Operative Therapie des Endometriumkarzinoms und mögliche Entwicklungen

Postmenopausenblutungen bei dickem Endometrium weisen auf ein Endometriumkarzinom hin. 20% der Endometriumkarzinome betreffen jedoch prämenopausale Frauen. Die Standardtherapie des Endometriumkarzinoms besteht in der kompletten Hysterektomie und bilateralen Salpingo-Ovarektomie, kann jedoch bei Wunsch nach Fertilitätserhalt in bestimmten Fällen verzögert werden. Zusätzlich geben tumorbiologische Faktoren Entscheidungshilfe für das OP-Management.

Kernaussagen

• Das Endometriumkarzinom stellt weltweit die vierthäufigste Krebserkrankung bei Frauen dar.

• Typisches Frühsymptom des Endometriumkarzinoms ist die postmenopausale Blutung.

• Aufgrund früher Diagnosestellung ist die Prognose im Vergleich zu anderen gynäkologischen Malignomen gut.

• Die operative Standardtherapie des Endometriumkarzinoms besteht in der kompletten Hysterektomie und bilateralen Salpingo-Ovarektomie.

• Die operative Therapie des Endometriumkarzinoms ist in den letzten Jahren von Ansätzen zur De-Eskalation der operativen Radikalität charakterisiert.

• Dabei ist vor allem die Lymphonodektomie im Fokus.

• Sie kann einerseits erhebliche postoperative Morbidität hervorrufen, beeinflusst andererseits aber die Stratifizierung der adjuvanten Therapie bislang maßgeblich.

• Die Einführung einer tumorbiologischen Klassifikation des Endometriumkarzinoms wird in Zukunft auch das operative Management beeinflussen.

Schlüsselwörter

Laparoskopie - Laparotomie - Hysterektomie - Abrasio - Fertilitätserhalt - Lymphknotenstatus - Ovarialkarzinom

Publication History

Article published online:
08 June 2022

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