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Aim This update of the interdisciplinary S3 guideline on the Diagnosis, Therapy and Follow-up of Cervical Cancer (AWMF Registry No. 032/033OL) was published in March 2021. This updated guideline was funded by German Cancer Aid (Deutsche Krebshilfe) as part of the German Guideline Program in Oncology. The guideline was coordinated by the German Society of Gynecology and Obstetrics (Deutsche Gesellschaft für Gynäkologie und Geburtshilfe, DGGG) and the Working Group on Gynecological Oncology (Arbeitsgemeinschaft Gynäkologische Onkologie, AGO) of the German Cancer Society (Deutsche Krebsgesellschaft, DKG). Method The process of updating the S3 guideline dating from 2014 was based on an appraisal of the available evidence using the criteria of evidence-based medicine, adaptations of existing evidence-based national and international guidelines or – if evidence was lacking – on a consensus of the specialists involved in compiling the update. After an initial review of the current literature was carried out according to a prescribed algorithm, several areas were identified which, in contrast to the predecessor version from September 2014, required new recommendations or statements which took account of more recently published literature and the appraisal of the new evidence. Recommendations The short version of this guideline consists of recommendations and statements on the epidemiology, screening, diagnostic workup and therapy of patients with cervical cancer. The most important new aspects included in this updated guideline include the newly published FIGO classification of 2018, the radical open surgery approach for cervical cancers up to FIGO stage IB1, and use of the sentinel lymph node technique for tumors ≤ 2 cm. Other changes include the use of PET-CT, new options in radiotherapy (e.g., intensity-modulated radiotherapy, image-guided adaptive brachytherapy), and drug therapies to treat recurrence or metastasis.

Summary The first German interdisciplinary S3-guideline on the diagnosis, therapy and follow-up of patients with endometrial cancer was published in April 2018. Funded by German Cancer Aid as part of an Oncology Guidelines Program, the lead coordinators of the guideline were the German Society of Gynecology and Obstetrics (DGGG) and the Gynecological Oncology Working Group (AGO) of the German Cancer Society (DKG). Purpose Using evidence-based, risk-adapted therapy to treat low-risk women with endometrial cancer avoids unnecessarily radical surgery and non-useful adjuvant radiotherapy and/or chemotherapy. This can significantly reduce therapy-induced morbidity and improve the patientʼs quality of life as well as avoiding unnecessary costs. For women with endometrial cancer and a high risk of recurrence, the guideline defines the optimal extent of surgical radicality together with the appropriate chemotherapy and/or adjuvant radiotherapy if required. An evidence-based optimal use of different therapeutic modalities should improve the survival rates and quality of life of these patients. This S3-guideline on endometrial cancer is intended as a basis for certified gynecological cancer centers. The aim is that the quality indicators established in this guideline will be incorporated in the certification processes of these centers. Methods The guideline was compiled in accordance with the requirements for S3-level guidelines. This includes, in the first instance, the adaptation of source guidelines selected using the DELBI instrument for appraising guidelines. Other consulted sources included reviews of evidence, which were compiled from literature selected during systematic searches of literature databases using the PICO scheme. In addition, an external biostatistics institute was commissioned to carry out a systematic search and assessment of the literature for one part of the guideline. Identified materials were used by the interdisciplinary working groups to develop suggestions for Recommendations and Statements, which were then subsequently modified during structured consensus conferences and/or additionally amended online using the DELPHI method, with consent between members achieved online. The guideline report is freely available online. Recommendations Part 2 of this short version of the guideline presents recommendations for the therapy of endometrial cancer including precancers and early endometrial cancer as well as recommendations on palliative medicine, psycho-oncology, rehabilitation, patient information and healthcare facilities to treat endometrial cancer. The management of precancers of early endometrial precancerous conditions including fertility-preserving strategies is presented. The concept used for surgical primary therapy of endometrial cancer is described. Radiotherapy and adjuvant medical therapy to treat endometrial cancer and uterine carcinosarcomas are described. Recommendations are given for the follow-up care of endometrial cancer, recurrence and metastasis. Palliative medicine, psycho-oncology including psychosocial care, and patient information and rehabilitation are presented. Finally, the care algorithm and quality assurance steps for the diagnosis, therapy and follow-up of patients with endometrial cancer are outlined.

Purpose This is an official guideline, published and coordinated by the Gynecological Oncology Working Group (AGO) of the German Cancer Society (DKG) and the German Society for Gynecology and Obstetrics (DGGG). Vaginal cancers are rare tumors, which is why there is very little evidence on these tumors. Knowledge about the optimal clinical management is limited. This first German S2k guideline on vaginal cancer has aimed to compile the most current expert knowledge and offer new recommendations on the appropriate treatment as well as providing pointers about individually adapted therapies with lower morbidity rates than were previously generally available. The purpose of this guideline is also to set up a register to record data on treatment data and the course of disease as a means of obtaining evidence in future. Methods The present S2k guideline was developed by members of the Vulvar und Vaginal Tumors Commission of the AGO in an independently moderated, structured, formal consensus process and the contents were agreed with the mandate holders of the participating scientific societies and organizations. Recommendations To optimize the daily care of patients with vaginal cancer: 1. Monitor the spread pattern; 2. Follow the step-by-step diagnostic workup based on initial stage at detection; 3. As part of individualized clinical therapeutic management of vaginal cancer, follow the sentinel lymph node protocol described here, where possible; 4. Participate in the register study on vaginal cancer.

Der Beitrag schildert die Sichtweise und die Erfahrungen der Au torin als Praxismanagerin in einer onkologischen Tagesklinik sowie als Vorstandssprecherin der Konferenz onkologischer Kranken- und Kinderkrankenpflege (KOK) in der Deutschen Krebsgesellschaft e. V. (DKG). Es werden Kriterien fur die Bemessung der Versorgungsqualitat erortert, ferner wird auf die individuelle Situation des krebskranken Patienten im Fokus der Pflege eingegangen. Die Betrachtung der Rolle der Pflegeberatung in besonderem Hinblick auf die Forderung der Patientenkompetenz bildet einen weiteren Schwerpunkt.

Summary The first German interdisciplinary S3-guideline on the diagnosis, therapy and follow-up of patients with endometrial cancer was published in April 2018. Funded by German Cancer Aid as part of an Oncology Guidelines Program, the lead coordinators of the guideline were the German Society of Gynecology and Obstetrics (DGGG) and the Gynecological Oncology Working Group (AGO) of the German Cancer Society (DKG). Purpose The use of evidence-based, risk-adapted therapy to treat low-risk women with endometrial cancer avoids unnecessarily radical surgery and non-useful adjuvant radiotherapy and/or chemotherapy. This can significantly reduce therapy-induced morbidity and improve the patientʼs quality of life as well as avoiding unnecessary costs. For women with endometrial cancer and a high risk of recurrence, the guideline defines the optimal surgical radicality together with the appropriate chemotherapy and/or adjuvant radiotherapy where required. The evidence-based optimal use of different therapeutic modalities should improve survival rates and the quality of life of these patients. The S3-guideline on endometrial cancer is intended as a basis for certified gynecological cancer centers. The aim is that the quality indicators established in this guideline will be incorporated in the certification processes of these centers. Methods The guideline was compiled in accordance with the requirements for S3-level guidelines. This includes, in the first instance, the adaptation of source guidelines selected using the DELBI instrument for appraising guidelines. Other consulted sources include reviews of evidence which were compiled from literature selected during systematic searches of literature databases using the PICO scheme. In addition, an external biostatistics institute was commissioned to carry out a systematic search and assessment of the literature for one area of the guideline. The identified materials were used by the interdisciplinary working groups to develop suggestions for Recommendations and Statements, which were then modified during structured consensus conferences and/or additionally amended online using the DELPHI method with consent being reached online. The guideline report is freely available online. Recommendations Part 1 of this short version of the guideline presents recommendations on epidemiology, screening, diagnosis and hereditary factors, The epidemiology of endometrial cancer and the risk factors for developing endomentrial cancer are presented. The options for screening and the methods used to diagnose endometrial cancer including the pathology of the cancer are outlined. Recommendations are given for the prevention, diagnosis, and therapy of hereditary forms of endometrial cancer.

Geburtshilfe und Frauenheilkunde 78(11), 1056-1088 (2018). doi:10.1055/a-0646-4630, Published by Thieme, New York, NY

Introduction: Lack of compliance and adherence in oral and s.c. treatment of breast cancer (BC) are huge problems leading to significant impacts in morbidity and mortality. During long term treatment, constant patient contact can’t be secured and possible side effects not be treated adequately. Where conventional mailing systems failed, as reported in the PACT program, eHealth could be a possible solution to increase adherence among patients and to ameliorate the communication between patients, oncologist and nurses. The objective of this study is to investigate the actual internet usage habits and property of new media among BC patients, their oncologists and the nursing staff to find new possible ways to improve compliance and adherence in long term treatment. Methods: By using 3 different questionnaires (33 items), the actual usage of internet and modern media among BC patients and their healthcare professionals (oncologists and nursing staff) is surveyed. Also, the equipment of media (computer, smartphone, etc.) in private as well as in business use is investigated. Huge care and attention is given to possible future eHealth systems for additional patient support. The collected data also includes age, sex, workplace and, in case of medical professionals, their emphasis. Patients completed the questionnaire at two patient conventions and before consultations, oncologists and nurses were asked to answer the questionnaire at several local BC meetings. Results: 631 patients, 120 oncologists and 96 nurses completed the questionnaire in 2013. The internet usage in general and for health related issues is very high among all three subgroups (patients: 93% and 77%, respectively; oncologists: 100% and 98%; nurses: 92% and 93%). Among patients, even above age 60, 51% report to use the internet every day. Taking a look at participant’s equipment of new media, the property of a personal computer is very high (78%; 99%; 95%). Medical professionals as well as the majority of patients can imagine getting additional support during long term therapy using eHealth technologies (e.g. for monitoring of and interventions concerning side effects) (see table). Discussion: This survey, which is the first BC specific study representing internet usage habits among BC patients and their medical professionals, shows high acceptance of new interactive ways of communication between patients, doctors and nurses who are all taking part in treatment of BC. Introducing eHealth may help increase compliance and improve and individualize the doctor-patient-relationship which will possibly lead to decreased mortality and higher patient and staff satisfaction. Table 1 PatientsDoctorsNursing StaffNumber of participants63112096Internet usage in general92.7% (495/534)100% (119/119)91.7% (88/96)Property of media:PC77.7% (490/631)99.2% (119/120)94.8% (91/96)Smartphone25.5% (161/631)70.8% (85/120)45.8% (44/96)Wish for additional patient support:via Internet53.8% (276/513)66.4% (79/119)56.8% (54/95)via Smartphone24.2% (119/49251.3% (60/117)31.1% (28/90)Registration of side effects via electronic devices41.1% (204/497)71.2% (84/118)56.1% (51/91) Citation Format: Rachel Wuerstlein, Thomas Kirkovits, Caroline Drewes, Daniel Schiltz, Ingo Bauerfeind, Renate Haidinger, Kerstin Paradies, Ursula Goldmann-Posch, Timo Schinkoethe, Nadia Harbeck. eHealth in modern breast cancer treatment: New possibilities in communication between patients, doctors and nursing staff [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P2-10-05.