Abstract
Introduction
In future there will be major problems in gynecologic oncology concerning the changes in epidemiology, etiology and the individualized multidisciplinary treatment modalities. The gynecologic oncology has to realize the rising incidence of elderly patients and in correlation to the age and the demography of the increase in breast and vulvar cancer.
Materials and methods
The literature and the own experience support the use of similar diagnostic and therapeutic efforts for elderly and younger women with modification for elderly patients based only on the comorbidity. For elderly patients, a breast conserving therapy should be preferred as in younger patients. In vulvar cancer, an individualized therapy is also possible. In patients with endometrial cancer, the systematic lymphnode dissection should be realized.
Conclusion
The radicality does not depend on the measurement of depth of invasion based on the intraoperative frozen section. Only the surgical removal and histologic evaluation of the nodes may accurately determine the actual nodal status. In lymphnode negative patients, the postoperative adjuvant radiotherapy is preventable.
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References
Baltzer J (2004) Diagnostic and therapeutic dilemmas in vulvar cancer. Eur J Gynaecol Oncol 25:405–410
Bouchardy C, Rapiti E, Fioretta D, Laissue P, Neyroud-Caspar I, Schafer P, Kurtz J, Sappino AP, Vlastos G (2003) Undertreatment strongly decreases prognosis of breast cancer in elderly women. J Clin Oncol 19:3554–3556
Becker M (2004) Epidemiologie maligner Erkrankungen In: Hiddemann W, Huber H, Bartram C (eds) Die Onkologie, Epidemiologie, Pathogenese, Grundprinzipien der Therapie, Springer, Berlin
Gehrmann A, Riethdorf S, Riethdorf L, Poleska W, Baltzer J (2006) HPV-negative, klitorisnahe invasive und nichtinvasive Karzinome bei jüngeren Frauen 56. Kongress der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe, Abstrakt ID: 4240
Knappstein PG, Di Re F, DiSaia P, Haller U, Sevin WU (1991) Malignancies of the vulvar Thieme. Stuttgart, New York
Krebs in Deutschland, Häufigkeiten und Trends (2004) Edited by Arbeitsgemeinschaft bevölkerungsbezogener Krebsregister in Deutschland in Zusammenarbeit mit dem Robert-Koch-Institut, 4. überarbeitete aktualisierte Ausgabe, Saarbrücken
Ludwig H (2007) Gynäkologie und Geburtshilfe—gestern, heute, morgen. Der Gynäkologe 40:5–8
Morley GW, Hopkins MP (1991) Infiltrative carcinoma of the vulva, results of surgical treatment In: Knapstein PW, Di Re F, DiSaia P, Haller U, Sevin WU (eds) Malignancies of the vulva. Thieme, Stuttgart
Pinto HP, Lin MC, Crum CP (2000) Molecular and viral pathogenesis of vulvar cancer In: Luesly DM (ed) Cancer and precancer of the vulva. Arnold, London
Ranke H (1996) Neuartige Probleme des menschlichen Höchstalters, Teil 2, Allgemeine Probleme Z. Gerontol Geriatr 20:51–64
Schlag PM (ed) (2001) Sentinellymphknotenbiopsie, Ecomed Verlag Landsberg
Singh R, Hellman S, Heimann R (2004) The natural history of breast carcinoma in the elderly: implications for screening and treatment. Cancer 100:1807–1813
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Baltzer, J. Gynecologic oncology: the German view. Arch Gynecol Obstet 278, 257–260 (2008). https://doi.org/10.1007/s00404-007-0552-9
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DOI: https://doi.org/10.1007/s00404-007-0552-9