Skip to main content
Erschienen in: Der Pathologe 1/2019

01.02.2019 | Gynäkologische Tumoren | Schwerpunkt: Gynäkopathologie

TNM-Klassifikation gynäkologischer Tumoren

Was bleibt über 2017 hinaus zu tun?

verfasst von: Prof. Dr. L.-C. Horn, C. E. Brambs, S. Opitz, J. Einenkel, D. Mayr

Erschienen in: Die Pathologie | Ausgabe 1/2019

Einloggen, um Zugang zu erhalten

Zusammenfassung

Die Empfehlungen der WHO-Klassifikation von 2014, der TNM-Klassifikation von 2017 sowie der der International Collaboration of Cancer Reporting (ICCR) für gynäkologische Tumoren sind nicht für alle Fälle kongruent. Zwischen WHO und TNM gibt es Unterschiede in der Definition des Vaginalkarzinoms. Insbesondere für seltene gynäkologische Tumoren wie das primäre maligne Melanom und Sarkome von Vulva und Scheide sowie undifferenzierte uterine Sarkome (UUS), der PECom (perivaskulärer epitheloidzelliger Tumor) und extraintestinale gynäkologische GIST (gastrointestinale Stromatumoren) gibt es keine separate TNM-Kategorisierung. Bei nichtuterinen serösen Karzinomen sind im TNM die parakolischen Lymphknoten nicht zugeordnet, wohingegen die FIGO alle intrabadominalen Lymphknoten als regionär klassifiziert.
Literatur
8.
Zurück zum Zitat Brenn T, Calonje E (2013) Melanocytic Lesions oft he Vulva and Vagina. In: Brown B (Hrsg) Pathology oft he Vulva and Vagina. Springer, Dordrecht, Heidelberg, New York, London, S 113–146CrossRef Brenn T, Calonje E (2013) Melanocytic Lesions oft he Vulva and Vagina. In: Brown B (Hrsg) Pathology oft he Vulva and Vagina. Springer, Dordrecht, Heidelberg, New York, London, S 113–146CrossRef
9.
Zurück zum Zitat Chokoeva AA, Tchernev G, Cardoso JC, Patterson JW, Dechev I, Valkanov S, Zanardelli M, Lotti T, Wollina U (2015) Vulvar sarcomas: Short guideline for histopathological recognition and clinical management. Part 2. Int J Immunopathol Pharmacol 28(2):178–186CrossRef Chokoeva AA, Tchernev G, Cardoso JC, Patterson JW, Dechev I, Valkanov S, Zanardelli M, Lotti T, Wollina U (2015) Vulvar sarcomas: Short guideline for histopathological recognition and clinical management. Part 2. Int J Immunopathol Pharmacol 28(2):178–186CrossRef
10.
Zurück zum Zitat Chokoeva AA, Tchernev G, Cardoso JC, Patterson JW, Dechev I, Valkanov S, Zanardelli M, Lotti T, Wollina U (2015) Vulvar sarcomas: Short guideline for histopathological recognition and clinical management. Part 1. Int J Immunopathol Pharmacol 28(2):168–177 (Jun)CrossRef Chokoeva AA, Tchernev G, Cardoso JC, Patterson JW, Dechev I, Valkanov S, Zanardelli M, Lotti T, Wollina U (2015) Vulvar sarcomas: Short guideline for histopathological recognition and clinical management. Part 1. Int J Immunopathol Pharmacol 28(2):168–177 (Jun)CrossRef
11.
Zurück zum Zitat Crawford D, Nimmo M, Clement PB, Thomson T, Benedet JL, Miller D, Gilks CB (1999) Prognostic factors in Paget’s disease of the vulva: a study of 21 cases. Int J Gynecol Pathol 18(4):351–359CrossRef Crawford D, Nimmo M, Clement PB, Thomson T, Benedet JL, Miller D, Gilks CB (1999) Prognostic factors in Paget’s disease of the vulva: a study of 21 cases. Int J Gynecol Pathol 18(4):351–359CrossRef
12.
Zurück zum Zitat Crum CP, Herrington CS, McCluggage WG, Regauer S, Wilkinson EJ (2014) Epithelial Tumors oft he Vulva. In: Kurman RJ, Carcangiu ML, Herrington CS, Young RH (Hrsg) WHO Classification of Tumours of Female Reproductive Organs. IARC, Lyon, S 232–241 Crum CP, Herrington CS, McCluggage WG, Regauer S, Wilkinson EJ (2014) Epithelial Tumors oft he Vulva. In: Kurman RJ, Carcangiu ML, Herrington CS, Young RH (Hrsg) WHO Classification of Tumours of Female Reproductive Organs. IARC, Lyon, S 232–241
13.
Zurück zum Zitat Fanning J, Lambert HC, Hale TM, Morris PC, Schuerch C (1999) Paget’s disease of the vulva: prevalence of associated vulvar adenocarcinoma, invasive Paget’s disease, and recurrence after surgical excision. Am J Obstet Gynecol 180(1 Pt 1):24–27CrossRef Fanning J, Lambert HC, Hale TM, Morris PC, Schuerch C (1999) Paget’s disease of the vulva: prevalence of associated vulvar adenocarcinoma, invasive Paget’s disease, and recurrence after surgical excision. Am J Obstet Gynecol 180(1 Pt 1):24–27CrossRef
14.
Zurück zum Zitat Ferenczy AS, Colgan TJ, Herrington CS, Hirschowitz L, Löning T, Park KJ, Stoler M, Wells M, Wilbur DC, Wright T (2014) Epithelial tumors oft he vagina. In: Kurman RJ, Carcangiu ML, Herrington CS, Young RH (Hrsg) WHO classification of tumours of female reproductive organs. IARC, Lyon, S 210–217 Ferenczy AS, Colgan TJ, Herrington CS, Hirschowitz L, Löning T, Park KJ, Stoler M, Wells M, Wilbur DC, Wright T (2014) Epithelial tumors oft he vagina. In: Kurman RJ, Carcangiu ML, Herrington CS, Young RH (Hrsg) WHO classification of tumours of female reproductive organs. IARC, Lyon, S 210–217
15.
Zurück zum Zitat Gibb RK, Olawaiye AB, Chen LM, Grigsby PW, Hagemann IS, Wolfson AH, Zaino R, Mutch DG (2017) Vagina. In: Amin MB, American Joint Committee on Cancer (AJCC) (Hrsg) AJCC cancer staging manual. Springer, New York, S 641–647CrossRef Gibb RK, Olawaiye AB, Chen LM, Grigsby PW, Hagemann IS, Wolfson AH, Zaino R, Mutch DG (2017) Vagina. In: Amin MB, American Joint Committee on Cancer (AJCC) (Hrsg) AJCC cancer staging manual. Springer, New York, S 641–647CrossRef
16.
Zurück zum Zitat Hirschowitz L, Nucci M, Zaino RJ (2013) Problematic issues in the staging of endometrial, cervical and vulval carcinomas. Histopathology 62(1):176–202CrossRef Hirschowitz L, Nucci M, Zaino RJ (2013) Problematic issues in the staging of endometrial, cervical and vulval carcinomas. Histopathology 62(1):176–202CrossRef
17.
Zurück zum Zitat Höckel M, Horn LC, Illig R, Dornhöfer N, Fritsch H (2011) Ontogenetic anatomy of the distal vagina: relevance for local tumor spread and implications for cancer surgery. Gynecol Oncol 122(2):313–318CrossRef Höckel M, Horn LC, Illig R, Dornhöfer N, Fritsch H (2011) Ontogenetic anatomy of the distal vagina: relevance for local tumor spread and implications for cancer surgery. Gynecol Oncol 122(2):313–318CrossRef
18.
Zurück zum Zitat Höckel M, Schmidt K, Bornmann K, Horn LC, Dornhöfer N (2010) Vulvar field resection: novel approach to the surgical treatment of vulvar cancer based on ontogenetic anatomy. Gynecol Oncol 119(1):106–113CrossRef Höckel M, Schmidt K, Bornmann K, Horn LC, Dornhöfer N (2010) Vulvar field resection: novel approach to the surgical treatment of vulvar cancer based on ontogenetic anatomy. Gynecol Oncol 119(1):106–113CrossRef
19.
Zurück zum Zitat Horn LC, Bilek K, Fischer U, Einenkel J, Hentschel B (2014) A cut-off value of 2 cm in tumor size is of prognostic value in surgically treated FIGO stage IB cervical cancer. Gynecol Oncol 134(1):42–46CrossRef Horn LC, Bilek K, Fischer U, Einenkel J, Hentschel B (2014) A cut-off value of 2 cm in tumor size is of prognostic value in surgically treated FIGO stage IB cervical cancer. Gynecol Oncol 134(1):42–46CrossRef
20.
Zurück zum Zitat Horn LC, Mayr D, Brambs CE, Einenkel J, Sändig I, Schierle K (2016) Grading of gynecological tumors : current aspects. Pathologe 37(4):337–351CrossRef Horn LC, Mayr D, Brambs CE, Einenkel J, Sändig I, Schierle K (2016) Grading of gynecological tumors : current aspects. Pathologe 37(4):337–351CrossRef
21.
Zurück zum Zitat Horn LC, Trost M, Bilek K (2010) Staging of endometrial carcinoma: aspects of ovarian and cervical involvement. Int J Gynecol Pathol 29(1):63–66CrossRef Horn LC, Trost M, Bilek K (2010) Staging of endometrial carcinoma: aspects of ovarian and cervical involvement. Int J Gynecol Pathol 29(1):63–66CrossRef
22.
Zurück zum Zitat Karam A, Dorigo O (2012) Treatment outcomes in a large cohort of patients with invasive extramammary Paget’s disease. Gynecol Oncol 125(2):346–351CrossRef Karam A, Dorigo O (2012) Treatment outcomes in a large cohort of patients with invasive extramammary Paget’s disease. Gynecol Oncol 125(2):346–351CrossRef
23.
Zurück zum Zitat McCluggage WG, Colgan T, Duggan M, Hacker NF, Mulvany N, Otis C, Wilkinson N, Zaino RJ, Hirschowitz L (2013) Data set for reporting of endometrial carcinomas: recommendations from the International Collaboration on Cancer Reporting (ICCR) between United Kingdom, United States, Canada, and Australasia. Int J Gynecol Pathol 32(1):45–65CrossRef McCluggage WG, Colgan T, Duggan M, Hacker NF, Mulvany N, Otis C, Wilkinson N, Zaino RJ, Hirschowitz L (2013) Data set for reporting of endometrial carcinomas: recommendations from the International Collaboration on Cancer Reporting (ICCR) between United Kingdom, United States, Canada, and Australasia. Int J Gynecol Pathol 32(1):45–65CrossRef
24.
Zurück zum Zitat McCluggage WG, Judge MJ, Alvarado-Cabrero I, Duggan MA, Horn LC, Hui P, Ordi J, Otis CN, Park KJ, Plante M, Stewart CJR, Wiredu EK, Rous B, Hirschowitz L (2018) Data set for the reporting of carcinomas of the cervix: recommendations from the international collaboration on cancer reporting (ICCR). Int J Gynecol Pathol 37(3):205–228CrossRef McCluggage WG, Judge MJ, Alvarado-Cabrero I, Duggan MA, Horn LC, Hui P, Ordi J, Otis CN, Park KJ, Plante M, Stewart CJR, Wiredu EK, Rous B, Hirschowitz L (2018) Data set for the reporting of carcinomas of the cervix: recommendations from the international collaboration on cancer reporting (ICCR). Int J Gynecol Pathol 37(3):205–228CrossRef
25.
Zurück zum Zitat McCluggage WG, Judge MJ, Clarke BA, Davidson B, Gilks CB, Hollema H, Ledermann JA, Matias-Guiu X, Mikami Y, Stewart CJ, Vang R, Hirschowitz L (2015) International Collaboration on Cancer Reporting. Data set for reporting of ovary, fallopian tube and primary peritoneal carcinoma: recommendations from the International Collaboration on Cancer Reporting (ICCR). Mod Pathol 28(8):1101–1122CrossRef McCluggage WG, Judge MJ, Clarke BA, Davidson B, Gilks CB, Hollema H, Ledermann JA, Matias-Guiu X, Mikami Y, Stewart CJ, Vang R, Hirschowitz L (2015) International Collaboration on Cancer Reporting. Data set for reporting of ovary, fallopian tube and primary peritoneal carcinoma: recommendations from the International Collaboration on Cancer Reporting (ICCR). Mod Pathol 28(8):1101–1122CrossRef
26.
Zurück zum Zitat McCluggage G (2013) Vulvovaginal mesenchymal lesions. In: Brown B (Hrsg) Pathology oft he vulva and vagina. Springer, Dordrecht, Heidelberg, New York, London, S 207–244CrossRef McCluggage G (2013) Vulvovaginal mesenchymal lesions. In: Brown B (Hrsg) Pathology oft he vulva and vagina. Springer, Dordrecht, Heidelberg, New York, London, S 207–244CrossRef
27.
Zurück zum Zitat Mihajlovic M, Vlajkovic S, Jovanovic P, Stefanovic V (2012) Primary mucosal melanomas: a comprehensive review. Int J Clin Exp Pathol 5(8):739–753PubMedPubMedCentral Mihajlovic M, Vlajkovic S, Jovanovic P, Stefanovic V (2012) Primary mucosal melanomas: a comprehensive review. Int J Clin Exp Pathol 5(8):739–753PubMedPubMedCentral
28.
Zurück zum Zitat Mutch DG, Prat J (2014) 2014 FIGO staging for ovarian, fallopian tube and peritoneal cancer. Gynecol Oncol 133(3):401–404CrossRef Mutch DG, Prat J (2014) 2014 FIGO staging for ovarian, fallopian tube and peritoneal cancer. Gynecol Oncol 133(3):401–404CrossRef
29.
Zurück zum Zitat Nagase S, Mikami Y, Moriya T, Niikura H, Yoshinaga K, Takano T, Ito K, Akahira J, Sasano H, Yaegashi N (2007) Vaginal tumors with histologic and immunocytochemical feature of gastrointestinal stromal tumor: two cases and review of the literature. Int J Gynecol Cancer 17(4):928–933CrossRef Nagase S, Mikami Y, Moriya T, Niikura H, Yoshinaga K, Takano T, Ito K, Akahira J, Sasano H, Yaegashi N (2007) Vaginal tumors with histologic and immunocytochemical feature of gastrointestinal stromal tumor: two cases and review of the literature. Int J Gynecol Cancer 17(4):928–933CrossRef
30.
Zurück zum Zitat Nobbenhuis MA, Lalondrelle S, Larkin J, Banerjee S (2014) Management of melanomas of the gynaecological tract. Curr Opin Oncol 26(5):508–513CrossRef Nobbenhuis MA, Lalondrelle S, Larkin J, Banerjee S (2014) Management of melanomas of the gynaecological tract. Curr Opin Oncol 26(5):508–513CrossRef
31.
Zurück zum Zitat Prat J, FIGO Committee on Gynecologic Oncology (2014) Staging classification for cancer of the ovary, fallopian tube, and peritoneum. Int J Gynaecol Obstet 124(1):1–5CrossRef Prat J, FIGO Committee on Gynecologic Oncology (2014) Staging classification for cancer of the ovary, fallopian tube, and peritoneum. Int J Gynaecol Obstet 124(1):1–5CrossRef
32.
Zurück zum Zitat Singh N, Gilks CB, Wilkinson N, McCluggage WG (2014) Assignment of primary site in high-grade serous tubal, ovarian and peritoneal carcinoma: a proposal. Histopathology 65(2):149–154CrossRef Singh N, Gilks CB, Wilkinson N, McCluggage WG (2014) Assignment of primary site in high-grade serous tubal, ovarian and peritoneal carcinoma: a proposal. Histopathology 65(2):149–154CrossRef
33.
Zurück zum Zitat Tseng JH, Aloisi A, Sonoda Y, Gardner GJ, Zivanovic O, Abu-Rustum NR, Leitao MM Jr. (2018) Long-term oncologic outcomes of uterine-preserving surgery in young women with stage Ib1 cervical cancer. Int J Gynecol Cancer 28(7):1350–1359CrossRef Tseng JH, Aloisi A, Sonoda Y, Gardner GJ, Zivanovic O, Abu-Rustum NR, Leitao MM Jr. (2018) Long-term oncologic outcomes of uterine-preserving surgery in young women with stage Ib1 cervical cancer. Int J Gynecol Cancer 28(7):1350–1359CrossRef
34.
Zurück zum Zitat Wingen CB, Pauwels PA, Debiec-Rychter M, van Gemert WG, Vos MC (2005) Uterine gastrointestinal stromal tumour (GIST). Gynecol Oncol 97(3):970–972CrossRef Wingen CB, Pauwels PA, Debiec-Rychter M, van Gemert WG, Vos MC (2005) Uterine gastrointestinal stromal tumour (GIST). Gynecol Oncol 97(3):970–972CrossRef
35.
Zurück zum Zitat Wittekind C, Compton CC, Brierley J, Sobin LH (2012) TNM supplement. A commentary on uniform use. Wiley & Blackwell, Chichester, S 8–10 Wittekind C, Compton CC, Brierley J, Sobin LH (2012) TNM supplement. A commentary on uniform use. Wiley & Blackwell, Chichester, S 8–10
36.
Zurück zum Zitat Wittekind C (2017) TNM Klassifikation maligner Tumoren. Wiley-VCH, Weinheim Wittekind C (2017) TNM Klassifikation maligner Tumoren. Wiley-VCH, Weinheim
37.
Zurück zum Zitat Wittekind C (2019) TNM Supplement. A Commentary on Uniform Use, 5. Aufl. Wiley & Sons, Chichester (in preparation) Wittekind C (2019) TNM Supplement. A Commentary on Uniform Use, 5. Aufl. Wiley & Sons, Chichester (in preparation)
38.
Zurück zum Zitat Zeppernick F, Meinhold-Heerlein I (2014) The new FIGO staging system for ovarian, fallopian tube, and primary peritoneal cancer. Arch Gynecol Obstet 290(5):839–842CrossRef Zeppernick F, Meinhold-Heerlein I (2014) The new FIGO staging system for ovarian, fallopian tube, and primary peritoneal cancer. Arch Gynecol Obstet 290(5):839–842CrossRef
39.
Zurück zum Zitat Zhang W, Peng Z, Xu L (2009) Extragastrointestinal stromal tumor arising in the rectovaginal septum: report of an unusual case with literature review. Gynecol Oncol 113(3):399–401CrossRef Zhang W, Peng Z, Xu L (2009) Extragastrointestinal stromal tumor arising in the rectovaginal septum: report of an unusual case with literature review. Gynecol Oncol 113(3):399–401CrossRef
Metadaten
Titel
TNM-Klassifikation gynäkologischer Tumoren
Was bleibt über 2017 hinaus zu tun?
verfasst von
Prof. Dr. L.-C. Horn
C. E. Brambs
S. Opitz
J. Einenkel
D. Mayr
Publikationsdatum
01.02.2019
Verlag
Springer Medizin
Erschienen in
Die Pathologie / Ausgabe 1/2019
Print ISSN: 2731-7188
Elektronische ISSN: 2731-7196
DOI
https://doi.org/10.1007/s00292-018-0559-y

Weitere Artikel der Ausgabe 1/2019

Der Pathologe 1/2019 Zur Ausgabe

Schwerpunkt: Gynäkopathologie

Vorläuferläsionen der Endometriumkarzinome

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.