Treatment and follow-up of ­cutaneous melanoma

Source: Swiss Medical Weekly, February 2016

By Reinhard Dummer, et al.: In order to guide treatment decisions and follow-up of melanoma patients, guidelines for the management of melanoma in Switzerland were inaugurated in 2001 and revised in 2006 and, most recently, in 2016. Recent data from randomised trials necessitated modifications of the treatment and follow-up recommendations.

Abstract

Cutaneous melanoma is the most deadly cutaneous neoplasm and the incidence is still rising. Melanoma is responsible for most deaths caused by skin malignancies. For these reasons, treatment guidelines have been published in 2001 and were revised in the versions of 2006 and 2011, in order to provide reasonable practical recommendations for all physicians (general practitioners, dermatologists, surgeons, oncologists and others) who encounter cutaneous melanoma in their daily work. As before, the recommendations in the guideline have been graded according to the amount of scientific evidence supporting them using the “Level of Evidence” classification.

The purpose of these updated guidelines is to ensure the adequate management and treatment of melanoma patients in Switzerland. Patients with low-risk melanoma still tend to be over-treated, whereas the therapy and follow-up procedures for patients with high-risk or metastasising melanoma are sometimes inadequate, especially if the patients are managed outside centres of excellence. Drawing on the combined expertise of a multidisciplinary team, the guidelines reflect current international standards and the state of the art. Departure from these guidelines in special clinical situations is at the discretion of the individual physician.