Wiener Medizinische Wochenschrift

, Volume 163, Issue 15–16, pp 347–353

Advanced basal cell carcinoma

main topic

Summary

Basal cell carcinoma (BCC) is the most common skin malignancy worldwide. Ultraviolet light exposure is the best known exogenous factor in BCC development. This is also the target for primary prevention. Advanced BCC include locally advanced tumors and metastatic tumors. Prognosis is worse compared to stage I and II BCCs. Mohs or micrographically controlled surgery is the gold standard of treatment. In patients with tumors that cannot be completely removed radiotherapy was the only alternative in the past. More recently new drugs for targeted therapy of signaling pathways like sonic hedgehog or epidermal growth factor receptor became available. More small molecules are under investigation. Since the complete response rates are limited, future research has to evaluate their combination with surgery.

Keywords

Basal cell carcinoma Ultraviolet-light exposure Sonic hedgehog Epidermal growth factor Surgery 

Das fortgeschrittene Basalzellkarzinom

Zusammenfassung

Das Basalzellkarzinom (BCC) ist weltweit der häufigste maligne Tumor. Die Exposition gegenüber ultravioletter Strahlung gilt als bekanntester exogener Faktor in der BCC-Entwicklung. Hierauf zielen auch alle primären Präventionsmaßnahmen. Unter dem Begriff der fortgeschrittenen BCC werden lokal ausgedehnte Tumore und metastasierende Tumore zusammengefaßt. Ihre Prognose ist deutlich schlechter als bei den Stadien I und II. Mohs- oder mikrographisch-kontrollierte Chirurgie gilt als Goldstandard in der Behandlung. Bei Patienten, wo eine komplette Exzision des Tumors unmöglich war, blieb in der Vergangenheit nur die Strahlentherapie als Alternative. In jüngerer Zeit gibt es Medikamente für eine zielgerichtete Behandlung mit Beeinflussung von Signalkaskaden wie Sonic hedgehog oder epidermalem Wachstumsfaktor-Rezeptor. Weitere kleine Moleküle werden geprüft. Da bislang die kompletten Remissionsraten unter dieser Therapie limitiert sind, gilt es ihre bestmögliche Kombination mit der Chirurgie zu bestimmen.

Schlüsselwörter

Basalzellkarzinom Ultraviolett-Exposition Sonic hedgehog Epidermaler Wachstumsfaktor Chirurgie 

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Copyright information

© Springer-Verlag Wien 2013

Authors and Affiliations

  1. 1.Department of Dermatology and AllergologyAcademic Teaching Hospital Dresden-FriedrichstadtDresdenGermany
  2. 2.Policlinic for Dermatology and VenereologyUniversity Hospital Lozenetz, Academic Educational Hospital of the Saint Kliment Ohridski UniversitySofiaBulgaria

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