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Zervixkarzinom

Alte Entität − neue Therapieformen

Cervical cancer

Old entity – new therapy regimens

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Der Gynäkologe Aims and scope

Zusammenfassung

Die Einführung des zytologischen Screenings hat zu einer sinkenden Inzidenz des Zervixkarzinoms in Deutschland geführt, und es besteht die begründete Hoffnung, dass die HPV-Impfung zu einem weiteren Rückgang führen wird. Auch für die primäre Behandlung von Patientinnen mit manifestem Karzinom haben sich in den letzten Jahren technische und konzeptionelle Neuerungen ergeben. Hier vorgestellt werden aktuelle Vorgehensweisen in Diagnostik und Therapie, diskutiert werden die Beiträge von Magnetresonanz- (MRT) und Positronenemissionstomographie (PET) zum prätherapeutischen Staging und minimal-invasive Techniken zur Reduktion des operativen Traumas. Die totale mesometriale Resektion (TMMR) ist eine neue, kontrovers diskutierte chirurgische Technik, die auf einem Tumorausbreitungsmodell innerhalb morphogenetischer Einheiten basiert. Die ersten Daten deuten darauf hin, dass die TMMR in Kombination mit der therapeutischen Lymphonodektomie auch in Fällen mit histopathologischen Risikofaktoren lokale und regionale Tumorkontrolle gewährleistet.

Abstract

The introduction of cytological screening has led to a reduction in the incidence of cervical cancer in Germany and there is reason to hope that human papillomavirus (HPV) inoculation will lead to a further reduction. In recent years there have also been technical and conceptual improvements even for the primary treatment of patients with manifest cancer. This article presents the current approaches in diagnostics and therapy and the contribution of magnetic resonance imaging (MRI) and positron emission tomography (PET) for pretherapeutic staging and minimally invasive techniques for reduction of operative trauma will be discussed. Total mesometrial resection (TMMR) is a new but controversial surgical technique based on a tumor spread model within morphological entities. Initial data indicate that TMMR in combination with therapeutic lymphadenectomy guarantees local and regional control even in cases with histopathological risk factors.

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  1. Universitäts-Frauenklinik, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland

    M.C. Fleisch, C. Scholz, D.T. Rein & W. Janni

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  1. M.C. Fleisch
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  2. C. Scholz
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  3. D.T. Rein
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  4. W. Janni
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Correspondence to M.C. Fleisch.

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Fleisch, M., Scholz, C., Rein, D. et al. Zervixkarzinom. Gynäkologe 44, 694–700 (2011). https://doi.org/10.1007/s00129-011-2768-9

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