Patients treated for endometrial cancer who develop urinary incontinence must be offered appropriate therapy as outlined in the German-language S2e-guideline on incontinence: “Interdisziplinäre S2e-Leitlinie für die Diagnostik und Therapie der Belastungsinkontinenz der Frau” Patients with stage pT1pNX (all grades) endometrial cancer with “substantial LVSI” (the highest stage of the three-stage grading system for lymph node invasion) may be treated with percutaneous pelvic radiotherapy instead of vaginal brachytherapy. Patients with type I (stage pT1b pNX G3 or stage pT2 pNX) endometrioid endometrial cancer should be given vaginal brachytherapy; alternatively they may be treated with percutaneous radiotherapy.
If a patient with atypical endometrial hyperplasia wishes to preserve her uterus, the uterus and adnexa may be preserved if hysteroscopy with targeted biopsy or curettage is performed to confirm the diagnosis, and the diagnosis of “atypical hyperplasia” was either made or confirmed by a pathologist with a lot of experience in gynecological pathology. If a patient with atypical endometrial hyperplasia wishes to preserve her uterus, the uterus and adnexa may be preserved if the patient is informed that the standard treatment, which is almost always curative, is total hysterectomy; the patient agrees to close and regular monitoring; and the patient is informed that total hysterectomy will be necessary after she has either fulfilled her wish to have children or decided not to have children. Management of AEH in postmenopausal women or premenopausal women who do not wish to have children
The role of cytoreductive surgery for newly diagnosed advanced-stage uterine carcinosarcoma. Assessing the effects of lymphadenectomy and radiation therapy in patients with uterine carcinosarcoma: a SEER analysis. Surgery for endometrial cancers with suspected cervical involvement: is radical hysterectomy needed (a GOTIC study)?
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The uterus and adnexa may be preserved in women with endometrioid adenocarcinoma of the endometrium (cT1A, G1) with no evidence of myometrial infiltration and with progesterone receptor expression who wish to preserve their uterus if the following conditions are met: A hysterectomy should be carried out if the cancer does not respond to 6 months of conservative treatment. After the patient has had children or no longer wishes to have children, a total hysterectomy (with or without bilateral salpingectomy and with or without bilateral oophorectomy) must be carried out. If AEH is in complete remission after 6 months of conservative treatment, the patient should try for the planned pregnancy she wants.
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Statements are adopted after a formal consensus process using the same approach as that used when formulating recommendations and can be based either on study results or expert opinions. Recommendations are thematically grouped key sentences with a recommendation for action, which were developed by the guideline group and voted on in a formal consensus procedure.
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The uterus and adnexa may be preserved in women with early endometrial cancer who wish to preserve their uterus if the patient is given the recommendation to consult a specialist for reproductive medicine to assess her likelihood of being able to conceive and bear a child. The uterus and adnexa may be preserved in women with endometrial cancer who want to have (further) children and wish to preserve their fertility if the patient is informed that the standard treatment, which is almost always curative, is total hysterectomy; the patient temporarily eschews curative treatment of the malignancy at her own responsibility and is fully aware of the potentially fatal consequences (disease progression, metastasis) even if a pregnancy is carried to term. The recommendations of the guideline are aimed at all women with endometrial cancer and their relatives. Radiotherapy and adjuvant medical therapy to treat endometrial cancer and uterine carcinosarcomas are described. Kerrin opens up about how life has been since stepping away from the stage for a long off-season after non-stop prep for her pro card.
At our stand the nearly 500 participants were not only able to taste our delicious and healthy smoothies, but also learn a lot about the africrops! Special attention was paid to Africa and the topic of food security – areas in which africrops! Federal Minister of Food and Agriculture Julia Klöckner and Federal Minister for Economic Cooperation and Development Gerd Müller were among the speakers of a high-level programme. The “German Pavilion” was named the best foreign stand at the Saba Saba trade fair by the Tanzanian Prime Minister. The presence of German companies in Tanzania is highly appreciated by representatives of the Tanzanian politicians and the business community.