Geburtshilfe Frauenheilkd 2014; 74(3): 244-247
DOI: 10.1055/s-0034-1368268
Original Article
GebFra Science
Georg Thieme Verlag KG Stuttgart · New York

Recommendations for the Diagnosis and Treatment of Endometrial Cancer, Update 2013

Empfehlungen zur Diagnostik und Therapie des Endometriumkarzinoms, Update 2013
G. Emons
1   Universitäts-Frauenklinik, Gynäkologisches Krebszentrum, Göttingen
,
P. Mallmann
2   Universitäts-Frauenklinik, Gynäkologisches Krebszentrum, Köln
,
acting for the Uterus Commission of AGO › Author Affiliations
Further Information

Publication History

Publication Date:
09 April 2014 (online)

Introduction

The S2k guideline “Diagnosis and Treatment of Endometrial Cancer” was published on June 1, 2008; some of the recommendations in the guideline are still up-to-date; however, others are out-of-date and no longer apply. The update will be carried out in accordance with the requirements of the German National Cancer Plan and will lift the guideline into the S3 category. We expect that the funding required for the update will be available from the 2nd half of this year. Even if work starts promptly, the S3 guideline will only be available from the beginning of 2016 at the earliest. As an interim solution for the period for which no guideline is available, the Uterus Commission ([Table 2]) has issued recommendations for the diagnosis and treatment in April 2011, which were since updated in April 2013. The FIGO/TNM staging system ([Table 1]) was used.

Table 1 The new FIGO/TNM classification for endometrial cancer.

TNM categories

FIGO stages

Definitions

1 Endocervical glandular involvement should only be considered as stage I.
2 Positive cytology must be diagnosed separately and recorded without changing the stage.
3 Bullous edema is not sufficient to classify a tumor as T4. Invasion of bladder mucosa or bowel mucosa must be confirmed with biopsy.

TX

Primary tumor cannot be assessed

T0

No evidence of primary tumor

T1

I1

Tumor confined to corpus uteri

T1a

IA1

Tumor limited to endometrium or invades less than one half of the myometrium

T1b

IB

Tumor invades one half or more of the myometrium

T2

II

Tumor invades stromal connective tissue of the cervix but does not extend beyond uterus

T3 and/or N1

III

Local and/or regional extension or metastasis as described below:

T3a

IIIA

Tumor involves serosa or adnexa (direct extension or metastasis)

T3b

IIIB

Vaginal involvement or parametrial involvement (direct extension or metastasis)

N1

IIIC

Metastasis to pelvic and/or para-aortic lymph nodes2

IIIC1

Metastasis to pelvic lymph nodes

IIIC2

Metastasis to para-aortic lymph nodes

T4

IVA

Tumor invades bladder mucosa and/or bowel mucosa3

M1

IVB

Distant metastasis (excludes metastasis to the vagina, pelvic serosa or adnexa; includes metastasis to inguinal and intra-abdominal lymph nodes other than para-aortic and/or pelvic lymph nodes)

Table 2 Uterus Commission of AGO of the DGGG (German Society for Gynecology and Obstetrics) and the DKG (German Cancer Society).

Gynecological Oncology

  • Prof. Dr. M. W. Beckmann, Erlangen

  • Prof. Dr. D. Denschlag, Bad Homburg

  • Prof. Dr. G. Emons, Göttingen

  • Priv.-Doz. Dr. M. Fleisch, Düsseldorf

  • Prof. Dr. P. Hillemanns, Hannover

  • Dr. I. Juhasz-Böss, Homburg/Saar

  • Prof. Dr. L. Kiesel, Münster

  • Prof. Dr. R. Kimmig, Essen

  • Priv.-Doz. Dr. C. Köhler, Berlin

  • Prof. Dr. B. Lampe, Düsseldorf

  • Prof. Dr. W. Lichtenegger, Berlin

  • Prof. Dr. P. Mallmann, Cologne (Commission spokesman)

  • Priv.-Doz. Dr. H. Pilch, Cologne

  • Priv.-Doz. Dr. D. Rein, Cologne (Deputy Commission spokesman)

  • Prof. Dr. I. Runnebaum, Jena

  • Priv.-Doz. Dr. E. Steiner, Rüsselsheim

  • Dr. H. Strauss, Halle/Saale

  • Prof. Dr. C. Tempfer, Herne

  • Prof. Dr. U. Ulrich, Berlin

Radiation Oncology

  • Prof. Dr. S. Marnitz, Berlin

  • Prof. Dr. V. Strnad, Erlangen

  • Prof. Dr. D. Vordermark, Halle/Saale (ARO representative)

Pathology

  • Prof. Dr. L. C. Horn, Leipzig

  • Prof. Dr. D. Schmidt, Mannheim