Diagnostik, Therapie und Nachsorge der Patientin mit Zervixkarzinom. Leitlinie der DGGG, DKG und DKH (S3-Level, AWMF-Registernummer 032/033OL, Mai 2021) – Teil 2 mit Empfehlungen zu Psychoonkologie, Rehabilitation, Nachsorge, Lokalrezidiv, palliativer Therapie und Versorgungsstrukturen

Zusammenfassung

Ziel Im März 2021 erschien das Update der interdisziplinären S3-Leitlinie für die Diagnostik, Therapie und Nachsorge der Patientinnen mit Zervixkarzinom (AWMF-Registernummer: 032/033OL). Die Leitlinienarbeit ist von der Deutschen Krebshilfe im Rahmen des Leitlinienprogramms Onkologie gefördert. Die Koordination erfolgte durch die Deutsche Gesellschaft für Gynäkologie und Geburtshilfe (DGGG) und der Arbeitsgemeinschaft Onkologische Gynäkologie (AGO) der Deutschen Krebsgesellschaft (DKG).

Methoden Der Aktualisierungsprozess der S3-Leitlinie aus dem Jahre 2014 basierte entweder auf der Aufarbeitung der verfügbaren Evidenz nach den Kriterien der evidenzbasierten Medizin, einer Adaptierung von vorhandenen evidenzbasierten nationalen und internationalen Leitlinien oder – bei Fehlen einer Evidenzgrundlage – auf dem Konsens der beteiligten Fachexperten. Nach anfänglicher Sichtung der aktuellen Literatur nach vorgegebenem Algorithmus wurden mehrere Felder identifiziert, die im Gegensatz zur Vorläuferversion aus dem September 2014, neue Empfehlungen oder Statements benötigten, um der aktuell publizierten Literatur und der Evidenzaufarbeitung Genüge zu tun.

Empfehlungen Die Kurzversion dieser Leitlinie beinhaltet Empfehlungen und Statements zur palliativen Therapie und Nachsorge von Patientinnen mit Zervixkarzinom. Zu den wesentlichen Neuerungen durch die Aktualisierung der Leitlinie gehören die 2018 neu publizierte FIGO-Klassifikation, das offene radikale Vorgehen bei Zervixkarzinom bis Stadium FIGO IB1 sowie der Einsatz der Sentinel-Lymphknoten-Technik bis Tumoren ≤ 2 cm. Weitere Änderungen betreffen den Einsatz des PET-CTs, neue Optionen in der Strahlentherapie (z. B. intensitätsmodulierte Strahlentherapie, Image-guided adaptive Brachytherapie) und medikamentöse Therapien in der Rezidiv- bzw. metastasierten Situation.

Schlüsselwörter

Leitlinie - Zervixkarzinom - zervikale intraepitheliale Neoplasie - Therapie - Nachsorge

Publication History

Received: 29 September 2021
Received: 14 October 2021

Accepted: 17 October 2021

Article published online:
11 February 2022

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