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Frühes Ovarialkarzinom (FIGO Stadium I–IIA)

Early ovarian cancer (FIGO stage I–IIA)

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Zusammenfassung

Etwa 25% der Ovarialkarzinome werden im FIGO-Stadium I, etwa 7% im Stadium IIA diagnostiziert. Die Verdachtsdiagnose eines Ovarialkarzinoms macht immer eine operative Abklärung mit histologischer Diagnosesicherung durch Laparotomie oder evtl. Laparoskopie notwendig, da es präoperativ unmöglich ist, mit halbwegs akzeptabler Sicherheit abzuschätzen, dass es sich um ein Frühstadium eines Ovarialkarzinoms handelt. Der Nachweis eines einzigen positiven Lymphknotens bedeutet, dass die Erkrankung einem FIGO-Stadium IIIc zuzuordnen ist. Im klinischen Stadium I oder II liegt in 31% tatsächlich ein höheres Stadium vor, da sich intraoperativ Metastasen im Omentum majus, Peritoneum oder den Lymphknoten finden. Die Primäroperation umfasst ein operatives Staging per Abdominallängsschnitt und eine Radikaloperation mit dem Ziel der Feststellung des Ausmaßes der Erkrankung sowie einer primären maximalen Tumorreduktion im Becken und Abdomen einschließlich pelviner und paraaortaler Lymphadenektomie. Ungünstige Prognosefaktoren beim FIGO-Stadium I sind v. a. eine intraoperative Kapselruptur und ein Grading G3.

Abstract

About 25% and 7% of ovarian cancer patients are diagnosed as having FIGO stage I or IIA disease, respectively. If the suspicion of ovarian cancer exists, operative exploration and histologic confirmation are necessary. It is almost never possible to preoperatively diagnose ovarian cancer at an early stage. For example, if only one positive lymph node in the paraaortic region is diagnosed at final histology, the patient will be allocated to stage IIIC disease. In stages I and II disease in which ovarian cancer is limited to the pelvis, accurate surgical staging leads to upstaging of the disease to stage III in 31% of cases because of subclinical metastases in the greater omentum, the peritoneum, and/or retroperitoneal lymph nodes. Primary surgery comprises operative staging via midline laparotomy and radical surgery with the intent to accurately diagnose the extent of the disease and to resect all visible disease in the pelvis and abdomen, including a pelvic and paraaortic lymphadenectomy. Unfavorable prognostic factors in FIGO stage I disease mainly include intraoperative rupture of the capsule of the tumor as well as tumor grading of G3.

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Petru, E., Benedicic, C., Kimmig, R. et al. Frühes Ovarialkarzinom (FIGO Stadium I–IIA). Onkologe 14, 1130–1139 (2008). https://doi.org/10.1007/s00761-008-1472-4

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  • DOI: https://doi.org/10.1007/s00761-008-1472-4

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