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Der Onkologe

, Volume 25, Issue 9, pp 831–844 | Cite as

Plattenepithelkarzinom der Haut

  • Andreas Meiwes
  • Ulrike LeiterEmail author
CME
  • 292 Downloads

Zusammenfassung

Das Plattenepithelkarzinom (PEK) der Haut ist der zweithäufigste maligne Hauttumor. Aktuell macht es ca. 20 % aller nichtmelanozytären Hauttumoren aus und tritt am häufigsten an sonnenexponierten Stellen auf. Fortgeschrittene PEK entwickeln sich bei 5–20 % der Patienten. Risikofaktoren sind: Tumordicke >6 mm, -durchmesser ≥2 cm, histologische Differenzierung >Grad 3, Desmoplasie, perineurales Wachstum, Lokalisation, Immunsuppression. Eine histologische Sicherung klinisch verdächtiger Läsionen ermöglicht eine prognostische Einschätzung und korrekte Behandlung. Therapie der Wahl ist die operative Resektion. Die PEK können Lokalrezidive, Lymphknotenmetastasen sowie selten Fernmetastasen bilden. Bei fortgeschrittenen PEK sind Anti-PD-1-Inhibitoren (PD-1: „programmed cell death protein 1“) vielversprechend, die Zulassung wird in Kürze erwartet. Auch EGFR-Inhibitoren (EGFR: Rezeptor des epidermalen Wachstumsfaktors) sowie Chemotherapeutika werden eingesetzt. Es existiert kein Standardregime. Die Nachsorge sollte sich am jeweiligen Risiko orientieren.

Schlüsselwörter

Plattenepithelkarzinom UV-Strahlung Haut Hautkrebs Nachsorge 

Cutaneous squamous cell carcinoma

Abstract

Squamous cell carcinoma (SCC) of the skin is the most frequent malignant skin tumor, accounting for about 20% of all non-melanocytic skin tumors, and occurs most frequently on sun-exposed sites. Advanced cutaneous SCC develops in 5–20% of patients. Risk factors are tumor thickness >6 mm, diameter ≥2 cm, histological differentiation >grade 3, desmoplasia, perineural growth, location and immunosuppression. Histological confirmation of clinically suspicious lesions allows prognostic assessment and appropriate treatment. The therapy of choice is surgical resection. Cutaneous SCC can form local recurrences, lymph node metastases and rarely distant metastases. In advanced cutaneous SCC, anti-PD-1 inhibitors (PD-1: programmed cell death protein 1) are a promising approach, which is expected to receive approval soon. As there is no standard treatment, EGFR inhibitors (EGFR: epidermal growth factor receptor) and chemotherapeutics are also used. Follow-up schedules should be based on the respective risk of recurrence.

Keywords

Squamous cell carcinoma Ultraviolet rays  Skin Skin neoplasms Aftercare 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

Gemäß den Richtlinien des Springer Medizin Verlags werden Autoren und Wissenschaftliche Leitung im Rahmen der Manuskripterstellung und Manuskriptfreigabe aufgefordert, eine vollständige Erklärung zu ihren finanziellen und nichtfinanziellen Interessen abzugeben.

Autoren

A. Meiwes gibt an, dass kein Interessenkonflikt besteht. U. Leiter: Finanzielle Interessen: Honorare: Sanofi Aventis Pharma GmbH, Novartis Pharma GmbH, MSD Pharma GmbH | Honorare/Reisekosten: Roche Pharma GmbH | Reisekosten: Sun Pharma GmbH – Beraterin; MSD, Novartis, Sanofi Aventis | Beraterin/interne Schulungsreferentin: Roche Pharma. Nichtfinanzielle Interessen: Angestellte Hautärztin Universitäts-Hautklinik Tübingen, Oberärztin | Mitgliedschaft: DKG (Deutsche Krebsgesellschaft), ADO (Arbeitsgemeinschaft Dermatologische Onkologie), ASCO (American Society of Clinical Oncology), EADO (European Association of Dermato-Oncology), EADV (European Academy of Dermatology and Venereology), DDG (Deutsche Dermatologische Gesellschaft) | Leitung Komitee Epithelialer Tumoren der ADO | Referentin für Fortbildungsmaßnahmen bei Promedicis.

Wissenschaftliche Leitung

Die vollständige Erklärung zum Interessenkonflikt der Wissenschaftlichen Leitung finden Sie am Kurs der zertifizierten Fortbildung auf www.springermedizin.de/cme.

Der Verlag

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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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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  1. 1.Zentrum für Dermatoonkologie, Südwestdeutsches Tumorzentrum, Universitäts-Hautklinik TübingenEberhard-Karls-Universität TübingenTübingenDeutschland

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