Prognostische Parameter für flache MM bis 1 mm

Leider nur in Englisch

Ich übersetz mal kurz das Wichtigste in Kürze:

Zwischen 1976 und 2000 wurden 12.738 Patienten mit einem MM bis zu 1 mm untersucht. Grundlage war das deutsche Melanom-Zentralregister.

Ergebnis: Bei flachen Melanomen spielen Ulzeration und Regression weniger eine gefährliche Rolle als bei tiefen Melanomen.

Außerdem die wichtigsten prognostischen Parameter:

1. Tumordicke
2. Geschlecht (bessere Prognose: weiblich)
3. Alter (bessere Prognose ältere Patienten)
4. Lokalisation (bessere Prognose Arme und Beine)
5. Histopathologischer Subtypus.

10-Jahres-Überleben zwischen 91,8 und 98,1 %, wobei eine bessere Prognose zu verzeichnen war, je mehr Parameter hinzugezogen wurden. Eine alleinige Orientierung nach Breslow ergab eine schlechtere/ungenauere Prognose. Die neue Stadieneinteilung AJCC 2002 beinhaltet zwar Ulzeration und Clark-Level, doch haben diese Faktoren für die Prognose bei flachen MM keinerlei Relevanz.

http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

Prognostic factors of thin cutaneous melanoma: an analysis of the central malignant melanoma registry of the german dermatological society.

Leiter U, Buettner PG, Eigentler TK, Garbe C.

Department of Dermatology, Central Malignant Melanoma Registry of the Germany Dermatological Society, Eberhard-Karls-University, Tuebingen, Germany.

PURPOSE: The increasing number of thin cutaneous melanomas (CM) with tumor thickness up to 1 mm demands a detailed analysis of prognostic factors for the classification and grading of these tumors. The aim of the present study was to identify prognostic factors in thin CM. PATIENTS AND METHODS: A series of 12,728 patients with thin incident primary invasive CM and follow-up data recorded between 1976 and 2000 by the German-based Central Malignant Melanoma Registry was analyzed using the multivariate Cox proportional hazard model to evaluate prognostic factors, and classification and regression trees analysis (CART) to define prognostic groups. RESULTS: Multivariate analysis found tumor thickness, sex, age, body site, and histopathologic subtype to be significant prognostic factors of thin CM. Ulceration and regression did not affect prognosis significantly. Prognostic classification based on the results of CART analysis resulted in three groups defined by tumor thickness, age, and sex. Ten-year survival rates of these groups varied between 91.8% and 98.1%, with improved classification as compared with subgroups by tumor thickness alone. CONCLUSION: Classification by tumor thickness identified prognostic subgroups with highest significance in thin CM, and the classification was improved by the introduction of age and sex. However, neither ulceration nor the level of invasion included in the new American Joint Committee on Cancer TNM system classification, revealed statistical significance as prognostic factors in thin CM.

PMID: 15302905 [PubMed - indexed for MEDLINE]