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01.03.2012 | Leitthema

Sekundärprävention von Hauttumoren nach Organtransplantation

verfasst von: PD Dr. U. Leiter, M. Röcken, C. Garbe

Erschienen in: Die Onkologie | Ausgabe 3/2012

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Zusammenfassung

Tumorerkrankungen der Haut stellen eine bedeutende Langzeitkomplikation für Patienten nach Organtransplantation dar und sind mit 40–50% die größte Gruppe der Neoplasien post transplantationem. In den ersten 10 Jahren nach Organtransplantation treten bei 15–40% der Patienten maligne Hauttumoren auf, zu 95% Plattenepithel- und Basalzellkarzinome, seltener Melanome und Merkel-Zell-Karzinome. Die Sekundärprophylaxe hat im Management der Hauttumoren einen wichtigen Stellenwert. Die Aufklärung der Patienten über das erhöhte Hauttumorrisiko sowie die Durchführung einer Prophylaxe durch regelmäßigen UV-Schutz sind wichtige Maßnahmen. Um sekundären Hauttumoren (vor allem multifokalen hochaggressiven Plattenepithelkarzinomen) vorzubeugen, müssen epitheliale Präkanzerosen frühzeitig konsequent behandelt werden. Eine standardisierte risikoprofiladaptierte Nachsorge sollte für eine effektive Sekundärprophylaxe angeschlossen werden. Das Umstellen der immunsuppressiven Therapie auf neuere Substanzen wie mTOR-Inhibitoren, die antiproliferative Effekte zeigen, kann das Risiko sekundärer Hauttumoren senken.

Ismail F, Mitchell L, Casabonne D et al (2006) Specialist dermatology clinics for organ transplant recipients significantly improve compliance with photoprotection and levels of skin cancer awareness. Br J Dermatol 155(5):916–925PubMedCrossRef

Osterwalder U, Herzog B (2009) Sun protection factors: world wide confusion. Br J Dermatol 161 (Suppl 3):13–24PubMedCrossRef

Young AR, Boles J, Herzog B et al (2010) A sunscreen’s labeled sun protection factor may overestimate protection at temperate latitudes: a human in vivo study. J Invest Dermatol 130(10):2457–2462PubMedCrossRef

Seukeran DC, Newstead CG, Cunliffe WJ (1998) The compliance of renal transplant recipients with advice about sun protection measures. Br J Dermatol 138(2):301–303PubMedCrossRef

Ulrich C, Jurgensen JS, Degen A et al (2009) Prevention of non-melanoma skin cancer in organ transplant patients by regular use of a sunscreen: a 24 months, prospective, case-control study. Br J Dermatol 161(Suppl 3):78–84PubMedCrossRef

Diffey BL (2009) Sunscreens as a preventative measure in melanoma: an evidence-based approach or the precautionary principle? Br J Dermatol 161 (Suppl 3):25–27PubMedCrossRef

Held L, Eigentler TK, Garbe C (2009) Early recognition and prevention of skin cancer. MMW. Fortschr Med 151(39):31–33

Bichari W, Bartiromo M, Mohey H et al (2009) Significant risk factors for occurrence of cancer after renal transplantation: a single center cohort study of 1265 cases. Transplant Proc 41(2):672–673PubMedCrossRef

Green A, Williams G, Neale R et al (1999) Daily sunscreen application and betacarotene supplementation in prevention of basal-cell and squamous-cell carcinomas of the skin: a randomised controlled trial. Lancet 354(9180):723–729PubMedCrossRef

10.

Stasko T, Brown MD, Carucci JA et al (2004) Guidelines for the management of squamous cell carcinoma in organ transplant recipients. Dermatol Surg 30:642–650PubMedCrossRef

11.

Kasiske BL, Snyder JJ, Gilbertson DT, Wang C (2004) Cancer after kidney transplantation in the United States. Am J Transplant 4(6):905–913PubMedCrossRef

12.

Otley CC, Cherikh WS, Salasche SJ et al (2005) Skin cancer in organ transplant recipients: effect of pretransplant end-organ disease. J Am Acad Dermatol 53(5):783–790PubMedCrossRef

13.

Ulrich C, Kanitakis J, Stockfleth E, Euvrard S (2008) Skin cancer in organ transplant recipients – where do we stand today? Am J Transplant 8(11):2192–2198PubMedCrossRef

14.

Argenziano G, Mordente I, Ferrara G et al (2008) Dermoscopic monitoring of melanocytic skin lesions: clinical outcome and patient compliance vary according to follow-up protocols. Br J Dermatol 159(2):331–336PubMedCrossRef

15.

Kittler H, Pehamberger H, Wolff K, Binder M (2002) Diagnostic accuracy of dermoscopy. Lancet Oncol 3(3):159–165PubMedCrossRef

16.

Berg D, Otley CC (2002) Skin Cancer in organ transplant recipients: epidemiology, pathogenesis, and management. J Am Acad Dermatol 47(1):1–17PubMedCrossRef

17.

Graaf YG de, Basdew VR, Zwan-Kralt N et al (2006) The occurrence of residual or recurrent squamous cell carcinomas in organ transplant recipients after curettage and electrodesiccation. Br J Dermatol 154(3):493–497PubMedCrossRef

18.

Ulrich C, Hackethal M, Ulrich M et al (2007) Treatment of multiple actinic keratoses with topical diclofenac 3% gel in organ transplant recipients: a series of six cases. Br J Dermatol 156 (Suppl 3):40–42PubMedCrossRef

19.

Ulrich C, Johannsen A, Rowert-Huber J et al (2010) Results of a randomized, placebo-controlled safety and efficacy study of topical diclofenac 3% gel in organ transplant patients with multiple actinic keratoses. Eur J Dermatol 20(4):482–488PubMed

20.

Brown VL, Atkins CL, Ghali L et al (2005) Safety and efficacy of 5% imiquimod cream for the treatment of skin dysplasia in high-risk renal transplant recipients: randomized, double-blind, placebo-controlled trial. Arch Dermatol 141(8):985–993PubMedCrossRef

21.

Dragieva G, Prinz BM, Hafner J et al (2004) A randomized controlled clinical trial of topical photodynamic therapy with methyl aminolaevulinate in the treatment of actinic keratoses in transplant recipients. Br J Dermatol 151(1):196–200PubMedCrossRef

22.

Dragieva G, Hafner J, Dummer R et al (2004) Topical photodynamic therapy in the treatment of actinic keratoses and Bowen’s disease in transplant recipients. Transplantation 77(1):115–121PubMedCrossRef

23.

Graaf YG de, Kennedy C, Wolterbeek R et al (2006) Photodynamic therapy does not prevent cutaneous squamous cell carcinoma in organ tansplant recipients: rsults of a randomized-controlled trial. J Invest Dermatol 126(3):569–574PubMedCrossRef

24.

Perrett CM, McGregor JM, Warwick J et al (2007) Treatment of post-transplant premalignant skin disease: a randomized intrapatient comparative study of 5-fluorouracil cream and topical photodynamic therapy. Br J Dermatol 156(2):320–328PubMedCrossRef

25.

Smith KJ, Germain M, Skelton H (2001) Squamous cell carcinoma in situ (Bowen’s disease) in renal transplant patients treated with 5% imiquimod and 5% 5-fluorouracil therapy. Dermatol Surg 27(6):561–564PubMedCrossRef

26.

Euvrard S, Verschoore M, Touraine JL et al (1992) Topical retinoids for warts and keratoses in transplant recipients. Lancet 340(8810):48–49PubMedCrossRef

27.

Bavinck JN, Tieben LM, Woude FJ van der et al (1995) Prevention of skin cancer and reduction of keratotic skin lesions during acitretin therapy in renal transplant recipients: a double-blind, placebo-controlled study. J Clin Oncol 13(8):1933–1938PubMed

28.

McKenna DB, Murphy GM (1999) Skin cancer chemoprophylaxis in renal transplant recipients: 5 years of eperience using low-dose acitretin. Br J Dermatol 140(4):656–660PubMedCrossRef

29.

Kelly JW, Sabto J, Gurr FW, Bruce F (1991) Retinoids to prevent skin cancer in organ transplant recipients. Lancet 338(8779):1407PubMedCrossRef

30.

Rook AH, Shapiro M (2001) Cutaneous squamous-cell carcinoma. N Engl J Med 345(4):296–297PubMedCrossRef

31.

Ajithkumar TV, Parkinson CA, Butler A, Hatcher HM (2007) Management of solid tumours in organ-transplant recipients. Lancet Oncol 8(10):921–932PubMedCrossRef

32.

Wulff BC, Kusewitt DF, Vanbuskirk AM et al (2008) Sirolimus reduces the incidence and progression of UVB-induced skin cancer in SKH mice even with co-administration of cyclosporine A. J Invest Dermatol 128(10):2467–2473PubMedCrossRef

33.

O’Donovan P, Perrett CM, Zhang X et al (2005) Azathioprine and UVA light generate mutagenic oxidative DNA damage. Science 309(5742):1871–1874CrossRef

34.

Ulrich C, Stockfleth E (2007) Azathioprine, UV light, and skin cancer in organ transplant patients – do we have an answer? Nephrol Dial Transplant 22(4):1027–1029PubMedCrossRef

35.

Geissler EK (2008) The impact of mTOR inhibitors on the development of malignancy. Transplant Proc 40 (Suppl 10):S32–S35PubMedCrossRef

36.

Guba M, Breitenbuch P von, Steinbauer M et al (2002) Rapamycin inhibits primary and metastatic tumor growth by antiangiogenesis: involvement of vascular endothelial growth factor. Nat Med 8(2):128–135PubMedCrossRef

37.

Tessmer CS, Magalhaes LV, Keitel E et al (2006) Conversion to sirolimus in renal transplant recipients with skin cancer. Transplantation 82(12):1792–1793PubMedCrossRef

38.

Sanchez-Fructuoso A, Conesa J, Perez Flores I et al (2006) Conversion to sirolimus in renal transplant patients with tumors. Transplant Proc 38(8):2451–2452PubMedCrossRef

39.

Otley CC, Coldiron BM, Stasko T, Goldman GD (2001) Decreased skin cancer after cessation of therapy with transplant-associated immunosuppressants. Arch Dermatol 137(4):459–463PubMed

40.

Otley CC, Berg D, Ulrich C et al (2006) Reduction of immunosuppression for transplant-associated skin cancer: expert consensus survey. Br J Dermatol 154(3):395–400PubMedCrossRef

41.

Ulrich C, Degen A, Patel MJ, Stockfleth E (2008) Sunscreens in organ transplant patients. Nephrol Dial Transplant 23(6):1805–1808PubMedCrossRef

42.

Pols JC van der, Williams GM, Pandeya N et al (2006) Prolonged prevention of squamous cell carcinoma of the skin by regular sunscreen use. Cancer Epidemiol Biomarkers Prev 15(12):2546–2548PubMedCrossRef

Titel: Sekundärprävention von Hauttumoren nach Organtransplantation
verfasst von: PD Dr. U. Leiter
M. Röcken
C. Garbe
Publikationsdatum: 01.03.2012
Verlag: Springer-Verlag
Erschienen in: Die Onkologie / Ausgabe 3/2012
Print ISSN: 2731-7226
Elektronische ISSN: 2731-7234
DOI: https://doi.org/10.1007/s00761-011-2092-y

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Sekundärprävention von Hauttumoren nach Organtransplantation

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