Garbe C, Bertz J, Orfanos C E
Universitäts-Hautklinik und Poliklinik, Klinikum Steglitz der Freien Universität Berlin.
Hautarzt. 1987 Nov;38(11):639-44.
From July 1983 to April 1987, 2834 reports of malignant melanoma (MM) were received by the Central Registry of the German Dermatological Society in Berlin from 22 departments of dermatology in the German-speaking countries. Of these, 2277 reports were documented in a data bank and evaluated. Compared to earlier reports from the 1960s and 1970s the percentage of male patients with MM was found to be increased: 41% males, 59% females. Also, the tumor occurs today at a slightly younger age: 63% of all males and 56% of all females with MM were adults 30-60 years of age. In 10% of all MM patients, MM metastases were found during their first visit (stages II-IV). In addition, 37% of all patients in stage I without metastasis had MMs that were thicker than 1.5 mm. This indicates that there is a necessity for further information and early recognition of the MM in German-speaking countries. Regarding the therapeutic approach, considerable differences were noted among the various departments. Half of the primary MM excisions were conducted under local anesthesia, the rest with general anesthesia. In about 40% of all cases, a second surgical procedure was performed for larger excisions: half of the patients were operated on with safety margins of less than 3 cm. Twenty-seven percent of the patients in stage I MM received some type of adjuvant therapy, including chemo- and/or immunotherapy. However, postsurgical management varied greatly among the different departments. The additional results regarding possible risk factors, such as sun exposure and preexisting pigmented moles, are remarkable.
1983年7月至1987年4月,柏林的德国皮肤病学会中央登记处收到了来自德语国家22个皮肤科的2834例恶性黑色素瘤(MM)报告。其中,2277例报告被记录在数据库中并进行了评估。与20世纪60年代和70年代的早期报告相比,发现男性MM患者的比例有所增加:男性占41%,女性占59%。此外,如今该肿瘤的发病年龄略小:所有男性MM患者中有63%以及所有女性MM患者中有56%为30至60岁的成年人。在所有MM患者中,10%在首次就诊时就发现有MM转移(II - IV期)。此外,所有I期无转移的患者中,37%的MM厚度超过1.5毫米。这表明在德语国家有必要进一步宣传并尽早识别MM。关于治疗方法,各科室之间存在显著差异。一半的原发性MM切除手术是在局部麻醉下进行的,其余的则采用全身麻醉。在所有病例中,约40%因切除范围较大而进行了二次手术:一半患者手术的安全切缘小于3厘米。I期MM患者中有27%接受了某种辅助治疗,包括化疗和/或免疫治疗。然而,不同科室的术后管理差异很大。关于可能的风险因素,如阳光照射和既往色素痣等的其他结果也很显著。