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.

DOI: 10.1111/ddg.12113_suppl
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@article{Pflugfelder2013MalignantMS, title={Malignant melanoma S3-guideline "diagnosis, therapy and follow-up of melanoma".}, author={Annette Pflugfelder and Corinna Kochs and Andreas Blum and Marcus Capellaro and Christina Czeschik and Therese Dettenborn and Dorothee Dill and Edgar Dippel and Thomas Kurt Eigentler and Petra Christine Feyer and Markus Follmann and Bernhard Frerich and M. Ganten and Jan Gaertner and Ralf Gutzmer and Jessica Cecile Hassel and Axel Hauschild and Peter Hohenberger and Jutta Huebner and Martin Kaatz and Ulrich Richard Kleeberg and Oliver K{\"{o}lbl and Rolf - Dieter Kortmann and Albrecht F. Krause-Bergmann and Peter Kurschat and Ulrike Leiter and Hartmut Link and Carmen Loquai and Christoph R Loeser and Andreas Mackensen and Friedegund E Meier and Peter Mohr and Matthias C Moehrle and Doroth{\'e}e Nashan and Sven N. Reske and Christian Rose and Christian Sander and Imke Satzger and Meinhard Schiller and Heinz-Peter Schlemmer and Gerhard Strittmatter and Cord H Sunderk{\"{o}tter and Lothar Swoboda and Uwe Trefzer and Raymond Voltz and Dirk Vordermark and Michael Weichenthal and Andreas Werner and Simone Wesselmann and Ansgar J Weyergraf and Wolfgang Wick and Claus Garbe and Dirk Schadendorf}, journal={Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG}, year={2013}, volume={11 Suppl 6}, pages={1-116, 1-126} }