Endometriumkarzinom. Leitlinie der DGGG, DKG und DKH (S3-Level, AWMF-Register-Nummer 032/034-OL, September 2022) – Teil 2 mit Empfehlungen zur Therapie der Präkanzerosen und des frühen Endometriumkarzinoms, zur operativen Therapie, Strahlen- und medikamentösen Therapie, zu Nachsorge, Rezidiven und Metastasen und zur psychoonkologischen, palliativmedizinischen, patientenedukativen, rehabilitativen und physiotherapeutischen Versorgung

Zusammenfassung

Zusammenfassung Die im April 2018 erstmals publizierte S3-Leitlinie Endometriumkarzinom wurde von April 2020 bis Januar 2022 komplett geprüft und aktualisiert. Dies wurde von der Deutschen Krebshilfe im Rahmen des Leitlinienprogramms Onkologie gefördert und von der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe (DGGG), der Arbeitsgemeinschaft Onkologische Gynäkologie (AGO) der Deutschen Krebsgesellschaft (DKG) und der Deutschen Krebshilfe (DKH) federführend koordiniert. Für das Update der Leitlinie wurde die systematisch recherchierte und bewertete Literatur von 2016 bis 2020 verwendet. Alle Statements, Empfehlungen und Hintergrundtexte wurde geprüft und entweder bestätigt oder modifiziert. Soweit erforderlich, wurden neue Statements und Empfehlungen hinzugenommen.

Ziel Durch eine evidenzbasierte risikoadaptierte Therapie können bei den Frauen mit Endometriumkarzinom mit geringem Risiko eine unnötige Radikalität bei der Operation und nicht sinnvolle adjuvante Strahlen- und/oder Chemotherapie vermieden werden. Für die Frauen mit einem Endometriumkarzinom mit hohem Rezidivrisiko definiert die Leitlinie die optimale operative Radikalität sowie die ggf. erforderliche Chemotherapie und/oder adjuvante Strahlentherapie. Dadurch sollen Überleben und Lebensqualität dieser Patientinnen verbessert werden. Die S3-Leitlinie zum Endometriumkarzinom und die auf ihr basierenden Qualitätsindikatoren sollen eine Grundlage für die Arbeit der zertifizierten gynäkologischen Krebszentren sein.

Methoden Die Leitlinie wurde 2018 gemäß den Anforderungen eines S3-Niveaus erarbeitet und 2022 aktualisiert. Dies umfasst zum einen die Adaptation der mittels des DELBI-Instruments gefundenen Quellleitlinien. Zum anderen Evidenzübersichten, die anhand der in systematischen Recherchen nach dem PICO-Schema in ausgewählten Literaturdatenbanken selektierten Literatur erstellt wurden. Mit der systematischen Literaturrecherche und -Bewertung war die Clinical Guidelines Service Group beauftragt. Diese Ergebnisse dienten den interdisziplinären Arbeitsgruppen als Basis für die Erarbeitung von Vorschlägen für Empfehlungen und Statements, die in strukturierten Online-Konsensuskonferenzen und/oder ergänzend im DELPHI-Verfahren modifiziert und konsentiert wurden.

Empfehlungen Der Teil 2 dieser Kurzversion der Leitlinie gibt Empfehlungen zur Therapie der Präkanzerosen und des frühen Endometriumkarzinoms, zur operativen Therapie, Strahlen- und medikamentösen Therapie, zu Nachsorge, Rezidiven und Metastasen des Endometriumkarzinoms und zur psychoonkologischen, palliativmedizinischen, patientenedukativen, rehabilitativen und physiotherapeutischen Versorgungssituation.

Schlüsselwörter

Endometriumkarzinom - Präkanzerosen - operative Therapie - Rezidivtherapie - psychoonkologische Versorgung - onkologische Rehabilitation

Publikationsverlauf

Eingereicht: 17. März 2023

Angenommen nach Revision: 23. Juni 2023

Artikel online veröffentlicht:
15. August 2023

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