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Hauttumoren bei organtransplantierten Patienten

Epidemiologie und Management

Skin cancer in organ transplant patients

Epidemiology and management

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Zusammenfassung

Organtransplantierte Patienten zeigen ein erhöhtes Risiko, Krebskrankungen als Langzeitkomplikation zu entwickeln. Tumorerkrankungen der Haut stellen mit 40–50% die größte Gruppe der Neoplasien dar. In den ersten 10 Jahren nach Organtransplantation treten bei 15–40% der Patienten maligne Hauttumore, besonders Plattenepithelkarzinome, Basalzellkarzinome, aber auch Melanome, Merkel-Zell-Karzinome und virusinduzierte Kaposi-Sarkome, auf. Neben einer Sekundärprophylaxe ist die suffiziente Therapie einer bestehenden Feldkanzerisierung von entscheidender prognostischer Bedeutung. Hierbei werden vorwiegend topische Therapien empfohlen. Bei Hochrisikotumoren oder metastasierten Tumorstadien wird eine substanzielle Reduktion bzw. ein Umsetzen der immunsuppressiven Therapie auf mTOR-Inhibitoren zur Prognoseverbesserung beschrieben. Des Weiteren werden Empfehlungen zur Therapie der einzelnen Tumorentitäten gegeben, die sich weitgehend an den gültigen Leitlinien orientieren.

Abstract

Transplant recipients are at significantly increased risk of cancer development as a long term complication. Skin cancer is the most common cancer, representing 40-50% of post transplant malignancies. In the first 10 years post transplantation, some 15%-40% of patients develop skin cancer, primarily squamous cell carcinoma and basal cell carcinoma, but also melanoma, Merkel cell carcinoma and virally-induced Kaposi sarcoma. The management of skin cancer includes secondary prophylaxis and address attention to areas of widespread actinic damage, usually with topical agents. In high risk skin cancer or metastatic disease a substantial reduction in immunosuppression to switching to mTOR inhibitors appears to substantially improve the prognosis. The management of the individual tumor types is discussed; in general it follows the current guidelines.

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  1. Zentrum für Dermato-Onkologie, Universitäts-Hautklinik, Eberhard-Karls-Universität Tübingen, Liebermeisterstr. 25, 72076, Tübingen, Deutschland

    U. Leiter & C. Garbe

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  1. U. Leiter
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  2. C. Garbe
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Correspondence to U. Leiter.

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Leiter, U., Garbe, C. Hauttumoren bei organtransplantierten Patienten. Hautarzt 61, 207–213 (2010). https://doi.org/10.1007/s00105-009-1862-6

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