Geburtshilfe Frauenheilkd 2016; 76(10): 1035-1049
DOI: 10.1055/s-0042-103728
Guideline
GebFra Science
Georg Thieme Verlag KG Stuttgart · New York

Diagnosis, Therapy and Follow-up Care of Vulvar Cancer and its Precursors. Guideline of the DGGG and DKG (S2k-Level, AWMF Registry Number 015/059, November 2015

Diagnostik, Therapie und Nachsorge des Vulvakarzinoms und seiner Vorstufen. Leitlinie der DGGG und DKG (S2k-Level, AWMF-Registernummer 015/059, November 2015)
H. G. Schnürch
1   ehem. Frauenklinik Lukaskrankenhaus, Neuss
,
S. Ackermann
2   Frauenklinik, Klinikum Darmstadt, Darmstadt
,
C. D. Alt
3   Institut für Diagnostische und Interventionelle Radiologie, Universität Düsseldorf, Düsseldorf
,
J. Barinoff
4   Klinik für Gynäkologie und Geburtshilfe, Markus Krankenhaus, Frankfurt am Main
,
C. Böing
5   Katholisches Klinikum Oberhausen, Frauenklinik St. Clemens-Hospital, Oberhausen
,
C. Dannecker
6   Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe der Universität München, Campus Großhadern, München, Munich
,
F. Gieseking
7   Dysplasiezentrum in der Frauenarztpraxis Heussweg, Hamburg
,
A. Günthert
8   Frauenklinik Luzerner Kantonsspital, Lucerne, Switzerland
,
P. Hantschmann
9   Abteilung Gynäkologie und Geburtshilfe, Kreiskliniken Altötting – Burghausen, Altötting
,
L. C. Horn
10   Institut für Pathologie des Universitätsklinikums Leipzig, Leipzig
,
R. Kürzl
11   ehem. Universitätsfrauenklinik Maistraße, Munich
,
P. Mallmann
12   Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe der Universität Köln, Cologne
,
S. Marnitz
13   Klinik und Poliklinik für Radioonkologie und Strahlentherapie der Universität Köln, Cologne
,
G. Mehlhorn
14   Universitätsfrauenklinik Erlangen, Erlangen
,
C. C. Hack
14   Universitätsfrauenklinik Erlangen, Erlangen
,
M. C. Koch
14   Universitätsfrauenklinik Erlangen, Erlangen
,
U. Torsten
15   Klinik für Gynäkologie und Zentrum für Beckenbodenerkrankungen, Vivantes Klinikum Neukölln, Berlin
,
W. Weikel
16   Klinik für Gynäkologie und gynäkologische Onkologie, Universitätsfrauenklinik Mainz, Mainz
,
L. Wölber
17   Klinik und Poliklinik für Gynäkologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
,
M. Hampl
18   Klinik für Frauenheilkunde und Geburtshilfe des Universitätsklinikums Düsseldorf, Düsseldorf
› Author Affiliations
Further Information

Publication History

Publication Date:
14 October 2016 (online)

Abstract

Purpose: This is an official guideline, published and coordinated by the Arbeitsgemeinschaft Gynäkologische Onkologie (AGO, Study Group for Gynecologic Oncology) of the Deutsche Krebsgesellschaft (DKG, German Cancer Society) and the Deutsche Gesellschaft für Gynäkologie und Geburtshilfe (DGGG, German Society for Gynecology and Obstetrics). The number of cases with vulvar cancer is on the rise, but because of the former rarity of this condition and the resulting lack of literature with a high level of evidence, in many areas knowledge of the optimal clinical management still lags behind what would be required. This updated guideline aims to disseminate the most recent recommendations, which are much clearer and more individualized, and is intended to create a basis for the assessment and improvement of quality care in hospitals.

Methods: This S2k guideline was drafted by members of the AGO Committee on Vulvar and Vaginal Tumors; it was developed and formally completed in accordance with the structured consensus process of the Association of Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, AWMF).

Recommendations: 1. The incidence of disease must be taken into consideration. 2. The diagnostic pathway, which is determined by the initial findings, must be followed. 3. The clinical and therapeutic management of vulvar cancer must be done on an individual basis and depends on the stage of disease. 4. The indications for sentinel lymph node biopsy must be evaluated very carefully. 5. Follow-up and treatment for recurrence must be adapted to the individual case.

Zusammenfassung

Ziel: Offizielle Leitlinie, publiziert und koordiniert von der Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) in der Deutschen Krebsgesellschaft (DKG) und der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe (DGGG). Vulvakarzinome nehmen an Anzahl stetig zu, während die Kenntnisse über das optimale klinische Management wegen der früheren Seltenheit und dem daraus resultierenden Mangel an Literatur-Evidenz dem Bedarf an vielen Stellen noch hinterherhinken. Dieses Leitlinien-Update soll die aktuell deutlich klareren und individualisierten Behandlungsempfehlungen möglichst weit verbreiten und die Grundlage für eine Qualitätsmessung und Qualitätssteigerung in Kliniken bieten.

Methoden: Die vorliegende S2k-Leitlinie wurde von den Mitgliedern der Kommission Vulva- und Vaginaltumoren der AGO entworfen und in einem methodisch überwachten Konsensusverfahren der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) strukturiert entwickelt und formal abgeschlossen.

Empfehlungen: 1. Beachtung der Inzidenz. 2. Einhaltung der abgestuften Diagnostik in Abhängigkeit vom Ausgangsstadium. 3. Individualisiertes klinisch-therapeutisches Management der Vulvakarzinome in Abhängigkeit vom Stadium. 4. Ausgewogene Indikationsstellung zur Sentinel-Lymphknoten-Biopsie. 5. Adaptierte Nachsorge und Behandlung im Rezidivfall.

Supporting Information

 
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