Der Onkologe

, Volume 15, Issue 9, pp 904–911

Spezialfälle des Endometriumkarzinoms

Fertilitätserhalt und Prävention bei Hochrisikopatientinnen
  • B.J. Winterhoff
  • J.N. Bakkum-Gamez
  • A. Mariani
  • S.C. Dowdy
Leitthema
  • 39 Downloads

Zusammenfassung

Die Operation ist die Therapie der Wahl für Patientinnen mit Endometriumkarzinom. Dazu gehört die Hysterektomie, die bilaterale Salpingooophorektomie, die Beurteilung der peritonealen Zytologie sowie die pelvine und paraaortale Lymphadenektomie bei Patientinnen mit Lymphmetastasenrisiko. Der Erhalt der Ovarien sollte bei prämenopausalen Patientinnen mit Endometriumkarzinom ernsthaft in Erwägung gezogen werden. Bei jüngeren Patientinnen gilt zwar die operative Behandlung mit Hysterektomie und Staging als Therapiestandard, aber auch eine nichtoperative Behandlung mit Hormontherapie kann für ausgewählte Frauen in Frage kommen, die ihre Fertilität erhalten wollen. Wegen des hohen Risikos eines simultanen primären Ovarialkarzinoms bei jungen Patientinnen mit Endometriumskrebs ist eine sorgfältige Untersuchung der Eierstöcke erforderlich, wenn sie erhalten werden sollen.

Die meisten Endometriumkarzinome treten sporadisch auf, aber etwa 10% der Fälle sind erblich bedingt [25, 26, 27, 28, 29]. Es sind 4 genetische Modelle für die Entstehung eines EK aufgestellt worden: das hereditäre nichtpolypöse Kolorektalkarzinom (HNPCC oder Lynch-II-Syndrom), das Cowden-Syndrom (multiples Hamartom-Syndrom, PTEN Hamartom-Tumor-Syndrom), das Peutz-Jeghers Syndrom und eine isolierte Veranlagung zum EK.

Schlüsselwörter

Endometriumkarzinom Fertilitätserhalt Prävention Hochrisikopatientinnen Genetische Modelle 

Special cases of endometrial carcinoma

Fertility retention and prevention in high-risk patients

Abstract

Surgery is the therapy of choice for patients with endometrial carcinoma, including hysterectomy, bilateral salpingo-oophorectomy, assessment of peritoneal cytology and pelvic and para-aortic lymphadenectomy for patients with a risk of lymph metastases. Retention of the ovaries should be seriously considered for premenopausal women with endometrial carcinoma. For younger patients the standard therapy is operative treatment with hysterectomy and staging but a non-surgical treatment with hormone therapy can be applied for selected patients who wish to retain fertility. Because of the high risk of a simultaneous primary ovarian carcinoma in younger patients with endometrial cancer a thorough examination of the ovaries is necessary if they are to be retained.

Most endometrial carcinomas occur sporadically but approximately 10% are genetically linked. There are 4 genetic models for the occurrence of EC: hereditary nonpolyposis colorectal carcinoma (HNPCC or Lynch II syndrome), Cowden syndrome (multiple hamartoma syndrome, PTEN hamartoma tumor syndrome), Peutz-Jeghers syndrome and an isolated predisposition for EC.

Keywords

Endometrial carcinoma Fertility retention Prevention High-risk patients Genetic models 

Supplementary material

761_2009_1685_MO1_ESM.pdf (222 kb)
englische Version des Beitrags (PDF 200 KB)

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Copyright information

© Springer Medizin Verlag 2009

Authors and Affiliations

  • B.J. Winterhoff
    • 1
  • J.N. Bakkum-Gamez
    • 1
  • A. Mariani
    • 1
  • S.C. Dowdy
    • 1
  1. 1.Division of Gynecologic Surgery, Department of Obstetrics and GynecologyMayo ClinicRochester, MNUSA

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