S3-Leitlinie zum exokrinen Pankreaskarzinom

1. Informationen zu dieser Leitlinie

Bei diesem Dokument handelt es sich um die aktualisierte Fassung der 2006 erstmals erstellten S3-Leitlinie zum exokrinen Pankreaskarzinom.

1.1. Herausgeber

Leitlinienprogramm Onkologie der AWMF, Deutschen Krebsgesellschaft e. V. und Deutschen Krebshilfe e. V.

1.2. Federführende Fachgesellschaft

Deutsche Gesellschaft für Verdauungs- und Stoffwechselkrankheiten

1.3. Kontakt

Office Leitlinienprogramm Onkologie
c/o Deutsche Krebsgesellschaft e. V.
Kuno-Fischer-Straße 8
14 057 Berlin
[e-mail]
www.leitlinienprogramm-onkologie.de

1.4. Finanzierung der Leitlinie

Diese Leitlinie wurde von der Deutschen Krebshilfe im Rahmen des Leitlinienprogramms Onkologie (OL) gefördert.

1.5. Zitierweise

Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF): S3-Leitlinie Exokrines Pankreaskarzinom, Langversion 1.0, 2013, AWMF Registernummer: 032 – 010OL, http://leitlinienprogramm-onkologie.de/Leitlinien.7.0.html

1.6. Besonderer Hinweis

Die Medizin unterliegt einem fortwährenden Entwicklungsprozess, sodass alle Angaben, insbesondere zu diagnostischen und therapeutischen Verfahren, immer nur dem Wissensstand zur Zeit der Drucklegung der Leitlinie entsprechen können. Hinsichtlich der angegebenen Empfehlungen zur Therapie und der Auswahl sowie Dosierung von Medikamenten wurde die größtmögliche Sorgfalt beachtet. Gleichwohl werden die Benutzer aufgefordert, die Beipackzettel und Fachinformationen der Hersteller zur Kontrolle heranzuziehen und im Zweifelsfall einen Spezialisten zu konsultieren. Fragliche Unstimmigkeiten sollen bitte im allgemeinen Interesse der OL-Redaktion mitgeteilt werden.

Der Benutzer selbst bleibt verantwortlich für jede diagnostische und therapeutische Applikation, Medikation und Dosierung.

In dieser Leitlinie sind eingetragene Warenzeichen (geschützte Warennamen) nicht besonders kenntlich gemacht. Es kann also aus dem Fehlen eines entsprechenden Hinweises nicht geschlossen werden, dass es sich um einen freien Warennamen handelt.

Das Werk ist in allen seinen Teilen urheberrechtlich geschützt. Jede Verwertung außerhalb der Bestimmung des Urhebergesetzes ist ohne schriftliche Zustimmung des Leitlinienprogramms Onkologie (OL) unzulässig und strafbar. Kein Teil des Werkes darf in irgendeiner Form ohne schriftliche Genehmigung des OL reproduziert werden. Dies gilt insbesondere für Vervielfältigungen, Übersetzungen, Mikroverfilmungen und die Einspeicherung, Nutzung und Verwertung in elektronischen Systemen, Intranets und dem Internet.

1.7. Ziele des Leitlinienprogramms Onkologie

Die Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e. V., die Deutsche Krebsgesellschaft e. V. und die Deutsche Krebshilfe e. V. haben sich mit dem Leitlinienprogramm Onkologie (OL) das Ziel gesetzt, gemeinsam die Entwicklung und Fortschreibung und den Einsatz wissenschaftlich begründeter und praktikabler Leitlinien in der Onkologie zu fördern und zu unterstützen. Die Basis dieses Programms beruht auf den medizinisch-wissenschaftlichen Erkenntnissen der Fachgesellschaften und der DKG, dem Konsens der medizinischen Fachexperten, Anwender und Patienten sowie auf dem Regelwerk für die Leitlinienerstellung der AWMF [1] und der fachlichen Unterstützung und Finanzierung durch die Deutsche Krebshilfe. Um den aktuellen Stand des medizinischen Wissens abzubilden und den medizinischen Fortschritt zu berücksichtigen, müssen Leitlinien regelmäßig überprüft und fortgeschrieben werden. Die Anwendung des AWMF-Regelwerks soll hierbei Grundlage zur Entwicklung qualitativ hochwertiger onkologischer Leitlinien sein. Da Leitlinien ein wichtiges Instrument der Qualitätssicherung und des Qualitätsmanagements in der Onkologie darstellen, sollten sie gezielt und nachhaltig in den Versorgungsalltag eingebracht werden. So sind aktive Implementierungsmaßnahmen und auch Evaluationsprogramme ein wichtiger Bestandteil der Förderung des Leitlinienprogramms Onkologie. Ziel des Programms ist es, in Deutschland professionelle und mittelfristig finanziell gesicherte Voraussetzungen für die Entwicklung und Bereitstellung hochwertiger Leitlinien zu schaffen. Denn diese hochwertigen Leitlinien dienen nicht nur dem strukturierten Wissenstransfer, sondern können auch in der Gestaltung der Strukturen des Gesundheitssystems ihren Platz finden. Zu erwähnen sind hier evidenzbasierte Leitlinien als Grundlage zum Erstellen und Aktualisieren von Disease Management Programmen oder die Verwendung von aus Leitlinien extrahierten Qualitätsindikatoren im Rahmen der Zertifizierung von Organtumorzentren.

1.8. Zusammensetzung der Leitliniengruppe

1.8.1. Koordination und Redaktion

Prof. Dr. med. Thomas Seufferlein, Universitätsklinikum Ulm

Projektmanagement

• Dr. med. Marc Porzner, Universitätsklinikum Ulm

• Anja Wölfer, Universitätsklinikum Halle (Saale)

1.8.2. Beteiligte Fachgesellschaften und Organisationen

In [Tab. 1] sind die Autoren der ersten Auflage (2006) und in [Tab. 2] die beteiligten Personen an der 1. Aktualisierung (2013) aufgelistet.

Tab. 1 Beteiligte Autoren und Organisationen an der ersten Auflage (2006) der Leitlinien zum exokrinen Pankreaskarzinom.

Autoren	Organisation
Adler, Guido Prof. Dr.	DGVS
Bischoff, Stephan Prof. Dr.	DGE
Brambs, Hans-Jürgen Prof. Dr.	DRG
Feuerbach, Stefan Prof. Dr.	DRG
Grabenbauer, Gerhard Prof. Dr.	DEGRO
Hahn, Stephan Prof. Dr.	DGVS
Heinemann, Volker Prof. Dr.	DGHO/AIO
Hohenberger, Werner Prof. Dr.	DGAV/CAO-V
Kopp, Ina Prof. Dr.	AWMF
Langrehr, Jan Prof. Dr.	DGCH/CAO-V
Lutz, Manfred Prof. Dr.	DGVS
Micke, Oliver PD Dr.	DEGRO
Neuhaus, Horst Prof. Dr.	DGVS
Neuhaus, Peter Prof. Dr.	DGAV
Oettle, Helmut PD Dr.	DGHO/AIO
Schlag, Peter Prof. Dr.	DGCH
Schlottmann, Klaus PD Dr.	DGVS
Schmid, Roland Prof. Dr.	DGVS
Schmiegel, Wolff Prof. Dr.	DGVS
Seufferlein, Thomas Prof. Dr.	DGVS
Werner, Jens Prof. Dr.	DGAV/CAO-V
Wiedenmann, Bertram Prof. Dr.	DGVS

Tab. 2 Beteiligte Personen und Organisationen an der 1. Aktualisierung (2013).

Autoren	Organisation
Arnold, Dirk Prof. Dr.	DGHO
Becker, Thomas Prof. Dr.	CAO-V
Büchler, Markus Prof. Dr.	CAO-V
Budach, Volker Prof. Dr.	ARO
Ceyhan, Güralp PD Dr.	DGAV
Esposito, Irene Prof. Dr.	DGP
Fietkau, Rainer Prof. Dr.	ARO
Follmann, Markus Dr. MPH, MSc	OL
Friess, Helmut Prof. Dr.	DGAV
Galle, Peter Prof. Dr.	DGVS
Geißler, Michael Prof. Dr.	DGVS
Glanemann, Matthias Prof. Dr.	CAO-V
Gress, Thomas Prof. Dr.	DGVS
Heinemann, Volker Prof. Dr.	DGHO/AIO
Hohenberger, Werner Prof. Dr.	CAO-V
Hopt, Ulrich Prof. Dr.	DGAV
Izbicki, Jakob Prof. Dr.	CAO-V/DGAV
Klar, Ernst Prof. Dr.	CAO-V
Kleeberg, Jürgen	AdP
Kleeff, Jörg Prof. Dr.	CAO-V
Klöppel, Günter Prof. Dr.	DGP
Kopp, Ina Prof. Dr.	AWMF
Kullmann, Frank Prof. Dr.	DGVS
Langer, Thomas Dipl.-Soz.Wiss.	OL
Langrehr, Jan Prof. Dr.	CAO-V
Lerch, Markus Prof. Dr.	DGVS
Löhr, Matthias Prof. Dr.	DGVS
Lüttges, Jutta Prof. Dr.	DGP
Lutz, Manfred Prof. Dr.	DGVS
Mayerle, Julia Prof. Dr.	DGVS
Michl, Patrick Prof. Dr.	DGVS
Möller, Peter Prof. Dr.	DGP
Molls, Michael Prof. Dr.	DEGRO
Münter, Marc Prof. Dr.	DEGRO
Nothacker, Monika Dr. MPH	ÄZQ/AWMF
Oettle, Helmut PD Dr.	DGHO/AIO
Porzner, Marc Dr.	DGVS
Post, Stefan Prof. Dr.	CAO-V
Reinacher-Schick, Anke Prof. Dr.	DGVS
Röcken, Christoph Prof. Dr.	DGP
Roeb, Elke Prof. Dr.	DGVS
Saeger, Hans-Detlev Prof. Dr.	CAO-V/DGAV
Schmid, Roland Prof. Dr.	DGVS
Schmiegel, Wolff Prof. Dr.	DGVS
Schoenberg, Michael Prof. Dr.	CAO-V
Seufferlein, Thomas Prof. Dr.	DGVS
Siveke, Jens PD Dr.	DGVS
Stuschke, Martin Prof. Dr.	DEGRO
Tannapfel, Andrea Prof. Dr.	DGP
Uhl, Wolfgang Prof. Dr.	DGAV
Unverzagt, Susanne Dr.	IMEBI (als externer Auftragnehmer)
van Oorschot, Birgitt Dr.	DEGRO
Vashist, Yogesh Dr.	CAO-V
Wagener, Christoph Prof. Dr.	DGKL
Werner, Jens Prof. Dr.	CAO-V/DGAV
Wylegalla, Christian	KOK
Yekebas, Emre Prof. Dr.	CAO-V
Zimpel Tanja	AdP

Die Leitliniengruppe der 1. Aktualisierung besteht aus Vertretern aller an der histopathologischen Diagnostik und Therapie des Pankreaskarzinoms im ambulanten und stationären Bereich beteiligten Fachgruppen, einschließlich der Selbsthilfegruppen. Die jeweiligen Fachgesellschaften bzw. Verbände wurden angeschrieben und gebeten, Vertreter ihrer Gruppierung in die Leitliniengruppe zu entsenden. Darüber hinaus konnten von den einzelnen Fachgruppen weitere interessierte Vertreter in die Leitliniengruppe entsandt werden.

Außerdem waren folgende Fachgesellschaften für den Leitlinienprozess angeschrieben worden: Deutsche Röntgengesellschaft, Deutsche Gesellschaft für Ernährung, Deutsche Gesellschaft für Palliativmedizin. Diese angeschriebenen Fachgesellschaften sahen sich entweder bei der Aktualisierung der behandelten Themen (s. 2.2.1) nicht gefragt und haben daher auf die Teilnahme verzichtet oder haben nicht rückgemeldet.

Die Erarbeitung der Kapitel erfolgte in Arbeitsgruppen, deren Mitglieder in [Tab. 3] aufgeführt sind. Weitere Informationen zu den Mitgliedern der Arbeitsgruppen zu Risikofaktoren/Screening/Risikogruppen, Diagnostik sowie Supportive Therapie, können dem Leitlinienreport entnommen werden.

Tab. 3 Mitglieder der Arbeitsgruppen.

Kapitel	Koordinatoren (alphabetisch, AG-Leiter fett markiert)
Risikofaktoren/Screening/Risikogruppen (2006)	Adler G., Aschoff A., Bergheim I., Bischoff S. C., Gress T., Hahn S., Keim V., Lerch M., Lüttges J., Nagel G., Rieder H., Schmid R.
Diagnostik (2006)	Brambs H.-J., Dobritz M., Möller P., Mössner J., Post S. T., Reske S. N., Riemann J. F., Rösch T. Schäfer A.-O., Schlottmann K., Uhl W., Wagener C., Wiedenmann B.
Chirurgische Therapie (2013)	Friess H., Izbicki J., Klar E., Löhr M., Post S., Schönberg M., Uhl W.
Chirurgische Therapie/Pathologie (2013)	Esposito I., Galle P., Glanemann M., Kleeff J., Klöppel G., Lüttges J., Michl P., Möller P., Röcken C., Saeger H., Tannapfel A., Vashist Y., Werner J.
Adjuvante und neoadjuvante Therapie (2013)	Arnold D., Budach V., Fietkau R., Geißler M., Hohenberger W., Hopt U., Lerch M., Oettle H., Reinacher-Schick A., Roeb E., Siveke J., Stuschke M., Yekebas E.
Palliative Therapie (2013)	Becker T., Gress T., Heinemann V., Kullmann F., Langrehr J., Lutz M., Mayerle J., Molls M., Münter M., Schmid R., Schmiegel W., van Oorschot B.
Supportive Therapie und Nachsorge (2006)	Dietrich C. F., Feil A., Feuerbach S., Graeven U., Hege-Scheuing G., Klar E., Lordick F., Micke O., Neuhaus H., Pauls S., Scheppach W., Weitz J.

1.8.3. Zusammensetzung der AG Qualitätsindikatoren

Die Entwicklung der Vorschläge zu Qualitätsindikatoren erfolgte durch die in [Tab. 4] aufgeführte Arbeitsgruppe.

Tab. 4 Zusammensetzung der AG Qualitätsindikatoren (2013).

Personen	Organisation
Dr. Markus Follmann MPH, MSc	Deutsche Krebsgesellschaft (DKG), Leitlinienprogramm Onkologie
Prof. Dr. Michael Geißler	Deutsche Gesellschaft für Verdauungs- und Stoffwechselkrankheiten (DGVS)
Prof. Dr. Frank Kullmann	Deutsche Gesellschaft für Verdauungs- und Stoffwechselkrankheiten (DGVS)
Dr. Monika Klinkhammer-Schalke	Arbeitsgemeinschaft Deutscher Tumorzentren (ADT)
Prof. Dr. Manfred Lutz	Deutsche Gesellschaft für Verdauungs- und Stoffwechselkrankheiten (DGVS)
Dr. Monika Nothacker, MPH	Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e. V. (AWMF), Leitlinienprogramm Onkologie
Prof. Dr. Thomas Seufferlein	Deutsche Gesellschaft für Verdauungs- und Stoffwechselkrankheiten (DGVS)
Prof. Dr. Andrea Tannapfel	Deutsche Gesellschaft für Pathologie (DGP)
Prof. Dr. Waldemar Uhl	Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie e. V. (DGAV)
Dr. Yogesh Vashist	Chirurgische Arbeitsgemeinschaft Onkologie (CAO-V)
Dr. Simone Wesselmann MBA	Deutsche Krebsgesellschaft (DKG), Bereich Zertifizierung

1.8.4. Patientenbeteilligung

Vertreter der Selbsthilfeorganisation Arbeitskreis der Pankreatektomierten (AdP) waren sowohl an der Erstellung, als auch an der 1. Aktualisierung der Leitlinie direkt beteiligt.

1.8.5. Methodische Begleitung bei der 1. Aktualisierung

1. durch das Leitlinienprogramm Onkologie:

   • Prof. Dr. med. Ina Kopp (AWMF), Marburg

   • Dr. Markus Follmann, MPH, MSC (DKG), Berlin

   • Dipl.-Soz.Wiss. Thomas Langer (DKG), Berlin

2. Dr. Susanne Unverzagt, Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle (Saale)

3. durch externe Auftragnehmer: Dr. Monika Nothacker, MPH (ehemals ÄZQ, heute AWMF), Berlin

1.9. Weitere Dokumente zu dieser Leitlinie

Bei diesem Dokument handelt es sich um die aktualisierte Fassung der 2006 erstmals erstellten S3-Leitlinie zum exokrinen Pankreaskarzinom. Diese Leitlinie ist über die folgenden Seiten zugänglich:

• Homepage der DGVS (www.dgvs.de)
  AWMF (www.leitlinien.net)

• Leitlinienprogramm Onkologie (http://www.leitlinienprogramm-onkologie.de/OL/leitlinien.html)

• Deutsche Krebsgesellschaft (http://www.krebsgesellschaft.de/wub_llevidenzbasiert,120 884.html)

• Deutsche Krebshilfe (http://www.krebshilfe.de/)

• Guidelines International Network (www.g-i-n.net)

Neben der Langversion gibt es folgende ergänzende Dokumente zu dieser Leitlinie:

• Kurzfassung der Leitlinie,

• Patientenleitlinie (Laienversion),

• Leitlinienreport,

• Evidenzberichte, die für die 1. Aktualisierung (2013) erstellt wurden

Alle diese Dokumente werden ebenfalls auf den o. g. Homepages abrufbar sein.

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