Gynecologic oncology: the German view

In future there will be major problems in gynecologic oncology concerning the changes in epidemiology, etiology and the individualized multidisciplinary treatment modalities. The gynecologic oncology has to realize the rising incidence of elderly patients and in correlation to the age and the demography of the increase in breast and vulvar cancer.

The literature and the own experience support the use of similar diagnostic and therapeutic efforts for elderly and younger women with modification for elderly patients based only on the comorbidity. For elderly patients, a breast conserving therapy should be preferred as in younger patients. In vulvar cancer, an individualized therapy is also possible. In patients with endometrial cancer, the systematic lymphnode dissection should be realized.

The radicality does not depend on the measurement of depth of invasion based on the intraoperative frozen section. Only the surgical removal and histologic evaluation of the nodes may accurately determine the actual nodal status. In lymphnode negative patients, the postoperative adjuvant radiotherapy is preventable.