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Kutanes Melanom

Cutaneous melanoma

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Zusammenfassung

Während die Inzidenz des kutanen Melanoms (CM) ständig steigt, haben sich die Mortalitätszahlen stabilisiert. Risikofaktoren für die CM-Entwicklung sind Exposition gegenüber UV-Licht und individuelle Merkmale des Pigmentsystems, v. a. die Anzahl melanozytärer Nävi. Der entscheidende prognostische Faktor ist die vertikale Tumordicke am histologischen Präparat. Die Exzision des Primärtumors mit angepasstem Sicherheitsabstand ist die Therapie der Wahl. Ab einer Tumordicke von 1,0 mm wird eine Wächterlymphknotenbiopsie empfohlen. In der adjuvanten Situation zeigte nur Interferon-α in prospektiv randomisierten Studien einen signifikanten Vorteil. Die Therapie bei Fernmetastasierung ist palliativ. Primär wird versucht, durch operative, radiologische und chemotherapeutische Maßnahmen eine Remission zu erreichen. Als systemische Standardtherapie ist am ehesten die Dacarbazinmonochemotherapie anzusehen. Die Nachsorge orientiert sich an den initialen Tumordaten sowie am aktuellen Stadium.

Abstract

While the incidence of cutaneous melanoma (CM) continues to rise steadily, the mortality has stabilized. Risk factors for the development of CM are UV light exposure and individual characteristics relating to pigmentation, and especially the number of melanocytic nevi. The most important prognostic factor in CM is the vertical thickness of the primary tumor in the histological specimen. Excision of the primary tumor with adequate safety margins is the treatment of choice. In the case of a tumor 1.0 mm or more thick biopsy of the sentinel node is recommended. Interferon-α is currently the only adjuvant therapy shown to have significant benefit in prospective randomized trials. When distant metastases are present treatment is palliative and is aimed primarily at achieving tumor remission by operative, radiological, and pharmacological means. Dacarbazine is considered the standard drug for systemic treatment. Follow-up depends on the initial tumor parameters and the current stage of the disease.

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Authors and Affiliations

  1. Zentrum für Hauttumoren, Südwestdeutsches Tumorzentrum, Universitätshautklinik Tübingen, Tübingen, Deutschland

    T.K. Eigentler & C. Garbe

  2. Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Deutschland

    L.-O. Mügge

  3. Klinik für Chirurgie und Chirurgische Onkologie, Robert-Rössle-Klinik, Charité-Universitätsmedizin Berlin, Campus Buch, Berlin, Deutschland

    A. Bembenek

Authors
  1. T.K. Eigentler
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  2. L.-O. Mügge
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  3. A. Bembenek
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  4. C. Garbe
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Correspondence to T.K. Eigentler.

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Eigentler, T., Mügge, LO., Bembenek, A. et al. Kutanes Melanom. Onkologe 13, 745–758 (2007). https://doi.org/10.1007/s00761-007-1203-2

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