Aktueller Stand der chirurgischen und adjuvanten Therapie der Malignome der Gesichtshaut und der Ohrmuschel

Zusammenfassung

Stellten die verschiedenen malignen Neoplasien (MN) der Haut [1] vor 2 Jahrzehnten noch eine relativ seltene Entität dar, sind sie heute mit zunehmender Inzidenz weltweit stark verbreitet. MN der Haut, des größten menschlichen Organes, können von allen Strukturen und Schichten ausgehen. Während früher Hautkrebs-Erkrankungen überwiegend nach dem 60. Lebensjahr auftraten, steigt die Inzidenz aktuell auch bei jüngeren Jahrgängen. U. a. starke Sonnenbrände in der Kindheit und vor dem 20. Lebensjahr stellen neben anderen Einflüssen wichtige Risikofaktoren für die Entstehung von MN der Haut dar. Eine erhöhte Exposition gegenüber UV-Strahlen findet sich vor allem bei der Gesichtshaut, wo Basalzellkarzinome, Plattenepithelkarzinome, maligne Melanome und Merkelzellkarzinome die häufigsten MN darstellen. Frühzeitige Diagnosestellung und eine adäquate (meist chirurgische) Behandlung auch unter funktionellen Gesichtspunkten unter Einbindung in eine interdisziplinäre Therapieentscheidung sind entscheidend für die Prognose sämtlicher MN. Unter Berücksichtigung der zunehmenden Inzidenz der o. g. MN werden die Grenzen der chirurgischen Therapiemöglichkeiten und multimodale Behandlungsaspekte bis hin zu neuen, teils noch in der Prüfphase befindlichen Optionen nach neuesten Erkenntnissen und Vorgaben dargestellt.

Abstract

Malignant tumors of the skin had been a rare entity 2 decades ago. Today they are spread rapidly worldwide. Malignant neoplasms of the skin, the largest human organ, may occur from all structures and layers. While previously skin cancer ­occurred mainly after the age of 60, the incidence increases now in younger ages. Strong sunburns in the childhood and before the age of 20 are important risk factors for the development of malignancies of the skin. An increased exposure to UV rays is found especially in the facial skin, where basal cell carcinoma, squamous cell carcinoma, malignant melanoma and Merkel cell carcinomas are the most common malignancies. Early diagnosis of malignancies and therapy-oriented mostly surgical approaches are crucial for the prognosis of all skin cancers. Therefore under the aspect of the increasing incidence these topics will be pointed out according to the latest findings including current multimodal therapy concepts and future treatment options.

Schlüsselwörter

Basalzellkarzinom - Plattenepithelkarzinom - Melanom - Merkelzellkarzinom - multimodale Therapie

Key words

basal cell carcinoma - squamous cell carcinoma - melanoma - Merkel cell carcinoma - multimodal therapy

*

^* C. Götz and A. W. Eckert haben zu gleichen Teilen zu diesem Manuskript beigetragen.

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