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Maligne epitheliale Tumoren des Corpus uteri (einschließlich des Karzinosarkoms)

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Praxisbuch Gynäkologische Onkologie

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Zusammenfassung

Das Endometriumkarzinom stellt in Mitteleuropa das häufigste Genitalmalignom dar. Bis jetzt existiert kein effektives Screening. Die uterine Blutungsstörung stellt meist ein Frühsymptom dar, das unmittelbar zur Diagnose eines Endometriumkarzinoms führt. Bei palpatorisch unauffälliger Cervix uteri und unauffälligen Parametrien erfolgt die extrafasziale Hysterektomie mit beidseitiger Adnexektomie. Eine Lymphadenektomie wird in jedem Fall von serösem und klarzelligem Karzinom empfohlen, des Weiteren beim endometrioiden Typ beginnend ab dem Stadium IB G3. Im Stadium I des Endometriumkarzinoms beträgt die Heilungsrate mit der alleinigen Operation 85–95 %. Eine adjuvante Radiotherapie reduziert die Anzahl lokoregionaler Rezidive, verbessert aber nicht das Gesamtüberleben. Eine adjuvante Chemotherapie, v. a. mit Carboplatin und Taxol, ist im Stadium III–IV indiziert. Auch im Stadium I–II kann eine Chemotherapie, v. a. bei ungünstiger Histologie, tiefer myometraner Invasion und/oder G3-Tumoren in Sequenz mit der Strahlentherapie des Beckens diskutiert werden. Nach Scheidenstumpfrezidiv beträgt das 3-Jahres-Überleben 69 % und nach pelvinem Rezidiv oder Fernmetastasen 13 %, wobei die Überlebensrate bei Patientinnen, die noch keine Radiotherapie erhalten hatten, deutlich besser ist als bei vorbestrahlten Patientinnen.

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Authors and Affiliations

  1. Klinik für Gynäkologie, UniversitätsSpital Zürich, Zürich, Schweiz

    Patrick Imesch & Daniel Fink

  2. Frauenklinik, Kantonsspital Frauenfeld, Frauenfeld, Schweiz

    Mathias K. Fehr

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  1. Patrick Imesch
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  2. Mathias K. Fehr
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Correspondence to Patrick Imesch .

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Editors and Affiliations

  1. Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz, Graz, Austria

    Edgar Petru

  2. Klinik für Gynäkologie, UniversitätsSpital Zürich, Zürich, Switzerland

    Daniel Fink

  3. Gynäkologisch-onkologische Praxis, BrustCentrum, Privatklinik Zürich-Bethanien, Zürich, Switzerland

    Ossi R. Köchli

  4. German Breast Group Forschungs GmbH, Neu-Isenburg, Germany

    Sibylle Loibl

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Imesch, P., Fehr, M.K., Fink, D. (2019). Maligne epitheliale Tumoren des Corpus uteri (einschließlich des Karzinosarkoms). In: Petru, E., Fink, D., Köchli, O., Loibl, S. (eds) Praxisbuch Gynäkologische Onkologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-57430-0_3

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