Interdisciplinary Diagnosis, Therapy and Follow-up of Patients with Endometrial Cancer. Guideline (S3-Level, AWMF Registry Nummer 032/034-OL, April 2018) - Part 1 with Recommendations on the Epidemiology, Screening, Diagnosis and Hereditary Factors of Endometrial Cancer.

Emons G1, Steiner E2, Vordermark D3, Uleer C4, Bock N1, Paradies K5, Ortmann O6, Aretz S7, Mallmann P8, Kurzeder C9, Hagen V10, van Oorschot B11, Höcht S12, Feyer P13, Egerer G14, Friedrich M15, Cremer W16, Prott FJ17, Horn LC18, Prömpeler H19, Langrehr J20, Leinung S21, Beckmann MW22, Kimmig R23, Letsch A24, Reinhardt M25, Alt-Epping B26, Kiesel L27, Menke J28, Gebhardt M29, Steinke-Lange V30, Rahner N31, Lichtenegger W32, Zeimet A33, Hanf V34, Weis J35, Mueller M36, Henscher U37, Schmutzler RK38, Meindl A39, Hilpert F40, Panke JE41, Strnad V42, Niehues C43, Dauelsberg T44, Niehoff P45, Mayr D46, Grab D47, Kreißl M48, Witteler R27, Schorsch A49, Mustea A50, Petru E51, Hübner J52, Rose AD43, Wight E53, Tholen R54, Bauerschmitz GJ1, Fleisch M55, Juhasz-Boess I56, Sigurd L57, Runnebaum I58, Tempfer C59, Nothacker MJ60, Blödt S60, Follmann M61, Langer T61, Raatz H62, Wesselmann S63, Erdogan S1.

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Abstract

in English, German

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 The use of 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 patient's 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 surgical radicality together with the appropriate chemotherapy and/or adjuvant radiotherapy where required. The evidence-based optimal use of different therapeutic modalities should improve survival rates and the quality of life of these patients. The 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 include 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 area of the guideline. The identified materials were used by the interdisciplinary working groups to develop suggestions for Recommendations and Statements, which were then modified during structured consensus conferences and/or additionally amended online using the DELPHI method with consent being reached online. The guideline report is freely available online. Recommendations Part 1 of this short version of the guideline presents recommendations on epidemiology, screening, diagnosis and hereditary factors, The epidemiology of endometrial cancer and the risk factors for developing endomentrial cancer are presented. The options for screening and the methods used to diagnose endometrial cancer including the pathology of the cancer are outlined. Recommendations are given for the prevention, diagnosis, and therapy of hereditary forms of endometrial cancer.