title: Management of recurrent or metastatic endometrial cancer in Germany: results of the nationwide AGO pattern of care studies from the years 2013, 2009 and 2006.
abstract: OBJECTIVE
  The available literature on the treatment options for recurrent or metastatic endometrial cancer (EC) is full of controversies. Therefore, we explore the results of the AGO pattern of care studies from the years 2013, 2009 and 2006.
  
  
  METHODS
  A questionnaire was developed and sent to all 682 German gynecological departments in 2013 (775 in 2009, 500 in 2006, respectively). The results of the questionnaires were compared 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. In 2013 the most preferred endocrine drug was progestin (79.8 %), followed by tamoxifen (42.8 %), aromatase inhibitor (19.8 %), fulvestrant (16.3 %) and a combination (3.9 %) (p < 0.001). 65.3, 59.8, 51.7 and 38.2 % of the participants used platinum, taxane, a combination of cytostatic drugs, anthracycline in metastatic EC, respectively (p = 0.215). 96.2, 92.7, 49.8 and 60.9 % of the participants performed an operation, radiotherapy, endocrine therapy and chemotherapy in 2013 because of a local recurrence, respectively (p < 0.001). Compared to 2009 and 2006 these rates remained stable (no p value <0.05). Because of a distant metastasis 50.4, 64.2, 78.5 and 90.8 % of the participants performed an operation, radiotherapy, endocrine therapy and chemotherapy in 2013, respectively (p < 0.001). Compared to 2009 and 2006 more participants performed an operation or radiotherapy and less an endocrine treatment.
  
  
  CONCLUSIONS
  Whereas progestin was the favorite drug, the participants of this study did not prefer a specific cytostatic drug for metastatic EC in 2013. This might have reflected the available literature, which did not provide a real standard of care.
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital Mainz, Langenbeckstr. 1, 55131, Mainz, Germany. battist@uni-mainz.de.
authors.forename: Marco Johannes
authors.initials: MJ
authors.lastname: Battista
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Schmidt
authors.affiliation: Department of Gynecology and Obstetrics, Marienkrankenhaus Frankfurt, Frankfurt, Germany.|Scientific Board Uterine Neoplasm of the Arbeitsgemeinschaft Gynäkologische Onkologie (AGO), Taufkirchen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Eichbaum
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.
authors.forename: Katrin
authors.initials: K
authors.lastname: Almstedt
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Heimes
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital of Cologne, Cologne, Germany.|Scientific Board Uterine Neoplasm of the Arbeitsgemeinschaft Gynäkologische Onkologie (AGO), Taufkirchen, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Mallmann
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.
authors.forename: Gerald
authors.initials: G
authors.lastname: Hoffmann
authors.affiliation: Department of Gynecology and Obstetrics, GP Ruesselsheim, Ruesselsheim, Germany.|Scientific Board Uterine Neoplasm of the Arbeitsgemeinschaft Gynäkologische Onkologie (AGO), Taufkirchen, Germany.
authors.forename: Eric
authors.initials: E
authors.lastname: Steiner
mesh_terms: D047072:Aromatase Inhibitors / Q000627:therapeutic use; D019468:Disease Management; D016889:Endometrial Neoplasms / Q000473:pathology / Q000628:therapy*; D005260:Female; D005858:Germany; D019538:Health Care Surveys; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011372:Progestins / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D013629:Tamoxifen / Q000627:therapeutic use
chemical_list: D047072:Aromatase Inhibitors; D011372:Progestins; D013629:Tamoxifen
keywords: Chemotherapy; Endocrine treatment; Endometrial cancer; Pattern of care; Radiotherapy