Endometriumkarzinom – ein Update

Katharina Steger1, Alain Zeimet1
1Universitätsklinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck, Innsbruck, Österreich

Tóm tắt

In der im Dezember 2020 publizierten neuen ESGO-ESTRO-ESP-Guideline wird die molekulare Charakterisierung als neuer Standard zur Einteilung des Endometriumkarzinoms empfohlen. Diese Gliederung dient nicht nur der Risikostratifizierung, sondern ist auch wegweisend für die prognostische Einschätzung und Therapieentscheidung. Goldstandard der Therapie ist weiterhin ein chirurgisches Vorgehen im Sinne einer laparoskopischen totalen Hysterektomie mit bilateraler Salpingoophorektomie. Die Durchführung eines Sentinel-Lymphknoten-Samplings liefert dabei heute in den meisten Fällen ausreichend Informationen über den Lymphknotenstatus der Patientin und wird somit der vollständigen Lymphknotendissektion vorgezogen. In der Therapie von Patientinnen mit Endometriumkarzinom im fortgeschrittenen Stadium oder mit Rezidiverkrankung eröffnet die Immuntherapie in Form von Checkpointinhibitoren (z. B. Pembrolizumab oder Dostarlimab) als Monotherapie bei Mismatch-repair-defizienten bzw. in der Kombination von Pembrolizumab mit einem Multikinaseinhibitor (z. B. Lenvatinib) bei Mismatch-repair-profizienten Karzinomen neue Möglichkeiten in der Zweitlinientherapie.

Tài liệu tham khảo

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