Malignant Melanoma S3-Guideline "Diagnosis, Therapy and Follow-up of Melanoma"

被引:202
作者
Pflugfelder, Annette [1 ]
Kochs, Corinna [2 ]
Blum, Andreas
Capellaro, Marcus [3 ]
Czeschik, Christina [2 ]
Dettenborn, Therese [4 ]
Dill, Dorothee
Dippel, Edgar [5 ]
Eigentler, Thomas [1 ]
Feyer, Petra [6 ]
Follmann, Markus [7 ]
Frerich, Bernhard [8 ]
Ganten, Maria-Katharina [9 ]
Gaertner, Jan [10 ]
Gutzmer, Ralf [11 ]
Hassel, Jessica [12 ]
Hauschild, Axel [13 ]
Hohenberger, Peter [14 ]
Huebner, Jutta [15 ]
Kaatz, Martin [16 ]
Kleeberg, Ulrich R. [17 ]
Koelbl, Oliver [18 ]
Kortmann, Rolf-Dieter [19 ]
Krause-Bergmann, Albrecht [4 ]
Kurschat, Peter [20 ]
Leiter, Ulrike [1 ]
Link, Hartmut [21 ]
Loquai, Carmen [22 ]
Loeser, Christoph [5 ]
Mackensen, Andreas [23 ]
Meier, Friedegund [1 ]
Mohr, Peter [3 ]
Moehrle, Matthias [1 ,24 ]
Nashan, Dorothee [25 ]
Reske, Sven [26 ]
Rose, Christian
Sander, Christian [27 ]
Satzger, Imke [11 ]
Schiller, Meinhard [28 ]
Schlemmer, Heinz-Peter [9 ]
Strittmatter, Gerhard [29 ]
Sunderkoetter, Cord [28 ]
Swoboda, Lothar [30 ]
Trefzer, Uwe [31 ]
Voltz, Raymond [10 ]
Vordermark, Dirk [32 ]
Weichenthal, Michael [13 ]
Werner, Andreas [33 ]
Wesselmann, Simone [7 ]
Weyergraf, Ansgar J. [34 ]
机构
[1] Univ Tubingen Hosp, Dept Dermatol, Tubingen, Germany
[2] Univ Hosp Essen, Dept Dermatol, Essen, Germany
[3] Assoc Dermatol Prevent, Buxtehude, Germany
[4] Fachklin Hornheide, Munster, Germany
[5] Ludwigshafen Hosp, Skin Canc Ctr, Dept Dermatol, Ludwigshafen, Germany
[6] Vivantes Clin Neukolln, Clin Radiotherapy & Radiooncol, Berlin, Germany
[7] German Canc Soc Berlin, Berlin, Germany
[8] Univ Rostock, Dept Oral & Maxillofacial Surg, D-18055 Rostock, Germany
[9] German Canc Res Ctr, Dept Radiol, Heidelberg, Germany
[10] Univ Hosp Cologne, Dept Palliat Med, Cologne, Germany
[11] Hannover Med Sch, Dept Dermatol & Allergy, Hannover, Germany
[12] German Canc Res Ctr, Heidelberg, Germany
[13] Univ Kiel, Dept Dermatol, Kiel, Germany
[14] Univ Mannheim, Med Ctr, Div Surg Oncol & Thorac Surg, Mannheim, Germany
[15] Goethe Univ Frankfurt, D-60054 Frankfurt, Germany
[16] SRH Waldklinikum Gera Gmbh, Dept Dermatol & Allergol, Gera, Germany
[17] HOPA, Hamburg, Germany
[18] Univ Hosp Regensburg, Dept Radiotherapy, Regensburg, Germany
[19] Univ Leipzig, Dept Radiat Therapy, D-04109 Leipzig, Germany
[20] Univ Hosp Cologne, Dept Dermatol & Venereol, Cologne, Germany
[21] Westpfalz Klinikum, Med Clin 1, Kaiserslautern, Germany
[22] Johannes Gutenberg Univ Mainz, Dept Dermatol, Mainz, Germany
[23] Univ Erlangen Nurnberg, Dept Internal Med Hematol Oncol 5, Erlangen, Germany
[24] Praxisklin Tubingen Haut & Venen, Tubingen, Germany
[25] Klinikum Dortmund gGmbH, Dept Dermatol, Dortmund, Germany
[26] Univ Clin, Dept Nucl Med, Ulm, Germany
[27] Asklepios Klin St Georg, Klin Dermatol & Allergol, Hamburg, Germany
[28] Univ Hosp Munster, Dept Dermatol, Munster, Germany
[29] Fachklin Hornheide, Dept Psychosocial Oncol, Munster, Germany
[30] German Soc Thorac Surg, Berlin, Germany
[31] Univ Hosp Charite Berlin, Dept Dermatol, Berlin, Germany
[32] Univ Klinikum Halle, Dept Radiooncol, Halle, Germany
[33] Tumor Ctr Rhineland Palatinate, Mainz, Germany
[34] Bad Bentheim Hosp, Dept Dermatol & Allergy, Bad Bentheim, Germany
[35] Univ Clin, Dept Neurooncol, Heidelberg, Germany
来源
JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT | 2013年 / 11卷
关键词
SENTINEL LYMPH-NODE; QUALITY-OF-LIFE; HIGH-RISK MELANOMA; RANDOMIZED PHASE-III; POSITRON-EMISSION-TOMOGRAPHY; AMERICAN-JOINT-COMMITTEE; POLYMERASE-CHAIN-REACTION; ISOLATED LIMB PERFUSION; PRIMARY CUTANEOUS MELANOMA; ISOLATED HEPATIC PERFUSION;
D O I
10.1111/ddg.12113_suppl
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
This first German evidence-based guideline for cutaneous melanoma was developed under the auspices of the German Dermatological Society (DDG) and the Dermatologic Cooperative Oncology Group (DeCOG) and funded by the German Guideline Program in Oncology. The recommendations are based on a systematic literature search, and on the consensus of 32 medical societies, working groups and patient representatives. This guideline contains recommendations concerning diagnosis, therapy and follow-up of melanoma. The diagnosis of primary melanoma based on clinical features and dermoscopic criteria. It is confirmed by histopathologic examination after complete excision with a small margin. For the staging of melanoma, the AJCC classification of 2009 is used. The definitive excision margins are 0.5 cm for in situ melanomas, 1 cm for melanomas with up to 2 mm tumor thickness and 2 cm for thicker melanomas, they are reached in a secondary excision. From 1 mm tumor thickness, sentinel lymph node biopsy is recommended. For stages II and III, adjuvant therapy with interferon-alpha should be considered after careful analysis of the benefits and possible risks. In the stage of locoregional metastasis surgical treatment with complete lymphadenectomy is the treatment of choice. In the presence of distant metastasis mutational screening should be performed for BRAF mutation, and eventually for CKIT and NRAS mutations. In the presence of mutations in case of inoperable metastases targeted therapies should be applied. Furthermore, in addition to standard chemotherapies, new immunotherapies such as the CTLA-4 antibody ipilimumab are available. Regular follow-up examinations are recommended for a period of 10 years, with an intensified schedule for the first three years.
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页码:1 / 116
页数:116
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