title: Spanish Multidisciplinary Melanoma Group (GEM) guidelines for the management of patients with advanced melanoma.
abstract: Advanced melanoma is a relatively uncommon condition whose therapeutic management has undergone major changes over the past four years. The present article aims to establish recommendations for the management of these patients based on the best available evidence reached by consensus of a group of professionals familiar in the treatment of these patients. These professionals, belonging to Spanish Multidisciplinary Melanoma Group, reviewed the diagnostic process and the incorporation of new techniques of molecular diagnosis of advanced disease; treatment and monitoring of stage III both as adjuvant locoregional treatments have been addressed, as well as new therapies for stage IV. We have reviewed the palliative treatment alternatives for disseminated disease, such as surgery, radiotherapy or non-cytotoxic systemic treatments. Finally, we have also reviewed the most relevant toxicities of new drugs and their management in clinical practice.
authors.affiliation: Department of Oncology.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Berrocal
authors.affiliation: Service of Oncology, Hospital La Paz, Madrid, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Espinosa
authors.affiliation: Plastic Surgery, Consorcio Hospital General Universitario, Avda, Tres Cruces, 2, 46014 Valencia, Spain.
authors.forename: Severiano
authors.initials: S
authors.lastname: Marín
authors.affiliation: Dermatology Department, Melanoma Unit, Hospital Clinic, Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Malvehy
authors.affiliation: Dermatology Unit, Hospital Universitario Virgen Macarena, Seville, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Moreno
authors.affiliation: Department of Pathology.
authors.forename: Maria Dolores
authors.initials: MD
authors.lastname: Lozano
authors.affiliation: Department of Oncology, Clinica Universitaria de Navarra, Pamplona, Spain.
authors.forename: Salvador
authors.initials: S
authors.lastname: Martin-Algarra
authors.affiliation: Department of Oncology.
authors.forename: Jose Antonio
authors.initials: JA
authors.lastname: Lopez
authors.affiliation: Department of Radiation Oncology, Hospital Clinic, Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Conill
authors.affiliation: Department of Pathology, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Rodriguez-Peralto
mesh_terms: D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D058990:Molecular Targeted Therapy / Q000379:methods; D009361:Neoplasm Invasiveness / Q000473:pathology; D017410:Practice Guidelines as Topic; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D018570:Risk Assessment; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D013030:Spain; D016019:Survival Analysis
keywords: advanced melanoma; diagnosis; therapeutic management