European consensus-based interdisciplinary guideline for melanoma. Part 1: Diagnostics - Update 2019.

Cutaneous melanoma (CM) is potentially the most dangerous form of skin tumor and causes 90% of skin cancer mortality. A unique collaboration of multidisciplinary experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization of Research and Treatment of Cancer (EORTC) was formed to make recommendations on CM diagnosis and treatment, based on systematic literature reviews and the experts' experience. The diagnosis of melanoma can be made clinically and shall always be confirmed through dermatoscopy. If a melanoma is suspected, a histopathological examination is required. Sequential digital dermatoscopy and full-body photography can be used in risk persons to detect the development of melanomas at an earlier stage. Where available, confocal reflectance microscopy can improve clinical diagnosis in special cases. Melanoma shall be classified according to the 8th version of the AJCC classification. Thin melanomas up to 0.8 mm tumor thickness does not require further imaging diagnostics. From stage IB onwards, examinations with lymph node sonography are recommended, but no further imaging examinations. From stage IIC whole-body examinations with CT or PET-CT in combination with brain MRI are recommended. From stage III and higher, mutation testing is recommended, particularly for BRAF V600 mutation. It is important to provide a structured follow-up to detect relapses and secondary primary melanomas as early as possible. There is no evidence to support the frequency and extent of examinations. A stage-based follow-up scheme is proposed, which, according to the experience of the guideline group, covers the minimum requirements; further studies may be considered. This guideline is valid until the end of 2021.

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Copyright © 2019. Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Conflict of interest statement Dr. Garbe reports personal fees from Amgen, personal fees from MSD, grants and personal fees from Novartis, grants and personal fees from NeraCare, grants and personal fees from BMS, personal fees from Pierre Fabre, personal fees from Philogen, grants and personal fees from Roche, grants and personal fees from Sanofi, outside the submitted work. Dr. Amaral reports personal fees and other from BMS, grants, personal fees, and others from Novartis, personal fees from Pierre Fabre, grants from Neracare, grants from Sanofi, outside the submitted work. Dr. Peris reports personal fees from Novartis, personal fees from Roche, personal fees from Sanofi, personal fees from Lilly, personal fees from Leopharma, personal fees from Pierre Fabre, personal fees from Almirall, personal fees from Celgene, outside the submitted work. Dr. Hauschild reports grants and personal fees from Amgen, grants and personal fees from BMS, grants and personal fees from MerckSerono, grants and personal fees from MSD/Merck, grants and personal fees from Philogen, grants and personal fees from Pierre Fabre, grants and personal fees from Provectus, grants and personal fees from Regeneron, grants and personal fees from Roche, personal fees from OncoSec, grants and personal fees from Sanofi-Genzyme, personal fees from Sun Pharma, grants and personal fees from Novartis Pharma outside the submitted work. Dr. Arenberger reports personal fees from Amgen, personal fees from MSD, personal fees from Novartis, personal fees from BMS, personal fees from Roche, outside the submitted work. Dr. Bastholt reports grants from BMS, during the conduct of the study; personal fees from BMS, personal fees from Novartis, personal fees from Merck MSD, personal fees from Roche, personal fees from Incyte, personal fees from Bayer, outside the submitted work. Dr. Bataille reports personal fees from Novartis, personal fees from Merck MSD, outside the submitted work. Dr. del Marmol reports personal fees from MSD, from BMS, personal fees from Sanofi, grants and personal fees from ABVIE, grants from Jansen, outside the submitted work. Dr. Dréno reports grants and personal fees from BMS, personal fees from MSD, grants and personal fees from Roche, grants and personal fees from Fabre, grants and personal fees from Sanofi, outside the submitted work. Dr. Fargnoli reports grants and personal fees from Almirall, grants and personal fees from Leo Pharma, personal fees from Janssen, grants and personal fees from Novartis, personal fees from Lilly, grants and personal fees from Sanofi, personal fees from UCB, grants and personal fees from Abbvie, personal fees from Celgene, personal fees from Pierre Fabre, grants and personal fees from Galderma, personal fees from Mylan, personal fees from Medac Pharma, personal fees from Roche, personal fees from Sun Pharma, outside the submitted work. Dr. Grob reports personal fees from Amgen, personal fees from MSD, personal fees from Novartis, personal fees from BMS, personal fees from Roche, personal fees from Pierre fabre, personal fees from MercK/Pfizer, outside the submitted work. Dr. Hoeller reports personal fees from Amgen, personal fees from MSD, personal fees from Novartis, personal fees from Incyte, personal fees from BMS, personal fees from Pierre Fabre, personal fees from Roche, personal fees from Sanofi, outside the submitted work. Dr. Kaufmann reports grants and personal fees from Novartis and Roche, and grants from AbbVie, Amgen, Bionteck, BMS, Celgene, Galderma, Janssen, Leo, Lilly, Merck, MSD, Pierre Fabre, Regeneron, and Wyeth, outside the submitted work. Dr. Lallas reports personal fees from Amgen, personal fees from Novartis, personal fees from BMS, grants and personal fees from Roche, personal fees from Sanofi, outside the submitted work. Dr. Lebbe reports grants and personal fees from Bristol-Myers Squibb, personal fees from MSD, personal fees from Novartis, personal fees from Amgen, grants and personal fees from Roche, personal fees from Avantis Medical Systems, personal fees from Pierre Fabre, personal fees from Pfizer, personal fees from Incyte, outside the submitted work. Dr. Malvehy reports personal fees from Amgen, personal fees from MSD, grants from Novartis, grants and personal fees from BMS, grants and personal fees from Roche, grants and personal fees from Almirall, personal fees from Sun Pharma, outside the submitted work. Dr. Middleton reports personal fees from Amgen, grants and personal fees from Roche, grants from Astrazeneca, grants and personal fees from GSK, personal fees and other from Novartis, other from Millennium, personal fees, non-financial support and other from Immunocore, personal fees and other from BMS, personal fees and other from Eisai, other from Pfizer, personal fees, non-financial support and other from Merck/MSD, personal fees and other from Rigontec (acquired by MSD), other from Regeneron, personal fees from BiolineRx, personal fees and other from Array Biopharma (now Pfizer), non-financial support and other from Replimune, outside the submitted work. Dr. Moreno-Ramírez has nothing to disclose. Dr. Pellacani reports personal fees from Novartis, personal fees from Sanofi, grants from Novartis, instruments from 3 Gen, Vidix, Fotofinder and MAVIG GmbH, outside the submitted work. Dr. Saiag reports personal fees from Amgen, personal fees from MSD, grants and personal fees from Novartis, grants and personal fees from NeraCare, grants and personal fees from BMS, grants and personal fees from Roche, grants and personal fees from Sanofi, personal fees from Pierre Fabre/array, outside the submitted work. Dr. Stratigos reports personal fees and/or research support from Novartis, Roche, BMS, Abbvie, Sanofi, Regeneron, Genesis Pharma, outside the submitted work. Dr. Vieira has nothing to disclose. Dr. Zalaudek reports personal fees from Difa Cooper, personal fees from MSD, personal fees from Novartis, grants and personal fees from Roche, personal fees from Sanofi, personal fees from Almirall Hermal, personal fees from Mylan, personal fees from Sunpharma, outside the submitted work. Dr. Eggermont reports personal fees from Biocad, Biovent, BMS, CatalYm, Ellipses, GSK, Incyte, IO Biotech, ISA Pharmaceuticals, Merck GmbH, MSD, Novartis, Pfizer, Polynoma, Regeneron, Sanofi, SkylineDx, Stellas, other from RiverD, SkylineDx, Theranovir, all outside the submitted work.