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Adjuvant treatment decisions for patients with endometrial cancer in Germany: results of the nationwide AGO pattern of care studies from the years 2013, 2009 and 2006

  • Original Article – Clinical Oncology
  • Published:
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Abstract

Purpose

In 2013, 2009 and 2006, the Arbeitsgemeinschaft Gynäkologische Onkologie evaluated the therapeutic approaches for endometrial carcinoma and the adherence to their guideline in Germany. Here, the adjuvant treatment decisions were presented.

Methods

A questionnaire was developed and sent to all 682 German gynecological departments in 2013 (775 in 2009 and 500 in 2006, respectively). The results of the questionnaires were compared with the recommendations of the guideline and with each other using Fisher’s exact test.

Results

Responses were available in 40.0 % in 2013, 33.3 % in 2009 and 35.8 % in 2006. Participants recommended external beam radiotherapy (EBRT) in 13 out of 16 requested stages and vaginal brachytherapy (VBT) in only 10 out of 16 requested stages as suggested by the guideline. Comparing the results of 2013 with 2009, less participants used EBRT and VBT in 7 out of 16 and in 6 out of 16 requested stages, respectively. Conversely, more participants offered adjuvant chemotherapy (CT) in 2013 (90.4 %) compared to 61.9 % in 2009 (p < 0.001) and 48.8 % in 2006 (p < 0.001), respectively. However, the stage-adjusted recommendations of CT were not in line with the guideline in 11 out of 15 requested stages. In total, 77.3 % of the participants use a multiple drug schedule with a platinum and a taxane compound.

Conclusions

The results suggest non-adherence to the guideline concerning the stage-adjusted use of VBT and CT in endometrial carcinoma. These findings emphasize great uncertainties and the need of more clarifying trials. Furthermore, a shift from radiotherapy toward CT is observable.

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Conflict of interest

The authors declare that they have no conflicts of interests.

Author information

Authors and Affiliations

  1. Department of Gynecology and Obstetrics, University Hospital Mainz, Langenbeckstr. 1, 55131, Mainz, Germany

    Marco Johannes Battista, Marcus Schmidt, Nicole Rieks, Isabel Sicking, Stefan Albrich & Gerald Hoffmann

  2. Department of Gynecology and Obstetrics, Marienkrankenhaus Frankfurt am Main, Frankfurt am Main, Germany

    Michael Eichbaum

  3. Department of Gynecology and Gynecological Oncology, Medical University of Vienna, General Hospital (AKH), Vienna, Austria

    Heinz Koelbl

  4. Department of Gynecology and Obstetrics, University Hospital of Cologne, Cologne, Germany

    Peter Mallmann

  5. Department of Gynecology and Obstetrics, GP Ruesselsheim, Ruesselsheim, Germany

    Eric Steiner

  6. Scientific Board Uterine Neoplasm of the Arbeitsgemeinschaft Gynäkologische Onkologie (AGO), Taufingen, Germany

    Michael Eichbaum, Peter Mallmann & Eric Steiner

Authors
  1. Marco Johannes Battista
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  2. Marcus Schmidt
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  3. Nicole Rieks
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  4. Isabel Sicking
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  5. Stefan Albrich
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  6. Michael Eichbaum
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  7. Heinz Koelbl
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  8. Peter Mallmann
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  9. Gerald Hoffmann
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  10. Eric Steiner
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Corresponding author

Correspondence to Marco Johannes Battista.

Appendix

Appendix

  1. 1.

    In which stage of an endometrioid endometrial carcinoma do you recommend the external beam radiotherapy? (multiple answers possible).

    • FIGO IA G1, FIGO IA G2, FIGO IA G3, FIGO IB G1, FIGO IB G2, FIGO IB G3, FIGO II, FIGO III, FIGO IVA, FIGO IVB, N+ , Nx.

  2. 2.

    In which stage of an endometrioid endometrial carcinoma do you recommend the radiotherapy of the vaginal vault? (multiple answers possible).

    • FIGO IA G1, FIGO IA G2, FIGO IA G3, FIGO IB G1, FIGO IB G2, FIGO IB G3, FIGO II, FIGO III, FIGO IVA, FIGO IVB, N+ , Nx.

  3. 3.

    Do you offer chemotherapy in an adjuvant setting? Yes or No

  4. 4.

    In which of the following cases do you offer chemotherapy?

    • I do not offer chemotherapy in an endometrioid EC. Yes or No

    • I offer chemotherapy in a case with an endometrioid EC and a…

    • … FIGO IA, G3. Yes or No

    • … FIGO IB, G1. Yes or No

    • … FIGO IB, G3. Yes or No

    • … FIGO II, G1. Yes or No

    • … FIGO II, G3. Yes or No

    • … FIGO III/IVA. Yes or No

    • … lymph node positive disease. Yes or No

    • I offer chemotherapy in every endometrioid EC. Yes or No

    • I offer chemotherapy in a serous-papillary EC and stage …

    • ... FIGO IA. Yes or No

    • … FIGO IB. Yes or No

    • … FIGO II. Yes or No

    • … FIGO III/IVA. Yes or No

    • … lymph node positive disease. Yes or No

    • I offer chemotherapy in every serous-papillary EC. Yes or No

  5. 5.

    Which chemotherapy do you use in an adjuvant setting? (multiple answers possible)

    • I use 6 courses of a …

    • … multiple drug chemotherapy with a platinum and a taxane compound. Yes or No

    • … multiple drug chemotherapy with a platinum compound without a taxane compound. Yes or No

    • … multiple drug chemotherapy without a platinum compound. Yes or No

    • … single drug chemotherapy with a platinum compound. Yes or No

    • … a single drug chemotherapy with an anthracycline compound. Yes or No

    • … a single drug chemotherapy with a taxane compound. Yes or No

    • … a single drug chemotherapy with another compound. Yes or No.

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Battista, M.J., Schmidt, M., Rieks, N. et al. Adjuvant treatment decisions for patients with endometrial cancer in Germany: results of the nationwide AGO pattern of care studies from the years 2013, 2009 and 2006. J Cancer Res Clin Oncol 141, 555–562 (2015). https://doi.org/10.1007/s00432-014-1834-9

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  • DOI: https://doi.org/10.1007/s00432-014-1834-9

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