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  • 2000-2004  (3)
  • 1
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background In several studies an increased risk for development of breast cancer, malignant lymphoma and neoplasms of the kidney as second primary cancers in patients with cutaneous melanomas was discussed. Objectives To determine the risk for development of second primary neoplasms in patients with cutaneous melanomas. Methods A prospective study was performed between 1977 and 1992 to evaluate the occurrence of second primary malignancies in 4597 patients (2083 men, 2514 women) with invasive cutaneous melanomas, diagnosed and treated at the Department of Dermatology and Allergology, Ludwig-Maximilians-University, Munich, Germany. Results During a median follow-up of 7·2 years, 296 of 4597 patients (6·4%) developed one or more neoplasms at the time of or subsequent to the diagnosis of the first cutaneous melanoma. More than half of these patients developed one or more further melanomas (152, 3·3%). Cancers of the breast, prostate, colon, rectum and kidney occurred less frequently. Statistical calculations revealed a 33·8-fold increased risk for the development of a second melanoma in the entire group [relative risk 38·5 for men (95% CI, 30·4–48·1), 29·0 for women (95% CI, 22·0–37·5)]. Moreover, a significantly increased risk for the development of kidney carcinoma in men was found [relative risk 3·5 (95% CI, 1·4–7·2)]. Conclusions Thorough follow-up and skin examination in patients with cutaneous melanomas is recommended for early detection of other primary melanomas. Furthermore, ultrasound examinations routinely performed in melanoma patients for the detection of melanoma metastases may also be of value for early detection of kidney carcinomas in male patients.
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  • 2
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background  Although survival in patients with thin melanomas (tumour thickness ≤ 0·75 mm) is usually excellent, thin melanomas have the potential to metastasize.Objectives  To determine risk factors for the development of disease progression in patients with thin cutaneous melanomas.Methods  A retrospective study was performed between 1977 and 1998 to identify risk factors for the development of disease progression in 2302 patients with cutaneous melanoma with tumour thickness ≤ 0·75 mm, diagnosed and treated at the Department of Dermatology and Allergology, Ludwig-Maximilians University, Munich, Germany. The Kaplan–Meier method was used to estimate the influence of different clinical characteristics for the occurrence of first progression during 10 years of follow-up.Results  An analysis of the data from 6298 patients with cutaneous melanoma identified 2302 patients (37%) who presented with cutaneous melanoma with a tumour thickness ≤ 0·75 mm, without clinical signs of metastasis at initial diagnosis (clinical stage Ia). A small subgroup of our patients (77 of 2302) developed metastatic disease during the follow-up period. The estimated rate of occurrence of metastasis after 10 years of follow-up was 4·7%. The mean follow-up time was 62 months (median 46). Of these 77 patients, 16 experienced progression at the primary tumour site and 32 presented with regional lymph node metastases. Twenty-eight patients primarily developed systemic metastases (seven patients with and 20 without regional lymph node metastases, one patient with regional lymph node metastases and local recurrence). In one patient the primary site of metastatic disease was not reported. Clinical characteristics included age, sex of the patient and different subtypes of cutaneous melanoma: superficial spreading melanoma, nodular melanoma, acrolentiginous melanoma (ALM) and lentigo maligna melanoma (LMM). Male patients and patients with LMM or ALM were significantly over-represented (P = 0·02 and P = 0·002). In the group of 77 patients with thin melanomas (≤ 0·75 mm), local recurrence was over-represented as compared with those with melanomas 〉 0·75 mm. No difference in group was found for overall survival after the occurrence of lymph node metastasis as the first manifestation of disease progression.Conclusions  Thorough follow-up and skin examination is recommended for a subgroup of patients with thin tumours, which consists of male patients with LMM or ALM located in the head and neck region.
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Der Radiologe 40 (2000), S. 177-183 
    ISSN: 1432-2102
    Keywords: Schlüsselwörter ; Mammakarzinom ; Früherkennung ; Qualitätssicherung ; Key words ; Breast cancer ; Screening ; Quality assessment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In Germany there is still an urgent need for action in regard to screening for breast cancer. The announcement of research projects for mammography screening proves this. The following reports the results of the Munich field study. In 2 years, 2489 breast cancer cases were registered (status 6/98). Screening data were available for 1319 patients. The reduction in mortality, found in randomized studies, due to mammography in women over 50 years old was confirmed. A relative reduction of 44.8% in 10-year mortality could be estimated through mammography and 25.1% through palpation, in comparison with ”doing nothing”. We could also estimate the participation of screening and the used methods in the Munich region. If the mammographies carried out today were used at 2-year intervals for women aged between 50 and 70 years, then the mammography screening could be performed with no additional costs for 70% of the women. The known facts regarding the population-based mortality and regarding the acceptance of the palpation screening and frequency of mammography are additional aspects for inclusion in the discussion of what research projects in Germany are and what they should fulfill.
    Notes: Zusammenfassung Hintergrund: Bei der Früherkennung des Mammakarzinoms besteht in Deutschland nach wie vor ein dringender Handlungsbedarf. Die Ausschreibung von Modellprojekten zur Einführung des Mammographiescreenings belegt dies. Im folgenden wird – als Diskussionsgrundlage –über erste Ergebnisse der Feldstudie München berichtet. Ergebnisse: In einem Zeitraum von 2 Jahren wurden 2489 Mammakarzinome registriert (Stand Juni 1998). Zu 1319 Patientinnen sind Angaben zur Früherkennung verfügbar. Die durch randomisierte Studien gesicherte Senkung der Mortalität durch die Mammographie im Alter 〉50 Jahre konnte bestätigt werden. Aufgrund der dokumentierten Stadienverteilung beträgt die Schätzung für die relative Senkung der 10-Jahres-Mortalität durch die Mammographie 44,8% und durch die Palpation 25,1% im Vergleich zum „Nichtstun”. Auch die Inanspruchnahme der Früherkennung und die in der Region München eingesetzten Methoden konnten abgeschätzt werden. Schlussfolgerungen: Würden die heute durchgeführten Mammographien bei Frauen im Alter zwischen 50 und 70 Jahren mit einem Abstand von 2 Jahren eingesetzt, so könnte das Mammographiescreening bei etwa 82% der Frauen kostenneutral durchgeführt werden. Die bekannten Fakten zur Mortalität und zur bundesweiten Inanspruchnahme des heutigen Früherkennungsangebots sind weitere Grundlagen für die Diskussion, was Modellprojekte in Deutschland sein und was sie wann leisten sollten.
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