Adipositas in der gynäkologischen Onkologie

Zusammenfassung

Als Folge der weltweit seit Jahrzehnten ansteigenden Adipositasprävalenz stellen die zunehmende Anzahl an Neudiagnosen adipositasassoziierter Malignome und damit einhergehende diagnostische und therapeutische Implikationen gynäkoonkologische Behandlungsstrategien vor eine Herausforderung. Im Spiegel der aktuellen Studienlage besteht solide Evidenz für eine unabhängige, linear positive Korrelation zwischen einem pathologisch erhöhten Body-Mass-Index und der Erkrankungswahrscheinlichkeit für Endometrium- und postmenopausale Mammakarzinome. Die Pathogenese ist komplex und Gegenstand intensiver Forschung, pathologisch erhöhte Serumspiegel von Sexualsteroiden und Adiponektinen, eine adipositasinduzierte Insulinresistenz sowie systemische Inflammationsprozesse werden als ursächlich diskutiert. Für andere gynäkologische Malignome zeigt sich die wissenschaftliche Evidenz weniger solide, Adipositas erscheint als Risikofaktor für epitheliale Ovarial,- Zervix und Vulvakarzinome von vergleichsweise untergeordneter klinischer Relevanz. Ein negativer Einfluss auf die Prognose und das onkologische Outcome zeigt sich hingegen für alle Tumorentitäten nachvollziehbar, wobei eine abschließende Bewertung, ob dieser Effekt korrelativ oder kausal zu interpretieren ist, weiterhin aussteht.

Schlüsselwörter

Adipositas - gynäkologische Malignome - BMI

Publication History

Received: 15 June 2020

Accepted after revision: 25 July 2020

Article published online:
03 December 2020

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