Neue tumorbiologische Erkenntnisse, vor allem über die Bedeutung von Oxygenation und Vaskularisation zusätzlich zum Tumorvolumen, in bezug auf Metastasierungspotential und Therapieresistenz, und die Entwicklung neuer ablativer und rekonstruktiver Operationstechniken könnten zu einer Änderung des Behandlungsparadigmas beim Zervixkarzinom führen. Im Vergleich mit den bisherigen Standards, abdominale radikale Hysterektomie mit lokoregionärer Lymphknotenentfernung beim «operablen» Tumor (FIGO-Stadien lb, Ha, und lib mit Einschränkungen) und Strahlentherapie in den fortgeschritteneren («inoperablen») Stadien, sollten – tumoradaptiert – einerseits weniger radikale und andererseits erweitert radikale Operationsverfahren innerhalb von kontrollierten klinischen Studien überprüft werden. Die Verbesserung des therapeutischen Indexes und die mögliche Erweiterung des therapeutischen Fensters beim Zervixkarzinom stellen eine spannende und anspruchsvolle Zukunftsperspektive für die operative Gynäkologie dar.

Keywords:
Cervical carcinoma, surgical treatment, Pelvic wall recurrence, Reconstructive surgery, pelvis, Tumor biology
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© 1995 S. Karger AG, Basel
1995
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