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Erschienen in: Der Gynäkologe 11/2021

07.10.2021 | Gynäkologische Diagnostik | CME

Diagnostik und Therapie des Zervixkarzinoms

verfasst von: Majdi Imterat, Jessica Holly, Philipp Harter, Beyhan Ataseven, MD PhD Florian Heitz

Erschienen in: Der Gynäkologe | Ausgabe 11/2021

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Zusammenfassung

Die Behandlung des primären Zervixkarzinoms sollte bei großer Sicherheit so wenig Therapiemodalitäten wie möglich beinhalten. Um diesem Grundsatz gerecht zu werden, muss ein optimaler Diagnostikalgorithmus eingehalten werden, der – wie bei anderen Karzinomen auch –die lokale (bezogen auf die Zervix), die lokoregionäre (bezogen auf die Lymphknoten) und die distante Krankheitsausbreitung mit einbezieht. Ist in frühen Stadien die alleinige Operation häufig ausreichend, muss gerade bei lokal fortgeschrittenen Tumoren genau evaluiert werden, ob eine alleinige Operation möglich sein wird oder ob aufgrund von Risikofaktoren im Anschluss an die Operation eine adjuvante Radiochemotherapie indiziert sein wird. Wenn dies vorhersehbar der Fall ist, sollte a priori die kombinierte simultane Radiochemotherapie durchgeführt werden. Beim metastasierten Zervixkarzinom gibt es neben der platinbasierten Chemotherapie zusammen mit Paclitaxel und Bevacizumab keine effektive Standardtherapie. Neueste Daten zeigen aber gerade auch bei Patientinnen, die mit platinhaltiger Chemotherapie vorbehandelt wurden, einen Gesamtüberlebensvorteil, wenn diese mit Cemiplimab, einem Checkpointinhibitor, behandelt wurden.
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Metadaten
Titel
Diagnostik und Therapie des Zervixkarzinoms
verfasst von
Majdi Imterat
Jessica Holly
Philipp Harter
Beyhan Ataseven
MD PhD Florian Heitz
Publikationsdatum
07.10.2021
Verlag
Springer Medizin
Erschienen in
Der Gynäkologe / Ausgabe 11/2021
Print ISSN: 0017-5994
Elektronische ISSN: 1433-0393
DOI
https://doi.org/10.1007/s00129-021-04861-x