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Frauenheilkunde up2date 2021; 15(01): 43-61
DOI: 10.1055/a-1098-0234
Gynäkologische Onkologie

Reproduktive Faktoren und das Ovarialkarzinomrisiko

Susanne Schüler-Toprak
,
Olaf Ortmann
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Trotz intensiver wissenschaftlicher Bemühungen handelt es sich beim Ovarialkarzinom um das gynäkologische Malignom mit der höchsten Mortalität. Parität, Laktation, aber auch das Alter bei Menarche und Menopause beeinflussen das Risiko, an einem Ovarialkarzinom zu erkranken. Dieser Artikel vermittelt einen Überblick über den Einfluss dieser reproduktiven Faktoren auf das Ovarialkarzinomrisiko entsprechend dem aktuellen Stand der Wissenschaft.
Kernaussagen

  • Beim Ovarialkarzinom handelt es sich um eine heterogene Erkrankung. Man unterteilt in Typ-I- und Typ-II-Karzinome, die sich sowohl in ihrer Entstehung als auch in ihrem Verhalten deutlich voneinander unterscheiden.

  • Auch die verschiedenen histologischen Subtypen wiesen eine unterschiedliche Karzinogenese auf. Leider wird in den bisherigen Arbeiten darauf und auf die Konsequenzen, die sich für die Therapie der Erkrankung ergeben, noch viel zu wenig eingegangen.

  • Das Ovarialkarzinom ist ein endokrin beeinflusster Tumor. Auch hier ist davon auszugehen, dass der Einfluss reproduktiver Faktoren auf die Entstehung der Malignome sich in den einzelnen histologischen Subgruppen deutlich voneinander unterscheidet. Allerdings war bislang die Beurteilung aufgrund oftmals kleiner Fallzahlen eingeschränkt. In zukünftigen Arbeiten wird man ein besonderes Augenmerk darauf legen müssen.

  • Verschiedene Hypothesen versuchen, das Verständnis für die Entstehung von Ovarialkarzinomen und den Einfluss reproduktiver Faktoren zu verbessern: Die Ovulationshypothese, die Gonadotropinhypothese und die Androgen-/Progesteronhypothese.

  • Eine späte Menarche und frühe Menopause reduzieren das Risiko für ein Ovarialkarzinom.

  • Den stärksten protektiven Effekt unter den reproduktiven Faktoren bewirkt Parität.

  • Auch Laktation mindert das Risiko, an einem Ovarialkarzinom zu erkranken.

  • Infertilität erhöht das Ovarialkarzinomrisiko. Allerdings handelt es sich hierbei um ein sehr heterogenes Krankheitsbild. Eine Beurteilung der verschiedenen Infertilitätsursachen ist sicherlich unabdingbar.

Schlüsselwörter

Ovarialkarzinom - Risikofaktoren - reproduktive Faktoren - Parität - Laktation


Publication History

Article published online:
10 February 2021

© 2021. Thieme. All rights reserved.

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