Hubert Drepper

Primary cutaneous melanoma. Prognostic classification of anatomic location

Background. Anatomic location has been identified by several investigators as a significant prognostic factor for patients with primary cutaneous melanoma (CM). However, the best determination of higher and lower risk sites is still controversial, and the biologic significance of tumor site in the course of primary CM is unknown. The aim of the present study was to identify higher and lower risk sites based on multivariate analysis.

The prognosis of patients with stage III melanoma prospective long-term study of 286 patients of the fachklinik hornheide

Background. Prognostic factors for patients with stage III melanoma are still controversial.

DNA Flow Cytometry in the Prognosis of Primary Malignant Melanoma

DNA flow cytometry was carried out on 804 primary melanomas. The data were analyzed with a follow-up of 24-96 months. 57% of the cases were diploid, 32% had one abnormal cell population, and 11% were multiclonal. In 8% of the aneuploid tumors there were cell lines in the hypertetraploid range. A reliable S phase determination was possible in 524 cases. Among these 11% had an S phase exceeding 15%. Using an increased tumor thickness, relapse rate and mortality as criteria of tumor progression, aneuploidy and multiclonality, the occurrence of hypertetraploid cell lines and a high S phase (greater than 15%) proved to be correlated with a poor prognosis.

Sequential DNA Flow Cytometry in Metastatic Malignant Melanoma

Sequential flow cytometry was performed on 73 metastatic malignant melanomas, derived from 804 primary tumors. Tumor thickness was confirmed an excellent prognostic parameter in primary melanoma, but did not allow reliable predictions in metastatic disease. Also, aneuploidy and genetic heterogeneity, both common in metastatic melanoma, were equally distributed among patients differing in survival time. However, a remarkable acceleration was observed in the generation of abnormal cell lines in patients dying early of metastatic disease.

Is the acral-lentiginous melanoma (ALM) more malignant than the superficial spreading melanoma (SSM) in a high-risk location? A matched-pair comparison of 113 each ALM and SSM in a multicenter study

Zusammenfassung. Die Prognose des akrolentiginösen Melanoms (ALM) wird auch heute noch kontrovers beurteilt. Diese große Fallstudie schließt deshalb alle bekannten prognoserelevanten Faktoren ein. Aus einem Kollektiv von 3616 Melanomen wurden den vorhandenen 113 ALM genau 113 Symptom-Zwillinge des superfiziell spreitenden Melanoms (SSM) aus einer 619 Fälle umfassenden high-risk-Lokalisationgruppe zugeordnet, die sich in Tumordicke, Geschlecht und Behandlungsmodalität glichen. Die Nachbeobachtung betrug mindestens 5 Jahre. Die 5-Jahres-Überlebenskurven nach Kaplan-Meier der beiden Gruppen unterschieden sich nicht. Die oftmals beschriebene schlechtere Prognose des ALM ist eine Folge der Lokalisation und nicht des Typs. Das ALM ist demnach als akral lokalisiertes Melanom zu betrachten.Abstract. Even today, the prognosis of acral-lentiginous melanoma (ALM) remains a controversial topic. We present a large case study including all known factors relevant for prognosis. 113 ALMs in 3616 melanoma patients were paired as precisely as possible with their twins, i.e. with 113 superficial spreading melanomas (SSM) from a group of 619 SSMs with high-risk location. The ALMs and SSMs were equivalent in tumor thickness, patient gender and mode of treatment. The follow-up period was for at least 5 years. The 5-year Kaplan-Meier survival curves in both groups are identical. The poor prognosis often ascribed to ALM results from the prognostic factor location. ALM should therefore be regarded as acral localized melanoma.

Validierung der TNM-Klassifikation des Malignen Melanoms — Zwischenergebnisse der Hornheider Melanomstudie —

In der Fachklinik Hornheide wird auf Anregung der UICC mit Unterstutzung der Bundesregierung eine prospektive Feldstudie zur Validierung des TNM-Systems beim ‘Malignen Melanom’ durchgefuhrt.