Kofler R, Rieger E, Soyer H P, Smolle J, Kerl H
Universitätsklinik für Dermatologie und Venerologie, Graz.
Hautarzt. 1994 Mar;45(3):145-8. doi: 10.1007/s001050050053.
Late recurrence of malignant melanoma, defined as the occurrence of metastases after a disease-free interval of 10 or more years, is a rare but well-known clinical phenomenon. We report on three female patients who developed in transit metastases 26, 15 and 10 years after excision of the primary tumour. All three patients are disease-free 8 and 9 years after resection of the metastases. Reports in the literature also indicate a favourable prognosis for patients with local recurrence or in transit or regional lymph node metastases. The prognosis for patients with late distant metastases, however, is generally poor. For the first group, an early therapeutic intervention is indicated. This and the occurrence of second and multiple primary melanomas make lifelong aftercare desirable. On the other hand, long-term aftercare of the constantly increasing number of melanoma patients will soon exceed the capacity of existing facilities. A high-risk group for late recurrence that would profit by long-term aftercare cannot be defined at the moment.
恶性黑色素瘤的晚期复发被定义为在无病间隔10年或更长时间后发生转移,这是一种罕见但广为人知的临床现象。我们报告了三名女性患者,她们在原发肿瘤切除后26年、15年和10年出现了途中转移。所有三名患者在转移灶切除后8年和9年均无疾病。文献报道也表明,局部复发、途中或区域淋巴结转移的患者预后良好。然而,晚期远处转移患者的预后通常较差。对于第一组患者,需要早期治疗干预。这以及第二原发性和多发性原发性黑色素瘤的发生使得终身随访成为必要。另一方面,不断增加的黑色素瘤患者的长期随访很快将超出现有设施的能力。目前还无法确定能从长期随访中获益的晚期复发高危人群。