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Frauenheilkunde up2date 2022; 16(03): 233-245
DOI: 10.1055/a-1333-0071
Operative Gynäkologie

Operative Therapie des Endometriumkarzinoms und mögliche Entwicklungen

Gerhard Gebauer
,
Tanja Fehm
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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


Publikationsverlauf

Artikel online veröffentlicht:
08. Juni 2022

© 2022. Thieme. All rights reserved.

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