title: Diagnosis and treatment of melanoma: European consensus-based interdisciplinary guideline.
abstract: Cutaneous melanoma (CM) is potentially the most dangerous form of skin tumour and causes 90% of skin cancer mortality. A unique collaboration of multi-disciplinary experts from the European Dermatology Forum, the European Association of Dermato-Oncology and the European Organization of Research and Treatment of Cancer was formed to make recommendations on CM diagnosis and treatment, based on systematic literature reviews and the experts' experience. Diagnosis is made clinically and staging is based upon the AJCC system. CMs are excised with one to two centimetre safety margins. Sentinel lymph node dissection is routinely offered as a staging procedure in patients with tumours more than 1mm in thickness, although there is as yet no resultant survival benefit. Interferon-alpha treatment can be offered to patients with more than 1.5mm in thickness and stage II to III melanoma as an adjuvant therapy, as this treatment increases the relapse-free survival. The lack of a clear survival benefit and the presence of toxicity however limit its use in practice. In distant metastasis, all options of surgical therapy have to be considered thoroughly. In the absence of surgical options, systemic medical treatment is indicated, but with, to date, low response rates. Therapeutic decisions should be made by the melanoma team and the informed patient after full discussion of the options.
authors: Center for Dermatooncology, Department of Dermatology, 72076 Tübingen, Germany. claus.garbe@med.uni-tuebingen.de
authors: Claus
authors: C
authors: Garbe
authors: Ketty
authors: K
authors: Peris
authors: Axel
authors: A
authors: Hauschild
authors: Philippe
authors: P
authors: Saiag
authors: Mark
authors: M
authors: Middleton
authors: Alain
authors: A
authors: Spatz
authors: Jean-Jacques
authors: JJ
authors: Grob
authors: Josep
authors: J
authors: Malvehy
authors: Julia
authors: J
authors: Newton-Bishop
authors: Alexander
authors: A
authors: Stratigos
authors: Hubert
authors: H
authors: Pehamberger
authors: Alexander
authors: A
authors: Eggermont
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy / Q000379:methods; D005060:Europe; D006801:Humans; D008134:Long-Term Care; D008197:Lymph Node Excision; D008545:Melanoma / Q000473:pathology* / Q000628:therapy*; D009362:Neoplasm Metastasis / Q000628:therapy; D009367:Neoplasm Staging / Q000379:methods; D021701:Sentinel Lymph Node Biopsy / Q000379:methods; D012878:Skin Neoplasms / Q000473:pathology* / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents