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Erschienen in: Der Gynäkologe 4/2017

31.01.2017 | Vulvakarzinom | Leitthema

Das Vulvakarzinomrezidiv: eine besondere Herausforderung

verfasst von: PD Dr. L. Woelber, K. Prieske

Erschienen in: Die Gynäkologie | Ausgabe 4/2017

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Zusammenfassung

Der wichtigste prognostische Faktor für das Auftreten eines Rezidivs ist das Vorliegen von inguinalen Lymphknotenmetastasen bei Erstdiagnose. Lokalrezidive treten mit einem Anteil von ca. 70 % am häufigsten auf und haben, wenn sie isoliert vorliegen, eine recht gute Prognose. Therapieoptionen reichen von der lokalen Exzision bis hin zur neoadjuvanten/definitiven Radio(chemo)therapie bei primärer Inoperabilität bzw. zur Schonung sensibler Strukturen (Klitoris, Urethra, Anus). Im Gegensatz zum isolierten Lokalrezidiv hat das Leistenrezidiv eine deutlich eingeschränktere Prognose und endet auch heute noch häufig letal. Meist ist ein multimodales Konzept mit operativer Resektion (im Z. n. Sentinel-Lymphonodektomie einer kompletten inguinofemoralen Lymphonodektomie), gefolgt von einer „adjuvanten“ Radio(chemo)therapie der Leisten- ± Beckenregion sinnvoll. Bei Auftreten von distanten Metastasen ist die Prognose mit einem Zweijahresgesamtüberleben von nur ca. 10 % sehr eingeschränkt. Therapiemodalitäten werden meist von anderen Tumorentitäten übernommen und sind generell experimentell. Der Übersichtsartikel konzentriert sich auf mögliche Therapieoptionen eines Vulvakarzinomrezidivs in Abhängigkeit von dessen Lokalisation.
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Metadaten
Titel
Das Vulvakarzinomrezidiv: eine besondere Herausforderung
verfasst von
PD Dr. L. Woelber
K. Prieske
Publikationsdatum
31.01.2017
Verlag
Springer Medizin
Erschienen in
Die Gynäkologie / Ausgabe 4/2017
Print ISSN: 2731-7102
Elektronische ISSN: 2731-7110
DOI
https://doi.org/10.1007/s00129-017-4025-3

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