Endometrial Cancer. Guideline of the DGGG, DKG and DKH (S3-Level, AWMF Registry Number 032/034-OL, September 2022). Part 1 with Recommendations on the Epidemiology, Screening, Diagnosis and Hereditary Factors of Endometrial Cancer, Geriatric Assessment and Supply Structures
Authors: 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 ,   Heinrich Prömpeler †,   Reina Tholen †
Published: August 2023

Summary 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.

Aim 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.

Methods 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.

Recommendations 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.