Emons Günter, Steiner Eric, Vordermark Dirk, Uleer Christoph, Paradies Kerstin, Tempfer Clemens, Aretz Stefan, Cremer Wolfgang, Hanf Volker, Mallmann Peter, Ortmann Olaf, Römer Thomas, Schmutzler Rita K, Horn Lars-Christian, Kommoss Stefan, Lax Sigurd, Schmoeckel Elisa, Mokry Theresa, Grab Dieter, Reinhardt Michael, Steinke-Lange Verena, Brucker Sara Y, Kiesel Ludwig, Witteler Ralf, Fleisch Markus C, Friedrich Michael, Höcht Stefan, Lichtenegger Werner, Mueller Michael, Runnebaum Ingo, Feyer Petra, Hagen Volker, Juhasz-Böss Ingolf, Letsch Anne, Niehoff Peter, Zeimet Alain Gustave, Battista Marco Johannes, Petru Edgar, Widhalm Simone, van Oorschot Birgitt, Panke Joan Elisabeth, Weis Joachim, Dauelsberg Timm, Haase Heidemarie, Beckmann Matthias W, Jud Sebastian, Wight Edward, Prott Franz-Josef, Micke Oliver, Bader Werner, Reents Nicola, Henscher Ulla, Schallenberg Miriam, Rahner Nils, Mayr Doris, Kreißl Michael, Lindel Katja, Mustea Alexander, Strnad Vratislav, Goerling Ute, Bauerschmitz Gerd J, Langrehr Jan, Neulen Joseph, Ulrich Uwe Andreas, Nothacker Monika J, Blödt Susanne, Follmann Markus, Langer Thomas, Wenzel Gregor, Weber Sylvia, Erdogan Saskia
Universitätsmedizin Göttingen, Klinik für Gynäkologie und Geburtshilfe, Göttingen, Germany.
Frauenklinik GPR Klinikum Rüsselsheim am Main, Rüsselsheim, Germany.
Geburtshilfe Frauenheilkd. 2023 Aug 15;83(8):919-962. doi: 10.1055/a-2066-2051. eCollection 2023 Aug.
The S3-guideline on endometrial cancer, first published in April 2018, was reviewed in its entirety between April 2020 and January 2022 and updated. The review was carried out at the request of German Cancer Aid as part of the Oncology Guidelines Program and the lead coordinators were the German Society for Gynecology and Obstetrics (DGGG), the Gynecology Oncology Working Group (AGO) of the German Cancer Society (DKG) and the German Cancer Aid (DKH). The guideline update was based on a systematic search and assessment of the literature published between 2016 and 2020. All statements, recommendations and background texts were reviewed and either confirmed or amended. New statements and recommendations were included where necessary. The use of evidence-based risk-adapted therapies to treat women with endometrial cancer of low risk prevents unnecessarily radical surgery and avoids non-beneficial adjuvant radiation therapy and/or chemotherapy. For women with endometrial cancer and a high risk of recurrence, the guideline defines the optimum level of radical surgery and indicates whether chemotherapy and/or adjuvant radiation therapy is necessary. This should improve the survival rates and quality of life of these patients. The S3-guideline on endometrial cancer and the quality indicators based on the guideline aim to provide the basis for the work of certified gynecological cancer centers. The guideline was first compiled in 2018 in accordance with the requirements for S3-level guidelines and was updated in 2022. The update included an adaptation of the source guidelines identified using the German Instrument for Methodological Guideline Appraisal (DELBI). The update also used evidence reviews which were created based on selected literature obtained from systematic searches in selected literature databases using the PICO process. The Clinical Guidelines Service Group was tasked with carrying out a systematic search and assessment of the literature. Their results were used by interdisciplinary working groups as a basis for developing suggestions for recommendations and statements which were then modified during structured online consensus conferences and/or additionally amended online using the DELPHI process to achieve a consensus. Part 1 of this short version of the guideline provides recommendations on epidemiology, screening, diagnosis, and hereditary factors. The epidemiology of endometrial cancer and the risk factors for developing endometrial cancer are presented. The options for screening and the methods used to diagnose endometrial cancer are outlined. Recommendations are given for the prevention, diagnosis, and therapy of hereditary forms of endometrial cancer. The use of geriatric assessment is considered and existing structures of care are presented.
子宫内膜癌S3指南于2018年4月首次发布，在2020年4月至2022年1月期间进行了全面审查并更新。该审查是应德国癌症援助组织的要求进行的，作为肿瘤学指南计划的一部分，牵头协调方为德国妇产科学会（DGGG）、德国癌症协会（DKG）的妇科肿瘤学工作组（AGO）和德国癌症援助组织（DKH）。该指南更新基于对2016年至2020年期间发表的文献进行的系统检索和评估。所有陈述、建议和背景文本均经过审查，要么得到确认，要么进行修改。必要时纳入了新的陈述和建议。使用基于证据的风险适应性疗法治疗低风险子宫内膜癌女性可避免不必要的根治性手术，并避免无益的辅助放疗和/或化疗。对于复发风险高的子宫内膜癌女性，该指南定义了最佳根治性手术水平，并指出是否需要化疗和/或辅助放疗。这应能提高这些患者的生存率和生活质量。子宫内膜癌S3指南及基于该指南的质量指标旨在为认证的妇科癌症中心的工作提供依据。该指南于2018年首次根据S3级指南的要求编制，并于2022年更新。更新包括对使用德国方法学指南评估工具（DELBI）确定的源指南进行调整。更新还使用了基于通过PICO流程在选定文献数据库中进行系统检索获得的选定文献创建的证据综述。临床指南服务组负责对文献进行系统检索和评估。跨学科工作组将其结果用作制定建议和陈述建议的基础，然后在结构化在线共识会议期间进行修改和/或使用德尔菲法在线进一步修改以达成共识。本简短版指南第1部分提供了关于流行病学、筛查、诊断和遗传因素的建议。介绍了子宫内膜癌的流行病学以及发生子宫内膜癌的风险因素。概述了筛查选项和用于诊断子宫内膜癌的方法。给出了遗传性子宫内膜癌预防、诊断和治疗的建议。考虑了老年评估的使用并介绍了现有的护理结构。
