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

Günter Emons; Eric Steiner; Dirk Vordermark; Christoph Uleer; Nina Bock; Kerstin Paradies; Olaf Ortmann; Stefan Aretz; Peter Mallmann; Christian Kurzeder; Volker Hagen; Birgitt van Oorschot; Stefan Höcht; Petra Feyer; Gerlinde Egerer; Michael Friedrich; Wolfgang Cremer; Franz-Josef Prott; Lars-Christian Horn; Heinrich Prömpeler; Jan Langrehr; Steffen Leinung; Matthias W. Beckmann; Rainer Kimmig; Anne Letsch; Michael Reinhardt; Bernd Alt-Epping; Ludwig Kiesel; Jan Menke; Marion Gebhardt; Verena Steinke-Lange; Nils Rahner; Werner Lichtenegger; Alain Zeimet; Volker Hanf; Joachim Weis; Michael Mueller; Ulla Henscher; Rita K. Schmutzler; Alfons Meindl; Felix Hilpert; Joan Elisabeth Panke; Vratislav Strnad; Christiane Niehues; Timm Dauelsberg; Peter Niehoff; Doris Mayr; Dieter Grab; Michael Kreißl; Ralf Witteler; Annemarie Schorsch; Alexander Mustea; Edgar Petru; Jutta Hübner; Anne Derke Rose; Edward Wight; Reina Tholen; Gerd J. Bauerschmitz; Markus Fleisch; Ingolf Juhasz-Boess; Lax Sigurd; Ingo Runnebaum; Clemens Tempfer; Monika J. Nothacker; Susanne Blödt; Markus Follmann; Thomas Langer; Heike Raatz; Simone Wesselmann; Saskia Erdogan

doi:10.1055/a-0713-1218

Geburtshilfe und Frauenheilkunde, Table of Contents

CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2018; 78(10): 949-971
DOI: 10.1055/a-0713-1218

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 Nummer 032/034-OL, April 2018) – Part 1 with Recommendations on the Epidemiology, Screening, Diagnosis and Hereditary Factors of Endometrial Cancer

Article in several languages: English | deutsch

Günter Emons

¹Klinik für Gynäkologie und Geburtshilfe, Universitätsmedizin Göttingen, Göttingen, Germany

,

Eric Steiner

²Frauenklinik, GPR Klinikum Rüsselsheim am Main, Rüsselsheim, Germany

,

Dirk Vordermark

³Radiotherapy, Universität Halle/Saale, Halle/Saale, Germany

,

Christoph Uleer

⁴Facharzt für Frauenheilkunde und Geburtshilfe, Hildesheim, Hildesheim, Germany

,

Nina Bock

¹Klinik für Gynäkologie und Geburtshilfe, Universitätsmedizin Göttingen, Göttingen, Germany

,

Kerstin Paradies

⁵Konferenz Onkologischer Kranken- und Kinderkrankenpflege, Hamburg, Germany

,

Olaf Ortmann

⁶Frauenheilkunde und Geburtshilfe, Universität Regensburg, Regensburg, Germany

,

Stefan Aretz

⁷Institut für Humangenetik, Universität Bonn, Zentrum für erbliche Tumorerkrankungen, Universitätsklinikum Bonn, Bonn, Germany

,

Peter Mallmann

⁸Frauenheilkunde, Uniklinik Köln, Köln, Germany

,

Christian Kurzeder

⁹Frauenklinik, Universitätsspital Basel, Basel, Switzerland

,

Volker Hagen

¹⁰Klinik für Innere Medizin II, St.-Johannes-Hospital Dortmund, Dortmund, Germany

,

Birgitt van Oorschot

¹¹Interdisziplinäres Zentrum Palliativmedizin, Universitätsklinikum Würzburg, Würzburg, Germany

,

Stefan Höcht

¹²Xcare, Praxis für Strahlentherapie, Saarlouis, Saarlouis, Germany

,

Petra Feyer

¹³Klinik für Strahlentherapie und Radioonkologie, Vivantes Klinikum Neukölln, Berlin, Germany

,

Gerlinde Egerer

¹⁴Zentrum für Innere Medizin, Universitätsklinikum Heidelberg, Heidelberg, Germany

,

Michael Friedrich

¹⁵Frauenklinik, HELIOS-Klinikum Krefeld, Krefeld, Germany

,

Wolfgang Cremer

¹⁶Praxis für Frauenheilkunde Hamburg, Hamburg, Germany

,

Franz-Josef Prott

¹⁷Facharzt für Radiologie und Strahlentherapie, Wiesbaden, Germany

,

Lars-Christian Horn

¹⁸Institut für Pathologie, Universitätsklinikum Leipzig, Leipzig, Germany

,

Heinrich Prömpeler

¹⁹Klinik für Frauenheilkunde, Universitätsklinikum Freiburg, Freiburg, Germany

,

Jan Langrehr

²⁰Klinik für Allgemein-, Gefäß- und Viszeralchirurgie, Martin-Luther-Krankenhaus, Berlin, Germany

,

Steffen Leinung†

²¹Muldentalkliniken, Grimma, Germany

,

Matthias W. Beckmann

²²Dept. of OB/Gyn, University Hospital Erlangen, Erlangen, Germany

,

Rainer Kimmig

²³Womenʼs Department, University Hospital of Essen, Essen, Germany

,

Anne Letsch

²⁴Medizinische Klinik mit Schwerpunkt Hämatologie und Onkologie, Charité, Campus Benjamin Franklin, Universitätsmedizin Berlin, Berlin, Germany

,

Michael Reinhardt

²⁵Klinik für Nuklearmedizin, Pius Hospital Oldenburg, Oldenburg, Germany

,

Bernd Alt-Epping

²⁶Klinik für Palliativmedizin, Universitätsmedizin Göttingen, Göttingen, Germany

,

Ludwig Kiesel

²⁷Obstetrics and Gynecology, Reproductive Medicine, University of Muenster, Germany, Münster, Germany

,

Jan Menke

²⁸Institut für Diagnostische und Interventionelle Radiologie, Universitätsmedizin Göttingen, Göttingen, Germany

,

Marion Gebhardt

²⁹Frauenselbsthilfe nach Krebs e. V., Erlangen, Erlangen/Forchheim, Germany

,

Verena Steinke-Lange

³⁰MGZ – Medizinisch Genetisches Zentrum, München und Medizinische Klinik und Poliklinik IV, Campus Innenstadt, Klinikum der Universität München, München, Germany

,

Nils Rahner

³¹Institut für Humangenetik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany

,

Werner Lichtenegger

³²Frauenklinik Charité, Campus Virchow-Klinikum, Universitätsmedizin Berlin, Berlin, Germany

,

Alain Zeimet

³³Frauenheilkunde, Medizinische Universität Innsbruck, Innsbruck, Austria

,

Volker Hanf

³⁴Frauenklinik Nathanstift – Klinikum Fürth, Fürth, Germany

,

Joachim Weis

³⁵Stiftungsprofessur Selbsthilfeforschung, Tumorzentrum/CCC Freiburg, Universitätsklinikum Freiburg, Freiburg, Germany

,

Michael Mueller

³⁶Universitätsklinik für Frauenheilkunde, Inselspital Bern, Bern, Switzerland

,

Ulla Henscher

³⁷Praxis für Physiotherapie, Hannover, Germany

,

Rita K. Schmutzler

³⁸Center for Familial Breast and Ovarian Cancer, University Hospital of Cologne, Cologne, Germany

,

Alfons Meindl

³⁹Frauenklinik am Klinikum rechts der Isar, München, Germany

,

Felix Hilpert

⁴⁰Mammazentrum, Krankenhaus Jerusalem, Hamburg, Germany

,

Joan Elisabeth Panke

⁴¹Medizinischer Dienst des Spitzenverbandes Bund der Krankenkassen e. V., Essen, Germany

,

Vratislav Strnad

⁴²Strahlenklinik, Universitätsklinikum Erlangen, CCC ER-EMN, Universitäts-Brustzentrum Franken, Erlangen, Germany

,

Christiane Niehues

⁴³Deutsche Rentenversicherung Bund, Berlin, Germany

,

Timm Dauelsberg

⁴⁴Winkelwaldklinik Nordrach, Fachklinik für onkologische Rehabilitation, Nordrach, Germany

,

Peter Niehoff

⁴⁵Strahlenklinik, Sana Klinikum Offenbach, Offenbach, Germany

,

Doris Mayr

⁴⁶Pathologisches Institut, LMU München, München, Germany

,

Dieter Grab

⁴⁷Frauenklinik Klinikum Harlaching, München, Germany

,

Michael Kreißl

⁴⁸Universitätsklinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg, Magdeburg, Germany

,

Ralf Witteler

²⁷Obstetrics and Gynecology, Reproductive Medicine, University of Muenster, Germany, Münster, Germany

,

Annemarie Schorsch

⁴⁹Frauenselbsthilfe nach Krebs e. V., Bad Soden, Germany

,

Alexander Mustea

⁵⁰Universitätsmedizin Greifswald, Greifswald, Germany

,

Edgar Petru

⁵¹Frauenheilkunde, Medizinische Universität Graz, Graz, Austria

,

Jutta Hübner

⁵²Klinikum für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany

,

Anne Derke Rose

⁴³Deutsche Rentenversicherung Bund, Berlin, Germany

,

Edward Wight

⁵³Frauenklinik des Universitätsspitals Basel, Basel, Switzerland

,

Reina Tholen

⁵⁴Deutscher Verband für Physiotherapie, Referat Bildung und Wissenschaft, Köln, Germany

,

Gerd J. Bauerschmitz

¹Klinik für Gynäkologie und Geburtshilfe, Universitätsmedizin Göttingen, Göttingen, Germany

,

Markus Fleisch

⁵⁵Landesfrauenklinik, HELIOS Universitätsklinikum Wuppertal, Wuppertal, Germany

,

Ingolf Juhasz-Boess

⁵⁶Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg, Saar, Germany

,

Lax Sigurd

⁵⁷Institut für Pathologie, Landeskrankenhaus Graz West, Graz, Austria

,

Ingo Runnebaum

⁵⁸Frauenklinik, Universitätsklinikum Jena, Jena, Germany

,

Clemens Tempfer

⁵⁹Marien Hospital Herne – Universitätsklinikum der Ruhr-Universität Bochum, Herne, Germany

,

Monika J. Nothacker

⁶⁰AWMF-IMWi, AWMF, Berlin, Germany

,

Susanne Blödt

⁶⁰AWMF-IMWi, AWMF, Berlin, Germany

,

Markus Follmann

⁶¹Deutsche Krebsgesellschaft, Office des Leitlinienprogramms Onkologie, Berlin, Germany

,

Thomas Langer

⁶¹Deutsche Krebsgesellschaft, Office des Leitlinienprogramms Onkologie, Berlin, Germany

,

Heike Raatz

⁶²Institut für Klinische Epidemiologie & Biostatistik (CEB), Basel, Switzerland

,

Simone Wesselmann

⁶³Deutsche Krebsgesellschaft e. V., Berlin, Germany

,

Saskia Erdogan

¹Klinik für Gynäkologie und Geburtshilfe, Universitätsmedizin Göttingen, Göttingen, Germany

› Author Affiliations

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 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 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 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.

Key words

endometrial cancer - epidemiology - genetics - guideline - screening - hereditary factors

Full Text

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