Lodde Georg, Zimmer Lisa, Livingstone Elisabeth, Schadendorf Dirk, Ugurel Selma
Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Hufelandstr. 55, 45147, Essen, Deutschland.
Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partnerstandort Essen, Essen, Deutschland.
Pathologe. 2020 May;41(3):281-292. doi: 10.1007/s00292-020-00776-x.
Malignant melanoma is an aggressive skin cancer that originates from cells of the melanocytic lineage and is associated with an invasive growth pattern and early spread. Besides endogenous risk factors such as fair skin type or genetic disposition for the formation of multiple nevi, exposure to ultraviolet light is the most important exogenous risk factor. Treatment of patients with primary tumors includes the complete excision of the primary lesion with appropriate safety margins and in patients with an increased risk of metastasis sentinel lymph node excision. Prognostically significant parameters are the Breslow invasion depth, ulceration of the primary lesion, and sentinel lymph node status. Systemic therapy plays an important role in the adjuvant setting and for inoperable tumors. Depending on the indication and the molecular profile of the tumor tissue, immune checkpoint inhibitors or targeted kinase inhibitors can be used and may result in a significant prolongation of survival times.
恶性黑色素瘤是一种侵袭性皮肤癌，起源于黑素细胞系细胞，具有侵袭性生长模式并易早期扩散。除了诸如白皙皮肤类型或形成多个痣的遗传倾向等内源性危险因素外，紫外线暴露是最重要的外源性危险因素。原发性肿瘤患者的治疗包括完整切除原发性病变并留有适当的安全切缘，对于转移风险增加的患者进行前哨淋巴结切除。具有预后意义的参数是 Breslow 浸润深度、原发性病变的溃疡情况以及前哨淋巴结状态。全身治疗在辅助治疗和不可切除肿瘤的治疗中发挥重要作用。根据适应证和肿瘤组织的分子特征，可使用免疫检查点抑制剂或靶向激酶抑制剂，这可能会显著延长生存期。
