Garbe Claus, Amaral Teresa, Peris Ketty, Hauschild Axel, Arenberger Petr, Basset-Seguin Nicole, Bastholt Lars, Bataille Veronique, Brochez Lieve, Del Marmol Veronique, Dréno Brigitte, Eggermont Alexander M M, Fargnoli Maria Concetta, Forsea Ana-Maria, Höller Christoph, Kaufmann Roland, Kelleners-Smeets Nicole, Lallas Aimilios, Lebbé Celeste, Leiter Ulrike, Longo Caterina, Malvehy Josep, Moreno-Ramirez David, Nathan Paul, Pellacani Giovanni, Saiag Philippe, Stockfleth Eggert, Stratigos Alexander J, Van Akkooi Alexander C J, Vieira Ricardo, Zalaudek Iris, Lorigan Paul, Mandala Mario
Center for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany.
Center for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany.
Eur J Cancer. 2025 Jan 17;215:115152. doi: 10.1016/j.ejca.2024.115152. Epub 2024 Nov 28.
This guideline was developed in close collaboration with multidisciplinary experts from the European Association of Dermato-Oncology (EADO), the European Dermatology Forum (EDF) and the European Organization for Research and Treatment of Cancer (EORTC). Recommendations for the diagnosis and treatment of melanoma were developed on the basis of systematic literature research and consensus conferences. Cutaneous melanoma (CM) is the most dangerous form of skin tumor and accounts for 90 % of skin cancer mortality. The diagnosis of melanoma can be made clinically and must always be confirmed by dermoscopy. If melanoma is suspected, a histopathological examination is always required. Sequential digital dermoscopy and whole-body photography can be used in high-risk patients to improve the detection of early-stage melanoma. If available, confocal reflectance microscopy can also improve the clinical diagnosis in special cases. Melanoma is classified according to the 8th version of the American Joint Committee on Cancer classification. For thin melanomas up to a tumor thickness of 0.8 mm, no further diagnostic imaging is required. From stage IB, lymph node sonography is recommended, but no further imaging examinations. From stage IIB/C, whole-body examinations with computed tomography or positron emission tomography CT in combination with magnetic resonance imaging of the brain are recommended. From stage IIB/C and higher, a mutation test is recommended, especially for the BRAF V600 mutation. It is important to perform a structured follow-up to detect relapses and secondary primary melanomas as early as possible. A stage-based follow-up regimen is proposed, which in the experience of the guideline group covers the optimal requirements, although further studies may be considered. This guideline is valid until the end of 2026.
本指南是与欧洲皮肤肿瘤学协会（EADO）、欧洲皮肤病学论坛（EDF）和欧洲癌症研究与治疗组织（EORTC）的多学科专家密切合作制定的。黑色素瘤诊断和治疗的建议是在系统文献研究和共识会议的基础上制定的。皮肤黑色素瘤（CM）是最危险的皮肤肿瘤形式，占皮肤癌死亡率的90%。黑色素瘤的诊断可通过临床做出，且必须始终通过皮肤镜检查来确认。如果怀疑是黑色素瘤，始终需要进行组织病理学检查。连续数字皮肤镜检查和全身摄影可用于高危患者，以提高早期黑色素瘤的检测率。如有条件，共聚焦反射显微镜检查在特殊情况下也可改善临床诊断。黑色素瘤根据美国癌症联合委员会第8版分类进行分类。对于肿瘤厚度达0.8mm的薄黑色素瘤，无需进一步的诊断性影像学检查。从IB期开始，建议进行淋巴结超声检查，但无需进一步的影像学检查。从IIB/C期开始，建议进行计算机断层扫描或正电子发射断层扫描CT联合脑部磁共振成像的全身检查。从IIB/C期及更高阶段开始，建议进行突变检测，尤其是针对BRAF V600突变。进行结构化随访以尽早发现复发和继发性原发性黑色素瘤非常重要。提出了一种基于分期的随访方案，根据指南制定小组的经验，该方案满足了最佳要求，不过可能需要考虑进一步的研究。本指南有效期至2026年底。
