiesel
27  Obstetrics and Gynecology, Reproductive Medicine, University of Muenster, Muenster, Germany
,
Jan Menke
28  Institut für Diagnostische und Interventionelle Radiologie, Universitätsmedizin Göttingen, Göttingen, Germany
,
Marion Gebhardt
29  Frauenselbsthilfe nach Krebs e. V., Erlangen, Erlangen/Forchheim, Germany
,
Verena Steinke-Lange
30  MGZ – Medizinisch Genetisches Zentrum, München und Medizinische Klinik und Poliklinik IV, Campus Innenstadt, Klinikum der Universität München, München, Germany
,
Nils Rahner
31  Institut für Humangenetik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
,
Werner Lichtenegger
32  Frauenklinik Charité, Campus Virchow-Klinikum, Universitätsmedizin Berlin, Berlin, Germany
,
Alain Zeimet
33  Frauenheilkunde, Medizinische Universität Innsbruck, Innsbruck, Austria
,
Volker Hanf
34  Frauenklinik Nathanstift – Klinikum Fürth, Fürth, Germany
,
Joachim Weis
35  Stiftungsprofessur Selbsthilfeforschung, Tumorzentrum/CCC Freiburg, Universitätsklinikum Freiburg, Freiburg, Germany
,
Michael Mueller
36  Universitätsklinik für Frauenheilkunde, Inselspital Bern, Bern, Switzerland
,
Ulla Henscher
37  Praxis für Physiotherapie, Hannover, Germany
,
Rita K. Schmutzler
38  Center for Familial Breast and Ovarian Cancer, University Hospital of Cologne, Cologne, Germany
,
Alfons Meindl
39  Frauenklinik am Klinikum rechts der Isar, München, Germany
,
Felix Hilpert
40  Mammazentrum, Krankenhaus Jerusalem, Hamburg, Germany
,
Joan Elisabeth Panke
41  Medizinischer Dienst des Spitzenverbandes Bund der Krankenkassen e. V., Essen, Germany
,
Vratislav Strnad
42  Strahlenklinik, Universitätsklinikum Erlangen, CCC ER-EMN, Universitäts-Brustzentrum Franken, Erlangen, Germany
,
Christiane Niehues
43  Deutsche Rentenversicherung Bund, Berlin, Germany
,
Timm Dauelsberg
44  Winkelwaldklinik Nordrach, Fachklinik für onkologische Rehabilitation, Nordrach, Germany
,
Peter Niehoff
45  Strahlenklinik, Sana Klinikum Offenbach, Offenbach, Germany
,
Doris Mayr
46  Pathologisches Institut, LMU München, München, Germany
,
Dieter Grab
47  Frauenklinik Klinikum Harlaching, München, Germany
,
Michael Kreißl
48  Klinik für Radiologie und Nuklearmedizin, Universitätsklinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg, Magdeburg, Germany
,
Ralf Witteler
27  Obstetrics and Gynecology, Reproductive Medicine, University of Muenster, Muenster, Germany
,
Annemarie Schorsch
49  Frauenselbsthilfe nach Krebs e. V., Bad Soden, Germany
,
Alexander Mustea
50  Universitätsmedizin Greifswald, Greifswald, Germany
,
Edgar Petru
51  Frauenheilkunde, Med. Univ. Graz, Graz, Austria
,
Jutta Hübner
52  Klinikum für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany
,
Anne Derke Rose
43  Deutsche Rentenversicherung Bund, Berlin, Germany
,
Edward Wight
53  Frauenklinik des Universitätsspitals Basel, Basel, Switzerland
,
Reina Tholen
54  Deutscher Verband für Physiotherapie, Referat Bildung und Wissenschaft, Köln, Germany
,
Gerd J. Bauerschmitz
1  Klinik für Gynäkologie und Geburtshilfe, Universitätsmedizin Göttingen, Göttingen, Germany
,
Markus Fleisch
55  Landesfrauenklinik, HELIOS Universitätsklinikum Wuppertal, Wuppertal, Germany
,
Ingolf Juhasz-Boess
56  Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg, Saar, Germany
,
Sigurd Lax
57  Institut für Pathologie, Landeskrankenhaus Graz West, Graz, Austria
,
Ingo Runnebaum
58  Frauenklinik, Universitätsklinikum Jena, Jena, Germany
,
Clemens Tempfer
59  Marien Hospital Herne – Universitätsklinikum der Ruhr-Universität Bochum, Herne, Germany
,
Monika J. Nothacker
60  AWMF-IMWi, AWMF, Berlin, Germany
,
Susanne Blödt
60  AWMF-IMWi, AWMF, Berlin, Germany
,
Markus Follmann
61  Deutsche Krebsgesellschaft, Office des Leitlinienprogrammes Onkologie, Berlin, Germany
,
Thomas Langer
61  Deutsche Krebsgesellschaft, Office des Leitlinienprogrammes Onkologie, Berlin, Germany
,
Heike Raatz
62  Institut für Klinische Epidemiologie & Biostatistik (CEB), Basel, Switzerland
,
Simone Wesselmann
63  Deutsche Krebsgesellschaft e. V., Berlin, Germany
,
Saskia Erdogan
1  Klinik für Gynäkologie und Geburtshilfe, Universitätsmedizin Göttingen, Göttingen, Germany
› Author Affiliations
Further Information

Publication History

received 21 August 2018
revised 23 August 2018

accepted 23 August 2018

Publication Date:
26 November 2018 (online)

Abstract

Summary The first German interdisciplinary S3-guideline on the diagnosis, therapy and follow-up of patients with endometrial cancer was published in April 2018. Funded by German Cancer Aid as part of an Oncology Guidelines Program, the lead coordinators of the guideline were the German Society of Gynecology and Obstetrics (DGGG) and the Gynecological Oncology Working Group (AGO) of the German Cancer Society (DKG).

Purpose Using evidence-based, risk-adapted therapy to treat low-risk women with endometrial cancer avoids unnecessarily radical surgery and non-useful adjuvant radiotherapy and/or chemotherapy. This can significantly reduce therapy-induced morbidity and improve the patientʼs quality of life as well as avoiding unnecessary costs. For women with endometrial cancer and a high risk of recurrence, the guideline defines the optimal extent of surgical radicality together with the appropriate chemotherapy and/or adjuvant radiotherapy if required. An evidence-based optimal use of different therapeutic modalities should improve the survival rates and quality of life of these patients. This S3-guideline on endometrial cancer is intended as a basis for certified gynecological cancer centers. The aim is that the quality indicators established in this guideline will be incorporated in the certification processes of these centers.

Methods The guideline was compiled in accordance with the requirements for S3-level guidelines. This includes, in the first instance, the adaptation of source guidelines selected using the DELBI instrument for appraising guidelines. Other consulted sources included reviews of evidence, which were compiled from literature selected during systematic searches of literature databases using the PICO scheme. In addition, an external biostatistics institute was commissioned to carry out a systematic search and assessment of the literature for one part of the guideline. Identified materials were used by the interdisciplinary working groups to develop suggestions for Recommendations and Statements, which were then subsequently modified during structured consensus conferences and/or additionally amended online using the DELPHI method, with consent between members achieved online. The guideline report is freely available online.

Recommendations Part 2 of this short version of the guideline presents recommendations for the therapy of endometrial cancer including precancers and early endometrial cancer as well as recommendations on palliative medicine, psycho-oncology, rehabilitation, patient information and healthcare facilities to treat endometrial cancer. The management of precancers of early endometrial precancerous conditions including fertility-preserving strategies is presented. The concept used for surgical primary therapy of endometrial cancer is described. Radiotherapy and adjuvant medical therapy to treat endometrial cancer and uterine carcinosarcomas are described. Recommendations are given for the follow-up care of endometrial cancer, recurrence and metastasis. Palliative medicine, psycho-oncology including psychosocial care, and patient information and rehabilitation are presented. Finally, the care algorithm and quality assurance steps for the diagnosis, therapy and follow-up of patients with endometrial cancer are outlined.