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S2k-Leitlinie Diagnostik und Therapie des Vaginalkarzinoms und seiner Vorstufen – Anforderungen an die Pathologie

Interdisciplinary S2k guidelines on the diagnosis and treatment of vaginal carcinoma and its precursors—recommendations on surgical pathology for histopathological workup, diagnostics, and reporting

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Zusammenfassung

Das Vaginalkarzinom ist ein seltenes Malignom des weiblichen Genitales. Pathogenetisch können ein HPV-high-risk-Pathogeneseweg und ein p53-abhängiger Pathogeneseweg definiert werden. Der vaginale M. Paget ist selten und zumeist assoziiert mit einem M. Paget der Vulva oder lokoregionären Karzinomen. Diagnostische Biopsien sollen in Stufenschnitten aufgearbeitet werden. Sentinel-Lymphknoten sollen vollständig und mittels Ultrastaging untersucht werden. Etablierte morphologische Prognosefaktoren sind das Tumorstadium und lokoregionäre Metastasen. Molekulare Marker spielen derzeit keine Rolle.

Abstract

Primary vaginal carcinoma is rare. There are two pathogenetic pathways, one associated with HPV high-risk infection and another one with inactivation of p53. Vaginal Paget’s disease is rare and mostly associated with vulvar disease or represents intravaginal spread of associated locoregional cancer. Diagnostic vaginal biopsies should be examined by step sections on H&E. Sentinel lymph nodes should be processed completely using ultrastaging. Morphology-based prognostic factors with good clinical evidence are tumour stage and lymph node status. Molecular markers are not currently relevant for treatment decision and prognosis.

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Mitglieder der Kommission zur Erstellung der S2k-Leitlinie Vaginalkarzinom

Prof. Dr. med. Lars-Christian Horn, Monika Hampl, Grit Mehlhorn, Markus Follmann, Hans-Georg Schnürch

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Authors and Affiliations

  1. Institut für Pathologie, Abteilung Mamma‑, Gynäko- & Perinatalpathologie, Universitätsklinikum Leipzig AöR, Liebigstraße 26, 04103, Leipzig, Deutschland

    Lars-Christian Horn & Anne Kathrin Höhn

  2. Universitätsfrauenklinik, Heinrich-Heine-Universität, Düsseldorf, Deutschland

    Monika Hampl

  3. Frauenarztpraxis Erlangen, Erlangen, Deutschland

    Grit Mehlhorn

  4. Deutsche Krebsgesellschaft, Berlin, Deutschland

    Markus Follmann

  5. Lukaskrankenhaus Neuss, Kaarst, Deutschland

    Hans-Georg Schnürch

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  1. Lars-Christian Horn
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  2. Anne Kathrin Höhn
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  3. Monika Hampl
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  4. Grit Mehlhorn
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  5. Markus Follmann
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  6. Hans-Georg Schnürch
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Consortia

Kommission zur Erstellung der S2k-Leitlinie Vaginalkarzinom

  • Lars-Christian Horn
  • , Monika Hampl
  • , Grit Mehlhorn
  • , Markus Follmann
  •  & Hans-Georg Schnürch

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Correspondence to Lars-Christian Horn.

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Interessenkonflikt

L.-C. Horn, A. K. Höhn, M. Hampl, G. Mehlhorn, M. Follmann und H.-G. Schnürch geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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K. W. Schmid, Essen

H. Baba, Essen

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Horn, LC., Höhn, A.K., Hampl, M. et al. S2k-Leitlinie Diagnostik und Therapie des Vaginalkarzinoms und seiner Vorstufen – Anforderungen an die Pathologie. Pathologe 42, 116–124 (2021). https://doi.org/10.1007/s00292-020-00876-8

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  • DOI: https://doi.org/10.1007/s00292-020-00876-8

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