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: Annette Pflugfelder, Corinna Kochs, Andreas Blum, Marcus Capellaro, Christina Czeschik, Therese Dettenborn, Dorothee Dill, Edgar Dippel, Thomas Eigentler, Petra Feyer, Markus Follmann, Bernhard Frerich, Maria-Katharina Ganten, Jan Gärtner, Ralf Gutzmer, Jessica Hassel, Axel Hauschild, Peter Hohenberger, Jutta Hübner, Martin Kaatz, Ulrich R Kleeberg, Oliver Kölbl, Rolf-Dieter Kortmann, Albrecht Krause-Bergmann, Peter Kurschat, Ulrike Leiter, Hartmut Link, Carmen Loquai, Christoph Löser, Andreas Mackensen, Friedegund Meier, Peter Mohr, Matthias Möhrle, Dorothee Nashan, Sven Reske, Christian Rose, Christian Sander, Imke Satzger, Meinhard Schiller, Heinz-Peter Schlemmer, Gerhard Strittmatter, Cord Sunderkötter, Lothar Swoboda, Uwe Trefzer, Raymond Voltz, Dirk Vordermark, Michael Weichenthal, Andreas Werner, Simone Wesselmann, Ansgar J Weyergraf, Wolfgang Wick, Claus Garbe, Dirk Schadendorf, German Dermatological Society, DermatologicCooperative Oncology Group
• Journal: Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG (J Dtsch Dermatol Ges) Vol. 11 Suppl 6 Pg. 1-116, 1-126 (Aug 2013) ISSN: 1610-0387 [Electronic] Germany
• PMID: 24028775 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Dermatology (standards)
• Dermoscopy (standards)
• Drug Therapy (standards)
• Humans
• Immunotherapy (standards)
• Lymphatic Metastasis
• Medical Oncology (standards)
• Melanoma (diagnosis, secondary, therapy)
• Practice Guidelines as Topic
• Skin Neoplasms (diagnosis, therapy)