Malignant Melanoma S3‐Guideline “Diagnosis, Therapy and Follow‐up of Melanoma”

Pflugfelder, Annette; Kochs, Corinna; Blum, Andreas; Capellaro, Marcus; Czeschik, Johanna Christina; Dettenborn, Therese; Dill, Dorothee; Dippel, Edgar; Eigentler, Thomas; Feyer, Petra; Follmann, Markus; Frerich, Bernhard; Ganten, Maria-Katharina; Gaertner, Jan; Gutzmer, Ralf; Hassel, Jessica C.; Hauschild, Axel; Hohenberger, Peter; Huebner, Jutta; Kaatz, Martin; Kleeberg, Ulrich R.; Koelbl, Oliver; Kortmann, Rolf‐Dieter; Krause-Bergmann, A.; Kurschat, Peter; Leiter, Ulrike; Link, Hartmut; Loquai, Carmen; Loeser, Christoph R.; Mackensen, Andréas; Meier, Friedegund; Möhr, Peter; Moehrle, Matthias; Nashan, Dorothée; Reske, Sven N.; Rosé, Christian; Sander, Christian; Satzger, Imke; Schiller, Meinhard; Schlemmer, Heinz–Peter; Strittmatter, Gerhard; Sunderköetter, Cord; Swoboda, L; Trefzer, Uwe; Voltz, Raymond; Vordermark, Dirk; Weichenthal, Michael; Werner, Andreas; Wesselmann, Simone; Weyergraf, A.; Wick, Wolfgang; Garbe, Claus; Schadendorf, Dirk

doi:10.1111/ddg.12113_suppl

Cited by 179 publications

(207 citation statements)

References 552 publications

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“…Published guidelines for the management of cutaneous melanoma in the United Kingdom, the Netherlands, and Australia do not recommend routine radiological investigations; however, German guidelines recommend cross-sectional imaging every 6 months for Stage IIC or greater for the first 3 years after resection. Swiss guidelines recommend annual CXRs for the first 5 years in patients with Stage I/Stage II disease, and PET/CT or CT in the follow-up of Stage III patients (22,23).…”

Section: Imagingmentioning

confidence: 99%

“…The NCCN states lymph node US may be considered in patients with an equivocal physical examination, in patients who were offered SLNB but refused, or patients with positive sentinel lymph nodes who did not receive complete lymph node dissections (1). German melanoma guidelines however do recommend lymph node ultrasonography every 6 months in Stage IB to Stage IIB and every 3 months for Stage IIC or greater (23).…”

Section: Lymph Node Ultrasonographymentioning

confidence: 99%

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Short-Term and Long-Term Management of Melanoma

Goel

Ward

et al. 2017

Cutaneous Melanoma: Etiology and Therapy

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Without consensus guidelines for surveillance in patients with resected melanoma, much debate exists on the appropriate short-term and long-term management of melanoma. When discussing surveillance, it is also important to keep in mind the long-term impact of ongoing surveillance in terms of improved survival, patient quality of life, cost effectiveness, and exposure to risks associated with certain surveillance methods. Most studies recommend frequent follow-up visits with dermatologic surveillance to detect potentially curable recurrence, especially resectable locoregional recurrences. Surveillance laboratory tests and chest x-rays (CXR) can have limited value while producing a relatively high falsepositive rate. Lymph node ultrasonography is a valuable imaging modality in patients with equivocal lymphatic nodal basin physical examinations. In patients with early stages of melanoma, the benefit of routine surveillance imaging studies is questionable; however, close surveillance with detailed medical history and physical examination is necessary, with special attention to regional recurrences every 3-12 months, depending on the American Joint Committee on Cancer (AJCC) stage category the patient falls into and the risk of recurrence. In Stage III or greater, more frequent surveillance in the form of more frequent physical examination, laboratory tests based on symptomatology, and cross-sectional imaging 162may be indicated because of the higher risk of recurrence in this population. CT, MRI, and/or PET/CT are often a component of the overall follow-up for these high-risk patients. Additional studies are needed to better define the role of surveillance in the asymptomatic patient with resected melanoma.

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Section: Imagingmentioning

confidence: 99%

Section: Lymph Node Ultrasonographymentioning

confidence: 99%

Short-Term and Long-Term Management of Melanoma

Goel

Ward

et al. 2017

Cutaneous Melanoma: Etiology and Therapy

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“…Bei sehr frühen/dünnen Melanomen ist die Prognose exzellent und entspricht der Prognose in der Allgemeinbevölke-rung. Entscheidend ist daher ihre früh-zeitige Diagnose und leitliniengerechte chirurgische Therapie [1]. In der primär chirurgischen Entfernung richtet sich der Sicherheitsabstand nach der Tumordicke (TD): Bei In-situ-Melanomen sollte dieser 0,5 cm zu allen Seiten betragen, < 2,0 mm TD 1 cm und ≥ 2,0 mm TD 2 cm Abstand zu allen Seiten.…”

Section: Hautneoplasien Und Immunmodulierende Pharmakotherapie Der Rhunclassified

“…Die Aktivierung des Immunsystems ist ein Schlüsselfaktor in der Tumorabwehr des malignen Melanoms, sodass Krankheitszustände mit kompromittierter Immunkompetenz, z. B. die dauerhafte Immunsuppression nach Organtransplantation, Risikofaktoren der Kanzerogenese sind [1]. Analog stellt sich daher die Frage, inwiefern die RA per se bzw.…”

Section: Hautneoplasien Und Immunmodulierende Pharmakotherapie Der Rhunclassified

Hautmalignome und immunmodulierende Antirheumatikatherapie

et al. 2016

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For the clinical practice there is uncertainty as to what degree the therapeutic immunomodulation of rheumatoid arthritis (RA) is associated with a weakening of protective tumor immunity. Neoplasms of the skin in particular are known to exhibit increased incidence rates in association with therapeutic immunosuppression in transplantation medicine; however, the immunosuppression required for the prevention of allogenic graft rejection is much more intensive and thus not directly transferable to the potential risks for an onset or relapse of melanoma or non-melanoma skin cancers (NMSC), e.g. spinocellular and basal cell carcinomas in association with the antirheumatic treatment of RA. This review covers the association of RA and its pharmacotherapy with conventional synthetic (cs) and biologic disease-modifying antirheumatic drugs (DMARD) on the basis of a systematic literature search. The incidence rates of NMSC are twice as high in biologicnaive RA patients compared to the general population, whereas the respective incidence rates for melanoma do not differ. A biologic treatment with tumor necrosis factor (TNF) blockers compared with administration of csDMARD only has a minor, if any effect on the increase of NMSC risk but is associated with a trend towards an elevated incidence rate of new onset melanoma although significance level was not reached in all of the reviewed studies. The data on non-TNF blocking biologics is sparse. Accordingly, it is inappropriate to draw any strong conclusions on potentially associated skin cancer risks from the present lack of safety signals. The consideration of individual risk factors, recommendations on sufficient UV protection and regular skin monitoring may serve to improve the safety of DMARD therapy in RA

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“…Sentinel lymph node biopsy (SLNB) is an integral part of the surgical management of primary malignant melanoma and is recommended in actual guidelines [1], in the absence of loco-regional or distant metastases, when the tumor thickness exceeds 1 mm [1]. Indeed, SLNB may be indicated when the tumor thickness is less than 1 mm in certain cases [2][3][4].…”

Section: Introductionmentioning

confidence: 99%