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Zentralbl Gynakol 2002; 124(11): 506-510
DOI: 10.1055/s-2002-39577
Übersicht

© Georg Thieme Verlag Stuttgart · New York

Diagnostik und Therapie der Uterussarkome

Uterine Sarcoma - Standards, Options and RecommendationsV. Viereck1 , A. Huschmand Nia1 , H. U. Pauer1 , G. Emons1 , T. Krauß1
  • 1Klinik für Gynäkologie und Geburtshilfe, Georg-August-Universität Göttingen (Direktor: Prof. Dr. med. G. Emons)
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Publication History

Publication Date:
10 June 2003 (online)

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Zusammenfassung

In den frühen Stadien (I und II) des Uterussarkoms ist die Radikaloperation mit kompletter Tumorentfernung die einzige kurative Behandlungsoption. Eine adjuvante Strahlen- und oder Chemotherapie kommt gegebenenfalls nach Entfernung größerer Tumore (z. B. > 4 cm) und Lymphknotenmetastasen mit hohem Lokalrezidivrisiko in Betracht. Dies gilt vorzugsweise für endometriale Stromasarkome und mesodermale Mischtumore (Karzinosarkome). Leiomyosarkome sind weitestgehend resistent gegenüber einer Strahlen- und Chemotherapie, ihre Anwendung dürfte hier mehr Toxizität als Nutzen bringen.

In höheren Stadien und in der Rezidivsituation ist das Behandlungskonzept palliativ. Dabei muss der mögliche - meist sehr begrenzte - Behandlungserfolg und die oft beträchtlichen Nebenwirkungen mit Einschränkung der Lebensqualität abgewogen werden

Abstract

Radical surgery in stage I and II uterine sarcoma removing all tumor manifestations is the only curative therapy option for early stage disease. Larger tumors (> 4 cm) and the presence of lymph node metastasis correlate with a high local recurrence rate. For these tumors adjuvant radiation and/or adjuvant chemotherapy may be recommended after surgical therapy. Adjuvant therapy however, should preferably be considered for uterine stromal sarcomas and mixed mesodermal tumors. The toxicity of radiation and/or chemotherapy is greater than any possible benefit for patients with leiomysarcomas as these tumors rarely respond to radiation or chemotherapy. For advanced (> stage I and II) and recurrent disease, curative therapy options are not available and palliative therapy for these patients has to take into consideration the negative side effects and weigh up quality of life against an often very limited possible benefit of such therapy.

Schlüsselwörter

Sarkome des Uterus - Diagnostik - Klassifikation - Stadieneinteilung - Therapie - Rezidiv - Prognose

Key words

Uterine sarcoma - classification - diagnosis - staging - therapy - recurrence - prognosis

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Dr. Volker Viereck

Klinik für Gynäkologie und Geburtshilfe · Georg-August-Universität Göttingen

Robert Koch-Straße 40

37 075 Goettingen

Phone: ++49/5 51/39 65 76

Fax: ++49/5 51/39 62 75

Email: viereck@med.uni-goettingen.de

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