title: Malignant melanoma S3-guideline "diagnosis, therapy and follow-up of melanoma".
abstract: This first German evidence-based guideline for cutaneous melanoma was developed under the auspices of the German Dermatological Society (DDG) and the Dermatologic Cooperative Oncology Group (DeCOG) and funded by the German Guideline Program in Oncology. The recommendations are based on a systematic literature search, and on the consensus of 32 medical societies, working groups and patient representatives. This guideline contains recommendations concerning diagnosis, therapy and follow-up of melanoma. The diagnosis of primary melanoma based on clinical features and dermoscopic criteria. It is confirmed by histopathologic examination after complete excision with a small margin. For the staging of melanoma, the AJCC classification of 2009 is used. The definitive excision margins are 0.5 cm for in situ melanomas, 1 cm for melanomas with up to 2 mm tumor thickness and 2 cm for thicker melanomas, they are reached in a secondary excision. From 1 mm tumor thickness, sentinel lymph node biopsy is recommended. For stages II and III, adjuvant therapy with interferon-alpha should be considered after careful analysis of the benefits and possible risks. In the stage of locoregional metastasis surgical treatment with complete lymphadenectomy is the treatment of choice. In the presence of distant metastasis mutational screening should be performed for BRAF mutation, and eventually for CKIT and NRAS mutations. In the presence of mutations in case of inoperable metastases targeted therapies should be applied. Furthermore, in addition to standard chemotherapies, new immunotherapies such as the CTLA-4 antibody ipilimumab are available. Regular follow-up examinations are recommended for a period of 10 years, with an intensified schedule for the first three years.
authors.affiliation: Department of Dermatology, University Hospital Tübingen, Germany.
authors.forename: Annette
authors.initials: A
authors.lastname: Pflugfelder
authors.forename: Corinna
authors.initials: C
authors.lastname: Kochs
authors.forename: Andreas
authors.initials: A
authors.lastname: Blum
authors.forename: Marcus
authors.initials: M
authors.lastname: Capellaro
authors.forename: Christina
authors.initials: C
authors.lastname: Czeschik
authors.forename: Therese
authors.initials: T
authors.lastname: Dettenborn
authors.forename: Dorothee
authors.initials: D
authors.lastname: Dill
authors.forename: Edgar
authors.initials: E
authors.lastname: Dippel
authors.forename: Thomas
authors.initials: T
authors.lastname: Eigentler
authors.forename: Petra
authors.initials: P
authors.lastname: Feyer
authors.forename: Markus
authors.initials: M
authors.lastname: Follmann
authors.forename: Bernhard
authors.initials: B
authors.lastname: Frerich
authors.forename: Maria-Katharina
authors.initials: MK
authors.lastname: Ganten
authors.forename: Jan
authors.initials: J
authors.lastname: Gärtner
authors.forename: Ralf
authors.initials: R
authors.lastname: Gutzmer
authors.forename: Jessica
authors.initials: J
authors.lastname: Hassel
authors.forename: Axel
authors.initials: A
authors.lastname: Hauschild
authors.forename: Peter
authors.initials: P
authors.lastname: Hohenberger
authors.forename: Jutta
authors.initials: J
authors.lastname: Hübner
authors.forename: Martin
authors.initials: M
authors.lastname: Kaatz
authors.forename: Ulrich R
authors.initials: UR
authors.lastname: Kleeberg
authors.forename: Oliver
authors.initials: O
authors.lastname: Kölbl
authors.forename: Rolf-Dieter
authors.initials: RD
authors.lastname: Kortmann
authors.forename: Albrecht
authors.initials: A
authors.lastname: Krause-Bergmann
authors.forename: Peter
authors.initials: P
authors.lastname: Kurschat
authors.forename: Ulrike
authors.initials: U
authors.lastname: Leiter
authors.forename: Hartmut
authors.initials: H
authors.lastname: Link
authors.forename: Carmen
authors.initials: C
authors.lastname: Loquai
authors.forename: Christoph
authors.initials: C
authors.lastname: Löser
authors.forename: Andreas
authors.initials: A
authors.lastname: Mackensen
authors.forename: Friedegund
authors.initials: F
authors.lastname: Meier
authors.forename: Peter
authors.initials: P
authors.lastname: Mohr
authors.forename: Matthias
authors.initials: M
authors.lastname: Möhrle
authors.forename: Dorothee
authors.initials: D
authors.lastname: Nashan
authors.forename: Sven
authors.initials: S
authors.lastname: Reske
authors.forename: Christian
authors.initials: C
authors.lastname: Rose
authors.forename: Christian
authors.initials: C
authors.lastname: Sander
authors.forename: Imke
authors.initials: I
authors.lastname: Satzger
authors.forename: Meinhard
authors.initials: M
authors.lastname: Schiller
authors.forename: Heinz-Peter
authors.initials: HP
authors.lastname: Schlemmer
authors.forename: Gerhard
authors.initials: G
authors.lastname: Strittmatter
authors.forename: Cord
authors.initials: C
authors.lastname: Sunderkötter
authors.forename: Lothar
authors.initials: L
authors.lastname: Swoboda
authors.forename: Uwe
authors.initials: U
authors.lastname: Trefzer
authors.forename: Raymond
authors.initials: R
authors.lastname: Voltz
authors.forename: Dirk
authors.initials: D
authors.lastname: Vordermark
authors.forename: Michael
authors.initials: M
authors.lastname: Weichenthal
authors.forename: Andreas
authors.initials: A
authors.lastname: Werner
authors.forename: Simone
authors.initials: S
authors.lastname: Wesselmann
authors.forename: Ansgar J
authors.initials: AJ
authors.lastname: Weyergraf
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Wick
authors.forename: Claus
authors.initials: C
authors.lastname: Garbe
authors.forename: Dirk
authors.initials: D
authors.lastname: Schadendorf
mesh_terms: D003880:Dermatology / Q000592:standards*; D046169:Dermoscopy / Q000592:standards*; D004358:Drug Therapy / Q000592:standards; D006801:Humans; D007167:Immunotherapy / Q000592:standards; D008207:Lymphatic Metastasis; D008495:Medical Oncology / Q000592:standards; D008545:Melanoma / Q000175:diagnosis* / Q000556:secondary / Q000628:therapy*; D017410:Practice Guidelines as Topic; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000628:therapy*