Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Die Onkologie
Erschienen in: Der Onkologe 6/2017

14.02.2017 | Plattenepithelkarzinom der Haut | CME

Kutanes Plattenepithelkarzinom

verfasst von: Ulrike Leiter, Prof. Dr. Ralf Gutzmer, Mareike Alter, Claas Ulrich, Anke S. Lonsdorf, Michael M. Sachse, Uwe Hillen

Erschienen in: Die Onkologie | Ausgabe 6/2017

Einloggen, um Zugang zu erhalten

Zusammenfassung

Das Plattenepithelkarzinom (PEK) der Haut ist eine der häufigsten Krebsarten der kaukasischen Population und macht 20 % aller Hauttumoren aus. Die Diagnose basiert auf der klinischen Untersuchung und der histologischen Sicherung. Therapie der 1. Wahl ist die histologisch kontrollierte vollständige Exzision. Eine Sentinel-Lymphknotenbiopsie kann bei PEK >6 mm Tumordicke erwogen werden, ihre Aussagekraft ist jedoch unklar. Die Radiatio ist eine Alternative zur Chirurgie bei inoperablen PEK oder kann adjuvant bei hohem Rezidivrisiko erwogen werden. Im fernmetastasierten Stadium können verschiedene Chemotherapeutika, EGFR-Inhibitoren (EGFR: „epidermal growth factor receptor“) oder Immun-Checkpoint-Blocker – aufgrund der geringen Evidenz vorzugsweise in klinischen Studien – eingesetzt werden. Die Nachsorge sollte risikoadaptiert stattfinden und schließt primär eine dermatologische Kontrolle, bei Hochrisikopatienten auch Ultraschalluntersuchungen ein.
Literatur
1.
English DR, Armstrong BK, Kricker A, Winter MG, Heenan PJ, Randell PL (1998) Demographic characteristics, pigmentary and cutaneous risk factors for squamous cell carcinoma of the skin: A case-control study. Int J Cancer 76:628–634CrossRefPubMed
2.
Katalinic A, Kunze U, Schafer T (2003) Epidemiology of cutaneous melanoma and non-melanoma skin cancer in Schleswig-Holstein, Germany: Incidence, clinical subtypes, tumour stages and localization (epidemiology of skin cancer). Br J Dermatol 149:1200–1206CrossRefPubMed
3.
Leiter U, Eigentler T, Garbe C (2014) Epidemiology of skin cancer. Adv Exp Med Biol 810:120–140PubMed
4.
Association of Population-based Cancer Registries in G (2011) Incidence and mortality of cancer in the German federal states. In: GEKID-Atlas
5.
Hollestein LM, de Vries E, Nijsten T (2012) Trends of cutaneous squamous cell carcinoma in the Netherlands: Increased incidence rates, but stable relative survival and mortality 1989–2008. EurJCancer 48:2046–2053
6.
Xiang F, Lucas R, Hales S, Neale R (2014) Incidence of nonmelanoma skin cancer in relation to ambient UV radiation in white populations, 1978–2012: empirical relationships. JAMA Dermatol 150:1063–1071CrossRefPubMed
7.
Karia PS, Han J, Schmults CD (2013) Cutaneous squamous cell carcinoma: Estimated incidence of disease, nodal metastasis, and deaths from disease in the United States, 2012. J Am Acad Dermatol 68:957–966CrossRefPubMed
8.
Brantsch KD, Meisner C, Schönfisch B, Trilling B, Wehner-Caroli J, Röcken M, Breuninger H (2008) Analysis of risk factors determining prognosis of cutaneous squamous-cell carcinoma: A prospective study. Lancet Oncol 9:713–720CrossRefPubMed
9.
El Ghissassi F, Baan R, Straif K, Grosse Y, Secretan B, Bouvard V, Benbrahim-Tallaa L, Guha N, Freeman C, Galichet L, Cogliano V; WHO International Agency for Research on Cancer Monograph Working Group (2009) Lancet Oncol. 10(8):751–752
10.
Rettberg P, Horneck G (2016) Intrinsic and extrinsic biomarkers for the assessment of risks from environmental UV radiation. In: Environmental UV Radiation: Impact on Ecosystems and Human Health and Predictive Models, pp. 51–69. DOI:10.​1007/​1-4020-3697-3_​5
11.
Martincorena I, Roshan A, Gerstung M, Ellis P, Van Loo P, McLaren S, Wedge DC, Fullam A, Alexandrov LB, Tubio JM, Stebbings L, Menzies A, Widaa S, Stratton MR, Jones PH, Campbell PJ (2015) Tumor evolution. High burden and pervasive positive selection of somatic mutations in normal human skin. Science 348(6237):880–886
12.
Hillen U, Ulrich M, Alter M, Becker JC, Gutzmer R, Leiter U, Lonsdorf A, Messerschmidt A, Ulrich C (2014) Cutaneous squamous cell carcinoma: A review with consideration of special patient groups. Hautarzt 65:590–599CrossRefPubMed
13.
Brantsch KD, Meisner C, Schonfisch B, Trilling B, Wehner-Caroli J, Rocken M, Breuninger H (2008) Analysis of risk factors determining prognosis of cutaneous squamous-cell carcinoma: A prospective study. Lancet Oncol 9:713–720CrossRefPubMed
14.
Schmults CD, Karia PS, Carter JB, Han J, Qureshi AA (2013) Factors predictive of recurrence and death from cutaneous squamous cell carcinoma: A 10-year, single-institution cohort study. JAMA Dermatol 149:541–547CrossRefPubMed
15.
Thompson AK, Kelley BF, Prokop LJ, Murad MH, Baum CL (2016) Risk factors for cutaneous squamous cell carcinoma recurrence, metastasis, and disease-specific death: A systematic review and Meta-analysis. JAMA Dermatol 152:419–28
16.
Breuninger H, Eigentler T, Bootz F, Hauschild A, Kortmann RD, Wolff K, Stockfleth E, Szeimies RM, Rompel R, Garbe C, Grabbe S (2013) Brief S2k guidelines – Cutaneous squamous cell carcinoma. J Dtsch Dermatol Ges 11(Suppl 3):37–47CrossRefPubMed
17.
Stratigos A, Garbe C, Lebbe C, Malvehy J, del Marmol V, Pehamberger H, Peris K, Becker JC, Zalaudek I, Saiag P, Middleton MR, Bastholt L, Testori A, Grob JJ, European Dermatology F, European Association of D‑O, European Organization for R, Treatment of C (2015) Diagnosis and treatment of invasive squamous cell carcinoma of the skin: European consensus-based interdisciplinary guideline. Eur J Cancer 51:1989–2007CrossRefPubMed
18.
Nappi O, Wick MR, Pettinato G, Ghiselli RW, Swanson PE (1992) Pseudovascular adenoid squamous cell carcinoma of the skin. A neoplasm that may be mistaken for angiosarcoma. Am J Surg Pathol 16:429–438CrossRefPubMed
19.
Weedon DMR, Kao GF, Harwood CA (2006) Keratinocytic tumors. IARC Press, Lyon
20.
Wittekind C (2010) 2010 TNM system: on the 7th edition of TNM classification of malignant tumors. Pathologe 31:331–332CrossRefPubMed
21.
Farasat S, Yu SS, Neel VA, Nehal KS, Lardaro T, Mihm MC, Byrd DR, Balch CM, Califano JA, Chuang AY, Sharfman WH, Shah JP, Nghiem P, Otley CC, Tufaro AP, Johnson TM, Sober AJ, Liegeois NJ (2011) A new American Joint Committee on Cancer staging system for cutaneous squamous cell carcinoma: Creation and rationale for inclusion of tumor (T) characteristics. J Am Acad Dermatol 64:1051–1059CrossRefPubMedPubMedCentral
22.
Breuninger H, Brantsch K, Eigentler T, Hafner HM (2012) Comparison and evaluation of the current staging of cutaneous carcinomas. J Dtsch DermatolGes 10:579–586
23.
Breuninger H, Eigentler T, Bootz F, Hauschild A, Kortmann RD, Wolff K, Stockfleth E, Szeimies RM, Rompel R, Garbe C, Grabbe S (2013) Brief S2k guidelines – Cutaneous squamous cell carcinoma. J Dtsch Dermatol Ges 11(Suppl 3):37–47CrossRefPubMed
24.
Chren MM, Linos E, Torres JS, Stuart SE, Parvataneni R, Boscardin WJ (2013) Tumor recurrence 5 years after treatment of cutaneous basal cell carcinoma and squamous cell carcinoma. J Invest Dermatol 133:1188–1196CrossRefPubMed
25.
Renzi C, Caggiati A, Mannooranparampil TJ, Passarelli F, Tartaglione G, Pennasilico GM, Cecconi S, Potenza C, Pasquini P (2007) Sentinel lymph node biopsy for high risk cutaneous squamous cell carcinoma: Case series and review of the literature. Eur J Surg Oncol 33:364–369CrossRefPubMed
26.
Ross AS, Schmults CD (2006) Sentinel lymph node biopsy in cutaneous squamous cell carcinoma: A systematic review of the English literature. Dermatol Surg 32:1309–1321PubMed
27.
Schmitt AR, Brewer JD, Bordeaux JS, Baum CL (2014) Staging for cutaneous squamous cell carcinoma as a predictor of sentinel lymph node biopsy results: meta-analysis of American Joint Committee on Cancer criteria and a proposed alternative system. JAMA Dermatol 150:19–24CrossRefPubMed
28.
Stratigos A, Garbe C, Lebbe C, Malvehy J, del MV, Pehamberger H, Peris K, Becker JC, Zalaudek I, Saiag P, Middleton MR, Bastholt L, Testori A, Grob JJ (2015) Diagnosis and treatment of invasive squamous cell carcinoma of the skin: European consensus-based interdisciplinary guideline. Eur J Cancer 51:1989–2007CrossRefPubMed
29.
Maubec E, Petrow P, Scheer-Senyarich I, Duvillard P, Lacroix L, Gelly J, Certain A, Duval X, Crickx B, Buffard V, Basset-Seguin N, Saez P, Duval-Modeste AB, Adamski H, Mansard S, Grange F, Dompmartin A, Faivre S, Mentre F, Avril MF (2011) Phase II study of cetuximab as first-line single-drug therapy in patients with unresectable squamous cell carcinoma of the skin. J Clin Oncol 29:3419–3426CrossRefPubMed
30.
Lewis CM, Glisson BS, Feng L, Wan F, Tang X, Wistuba II, El-Naggar AK, Rosenthal DI, Chambers MS, Lustig RA, Weber RS (2012) A phase II study of gefitinib for aggressive cutaneous squamous cell carcinoma of the head and neck. Clin Cancer Res 18:1435–1446CrossRefPubMed
31.
Borradori L, Sutton B, Shayesteh P, Daniels GA (2016) Rescue therapy with anti-programmed cell death protein 1 inhibitors (PD-1) of advanced cutaneous squamous cell carcinoma and basosquamous carcinoma: preliminary experience in 5 cases. Br J Dermatol 175:1382–6
32.
Chang AL, Kim J, Luciano R, Sullivan-Chang L, Colevas AD (2016) A case report of unresectable cutaneous squamous cell carcinoma responsive to Pembrolizumab, a programmed cell death protein 1 inhibitor. JAMA Dermatol 152:106–108CrossRefPubMed
33.
Winkler JK, Schneiderbauer R, Bender C, Sedlaczek O, Frohling S, Penzel R, Enk A, Hassel JC (2016) Anti-PD-1 therapy in nonmelanoma skin cancer. Br J Dermatol. Epub ahead of print
34.
Mecca C, Ponzetti A, Caliendo V, Ciuffreda L, Lista P (2012) Complete response of metastatic cutaneous squamous cell carcinoma to cetuximab plus paclitaxel. Eur J Dermatol 22:758–761PubMed
35.
Berg D, Otley CC (2002) Skin cancer in organ transplant recipients: Epidemiology, pathogenesis, and management. J Am Acad Dermatol 47:1–17 (quiz 18–20)CrossRefPubMed
36.
Euvrard S, Kanitakis J, Claudy A (2003) Skin cancers after organ transplantation. N Engl J Med 348:1681–1691CrossRefPubMed
37.
Zwald FO, Brown M (2011) Skin cancer in solid organ transplant recipients: advances in therapy and management: part I. Epidemiology of skin cancer in solid organ transplant recipients. J Am Acad Dermatol 65:253–261 (quiz 262)CrossRefPubMed
38.
Harwood CA, Mesher D, McGregor JM, Mitchell L, Leedham-Green M, Raftery M, Cerio R, Leigh IM, Sasieni P, Proby CM (2013) A surveillance model for skin cancer in organ transplant recipients: A 22-year prospective study in an ethnically diverse population. Am J Transplant 13:119–129CrossRefPubMed
39.
Marcil I, Stern RS (2000) Risk of developing a subsequent nonmelanoma skin cancer in patients with a history of nonmelanoma skin cancer: A critical review of the literature and meta-analysis. Arch Dermatol 136:1524–1530CrossRefPubMed
40.
Lott DG, Manz R, Koch C, Lorenz RR (2010) Aggressive behavior of nonmelanotic skin cancers in solid organ transplant recipients. Transplantation 90:683–687CrossRefPubMed
41.
Thompson AK, Kelley BF, Prokop LJ, Murad MH, Baum CL (2016) Risk factors for cutaneous squamous cell carcinoma recurrence, metastasis, and disease-specific death: A systematic review and Meta-analysis. JAMA Dermatol 152:419–428CrossRefPubMedPubMedCentral
42.
Euvrard S, Kanitakis J, Decullier E, Butnaru AC, Lefrancois N, Boissonnat P, Sebbag L, Garnier JL, Pouteil-Noble C, Cahen R, Morelon E, Touraine JL, Claudy A, Chapuis F (2006) Subsequent skin cancers in kidney and heart transplant recipients after the first squamous cell carcinoma. Transplantation 81:1093–1100CrossRefPubMed
43.
Glover MT, Deeks JJ, Raftery MJ, Cunningham J, Leigh IM (1997) Immunosuppression and risk of non-melanoma skin cancer in renal transplant recipients. Lancet 349:398CrossRefPubMed
44.
Brem R, Li F, Montaner B, Reelfs O, Karran P (2010) DNA breakage and cell cycle checkpoint abrogation induced by a therapeutic thiopurine and UVA radiation. Oncogene 29:3953–3963CrossRefPubMedPubMedCentral
45.
O’Donovan P, Perrett CM, Zhang X, Montaner B, Xu YZ, Harwood CA, McGregor JM, Walker SL, Hanaoka F, Karran P (2005) Azathioprine and UVA light generate mutagenic oxidative DNA damage. Science 309:1871–1874CrossRefPubMedPubMedCentral
46.
Han W, Ming M, He TC, He YY (2010) Immunosuppressive cyclosporin A activates AKT in keratinocytes through PTEN suppression: Implications in skin carcinogenesis. J Biol Chem 285:11369–11377CrossRefPubMedPubMedCentral
47.
Geissler EK, Schlitt HJ, Thomas G (2008) mTOR, cancer and transplantation. Am J Transplant 8:2212–2218CrossRefPubMed
48.
Koehl GE, Andrassy J, Guba M, Richter S, Kroemer A, Scherer MN, Steinbauer M, Graeb C, Schlitt HJ, Jauch KW, Geissler EK (2004) Rapamycin protects allografts from rejection while simultaneously attacking tumors in immunosuppressed mice. Transplantation 77:1319–1326CrossRefPubMed
49.
Mehrany K, Weenig RH, Lee KK, Pittelkow MR, Otley CC (2005) Increased metastasis and mortality from cutaneous squamous cell carcinoma in patients with chronic lymphocytic leukemia. J Am Acad Dermatol 53:1067–1071CrossRefPubMed
50.
Mehrany K, Weenig RH, Pittelkow MR, Roenigk RK, Otley CC (2005) High recurrence rates of squamous cell carcinoma after Mohs’ surgery in patients with chronic lymphocytic leukemia. Dermatol Surg 31:38–42 (discussion 42)CrossRefPubMed
51.
Royle JA, Baade PD, Joske D, Girschik J, Fritschi L (2011) Second cancer incidence and cancer mortality among chronic lymphocytic leukaemia patients: a population-based study. Br J Cancer 105:1076–1081CrossRefPubMedPubMedCentral
52.
Long MD, Martin CF, Pipkin CA, Herfarth HH, Sandler RS, Kappelman MD (2012) Risk of melanoma and nonmelanoma skin cancer among patients with inflammatory bowel disease. Gastroenterology 143:390–399CrossRefPubMedPubMedCentral
53.
Pedersen N, Duricova D, Elkjaer M, Gamborg M, Munkholm P, Jess T (2010) Risk of extra-intestinal cancer in inflammatory bowel disease: Meta-analysis of population-based cohort studies. Am J Gastroenterol 105:1480–1487CrossRefPubMed
54.
Setshedi M, Epstein D, Winter TA, Myer L, Watermeyer G, Hift R (2012) Use of thiopurines in the treatment of inflammatory bowel disease is associated with an increased risk of non-melanoma skin cancer in an at-risk population: A cohort study. J Gastroenterol Hepatol 27:385–389CrossRefPubMed
55.
Chen AC, Martin AJ, Choy B, Fernandez-Penas P, Dalziell RA, McKenzie CA, Scolyer RA, Dhillon HM, Vardy JL, Kricker A, George StG, Chinniah N, Halliday GM, Damian DL (2015) A phase 3 randomized trial of Nicotinamide for skin-cancer Chemoprevention. N Engl J Med 373:1618–1626CrossRefPubMed
56.
Alter M, Satzger I, Schrem H, Kaltenborn A, Kapp A, Gutzmer R (2014) Non-melanoma skin cancer is reduced after switch of immunosuppression to mTOR-inhibitors in organ transplant recipients. J Dtsch Dermatol Ges 12:480–488PubMed
57.
Surjana D, Halliday GM, Martin AJ, Moloney FJ, Damian DL (2012) Oral nicotinamide reduces actinic keratoses in phase II double-blinded randomized controlled trials. J Invest Dermatol 132:1497–1500CrossRefPubMed
58.
DeTemple V, Satzger I, Walter A, Schaper K, Gutzmer R (2016) Effects of mTOR Inhibitors on Cytokine Production and Differentiation in Keratinocytes. Exp Dermatol 25:775–82
59.
Levine DE, Karia PS, Schmults CD (2015) Outcomes of patients with multiple cutaneous squamous cell carcinomas: A 10-year single-institution cohort study. JAMA Dermatol 151:1220–1225CrossRefPubMed
60.
Euvrard S, Morelon E, Rostaing L, Goffin E, Brocard A, Tromme I, Broeders N, del MV, Chatelet V, Dompmartin A, Kessler M, Serra AL, Hofbauer GF, Pouteil-Noble C, Campistol JM, Kanitakis J, Roux AS, Decullier E, Dantal J (2012) Sirolimus and secondary skin-cancer prevention in kidney transplantation. N Engl J Med 367:329–339CrossRefPubMed
Metadaten
Titel
Kutanes Plattenepithelkarzinom
verfasst von
Ulrike Leiter
Prof. Dr. Ralf Gutzmer
Mareike Alter
Claas Ulrich
Anke S. Lonsdorf
Michael M. Sachse
Uwe Hillen
Publikationsdatum
14.02.2017
Verlag
Springer Medizin
Erschienen in
Die Onkologie / Ausgabe 6/2017
Print ISSN: 2731-7226
Elektronische ISSN: 2731-7234
DOI
https://doi.org/10.1007/s00761-017-0185-y

Weitere Artikel der Ausgabe 6/2017

Der Onkologe 6/2017 Zur Ausgabe

Einführung zum Thema

Prävention in der Onkologie

Leitthema

Nutzen und Risiken des Mammographiescreenings

Palliativmedizin und Supportivtherapie

SOP – Palliative Sedierung

Palliativmedizin und Supportivtherapie

SOP – Fatigue

Leitthema

Sport und Krebsprävention

Journal Club

Brustkrebs bei Männern

Weitere Lesetipps

ANZEIGE

Weißer Hautkrebs verursacht mehr Tote als das Melanom

"Adipositas ist eine Erkrankung, die jeden betreffen kann"

ANZEIGE

Neue Konzepte beim Handekzem

ANZEIGE

Im Dialog mit jungen Dermatologen: Wund- und Narbenversorgung in der Praxis

Nasopharynxkarzinom – ein aktueller Überblick über eine spezielle Tumorentität

Interdisziplinäre Behandlungsstrategien bei Hirnmetastasierung

Bildnachweise