Zur Hormonsubstitution beim malignen Melanom

Zusammenfassung

Beim malignen Melanom handelt es sich um einen Tumor, der von den pigmentbildenden Zellen der Haut ausgeht. Melanomzellen exprimieren teilweise und in unterschiedlichem Ausmaß Estrogenrezeptoren. In tierexperimentellen Untersuchungen konnte gezeigt werden, dass Sexualhormone einen Einfluss auf das Wachstumsverhalten von Melanomzellen ausüben. Es stellt sich daher die Frage, ob bei Frauen mit Melanomerkrankung die Zufuhr exogener Sexualhormone zulässig oder kontraindiziert ist.

Zu dieser Frage gibt es eine Reihe von epidemiologischen Studien, allerdings keine prospektive plazebokontrollierte und randomisierte Untersuchung. Aus den vorliegenden klinischen Studien lassen sich allerdings die folgenden Schlussfolgerungen und Empfehlungen ableiten: die Einnahme von Sexualhormonen erhöht weder das Risiko zur Entwicklung eines malignen Melanoms, noch hat sie einen ungünstigen Effekt auf den Verlauf und die Prognose einer bestehenden Melanom-Erkrankung.

Abstract

Malignant melanoma derives from pigmented cells of neuroectodermal origin. Melanoma cells express estrogen receptors. An influence of steroid hormones on the proliferation rate of melanoma cells was demonstrated in some animal experiments. Thus it is of concern whether or not women with malignant melanoma are candidates for hormone replacement therapy (HRT). Until today, no prospective randomized trial on the association between HRT and malignant melanoma has been published. However, from the data available from in vitro-studies, in vivo-studies, and epidemiological reports, we can draw the following conclusions: there is no convincing evidence that the intake of sexual steroids increases the risk for the development of malignant melanoma and there is no evidence that HRT, taken after a diagnosis of malignant melanoma, negatively influences the outcome of the disease.

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