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Hot Topic – Operative Strategien beim Ovarialkarzinom

A hot topic—Surgical strategies in ovarian cancer

  • Hot-Topic
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best practice onkologie Aims and scope

Zusammenfassung

Die Debulking-Operation mit anschließender platin- und taxanbasierten adjuvanten Therapie gilt als Therapiestandard für das fortgeschrittene Ovarialkarzinom. Aufgrund später Symptome wird das Ovarialkarzinom zumeist im fortgeschrittenen Stadium diagnostiziert. Patientinnen mit optimaler Tumorresektion (makroskopische Tumorfreiheit) haben die beste Prognose, dies trifft sowohl in der Primär- als auch in der Rezidivsituation zu. Bislang gibt es keine Methode, um die Möglichkeit einer vollständigen Tumorentfernung vorherzusagen. Das neoadjuvante Therapiekonzept mit anschließender Intervall-Op. kommt für die Patientin im schlechten Zustand infrage, wenn eine kurzfristige Verbesserung unwahrscheinlich erscheint bzw. wenn eine Tumorreduktion < 1 cm nicht möglich ist. Eine primäre Chemotherapie sollte bei Patientinnen mit unresezierbarer Tumorlast erfolgen. Bei platinsensitivem Rezidiv ist die Möglichkeit einer Rezidiv-Op. zu prüfen und ggf. anzubieten. Alle Ovarialkarzinompatientinnen sollten an einem Gyn-Onko-Zentrum von einem gynäkologischen Onkologen behandelt werden.

Abstract

It is well established that optimal cytoreduction followed by a combination of platinum- and taxane-based chemotherapy represents the standard of care for advanced ovarian cancer. Due to the lack of early symptoms, ovarian cancer is usually diagnosed at an already advanced stage. Cytoreductive surgery is the cornerstone of multimodal therapy in advanced ovarian cancer and relapse, the amount of residual tumor is one of the most important prognostic factors for both progression-free and overall survival. The factors predicting no postoperative residual tumor are yet to be identified. Neoadjuvant chemotherapy with consecutive interval debulking surgery should be reserved for patients with poor health status, when rapid improvement is unlikely or when tumor reduction < 1 cm is not possible. Patients with unresectable disease are candidates for primary chemotherapy. In the event of platinum-sensitive relapse, the possibility of surgery should be evaluated and offered, where appropriate. All ovarian cancer patients should be treated by a gynecologic oncologist at a cancer center.

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  1. Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie, Campus Virchow-Klinikum, Universitätsmedizin Berlin – Charité, Augustenburger Platz 1, 13353, Berlin, Deutschland

    A. M. Dückelmann &  J. Sehouli

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  1. A. M. Dückelmann
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A.M. Dückelmann und J. Sehouli geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Dückelmann, A.M., Sehouli, J. Hot Topic – Operative Strategien beim Ovarialkarzinom. best practice onkologie 16, 154–164 (2021). https://doi.org/10.1007/s11654-021-00303-1

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