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Operative Therapie beim Ovarialkarzinomrezidiv

Stellenwert und praktische Aspekte

Surgical procedures in recurrent ovarian cancer

Value and practical aspects

  • CME Weiterbildung • Zertifizierte Fortbildung
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Der Onkologe Aims and scope

Zusammenfassung

Trotz maximaler Tumorreduktion und einer anschließenden systemischen Chemotherapie mit Paclitaxel und Carboplatin entwickelt ein Großteil der Patientinnen mit Ovarialkarzinom innerhalb der ersten 3 postoperativen Jahren ein Tumorrezidiv und verstirbt an dieser Erkrankung. Hierbei werden Patientinnen mit platinsensitivem und -resistentem Ovarialkarzinom unterschieden. Im Gegensatz zur Primärsituation werden der Stellenwert und der Nutzen der Rezidivchirurgie, sowohl im klinischen Alltag als auch in der Wissenschaft, kontrovers diskutiert. Bei der Diskussion von Operationen in der Rezidivsituation müssen Eingriffe mit dem Ziel der Behebung eines Symptoms als palliative Maßnahme und Eingriffe mit dem Ziel der maximalen Tumorreduktion unterschieden werden. Im vorliegenden Artikel wird eine aktuelle Übersicht zu den Definitionen, Indikationen und operativen Techniken der Rezidivchirurgie beim Ovarialkarzinom sowie zum prä- und postoperativen Management gegeben.

Abstract

Despite maximal cytoreduction and adjuvant chemotherapy with paclitaxel and carboplatin, a large number of patients with epithelial ovarian cancer will experience tumor relapse within 3 years after their initial diagnosis. Therefore, two prognostic groups should be differentiated: patients with platinum-sensitive ovarian cancer and those with platinum-resistant ovarian cancer. In contrast to the primary situation, the benefit of surgery in recurrent ovarian cancer is controversial. The primary aim of relapse surgery is palliation or maximal tumor reduction. This article gives an overview of the indications, definitions, and practical aspects of operative management in salvage surgery. Based on the available evidence from the literature and guidelines, all surgical aspects are discussed.

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Authors and Affiliations

  1. Europäisches Kompetenzzentrum für Eierstockkrebs (EKZE), Klinik für Frauenheilkunde und Geburtshilfe, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Deutschland

    J. Sehouli, C. Fotopoulou, G. Oskay-Özcelik, D. Koensgen-Mustea, A. Mustea & W. Lichtenegger

  2. Klinik für Viszeral- und Transplantationschirurgie, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Deutschland

    U. Neumann, H. Weidemann & P. Neuhaus

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  1. J. Sehouli
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  2. C. Fotopoulou
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  3. G. Oskay-Özcelik
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  4. D. Koensgen-Mustea
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  5. A. Mustea
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  6. U. Neumann
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  7. H. Weidemann
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  8. P. Neuhaus
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  9. W. Lichtenegger
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Correspondence to J. Sehouli.

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Sehouli, J., Fotopoulou, C., Oskay-Özcelik, G. et al. Operative Therapie beim Ovarialkarzinomrezidiv. Onkologe 14, 201–218 (2008). https://doi.org/10.1007/s00761-007-1315-8

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