Lymphknotenstaging bei Genitalkarzinomen – wohin geht die Reise?

Lymphogenic metastasis is an important diagnostic and prognostic parameter of genital carcinomas; however, the therapeutic value of surgical lymph node resection is increasingly being discussed. In addition, systematic lymph node resection has a significant risk of morbidity, which is why the indications should be carefully verified. The importance of sentinel lymph node biopsies (SNB) has been increasing for years as it often enables adequate lymph node staging with a low risk of complications. According to the state of the art, systematic lymph node resection does not improve the survival rates in advanced ovarian cancer and endometrial carcinomas. Systematic pelvic lymph node resection in advanced vulvar neoplasms is also controversially discussed. The SNB in endometrial and vulvar cancers was extensively investigated and should be clinically applied with appropriate indications. In early cervical cancer SNB can also be an adequate treatment option. Within the next years the results of the SELLY study concerning SNB in early ovarian cancers are expected. The diagnostic relevance of systematic lymph node resection in cervical carcinomas currently remains high. In the case of pelvic lymph node metastases, chemoradiotherapy is usually applied instead of radical hysterectomy. This article presents the current state of knowledge concerning lymph node resection in genital carcinomas.