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Review
. 2022 Jul:170:236-255.
doi: 10.1016/j.ejca.2022.03.008. Epub 2022 May 12.

European consensus-based interdisciplinary guideline for melanoma. Part 1: Diagnostics: Update 2022

Claus Garbe  1 , Teresa Amaral  2 , Ketty Peris  3 , Axel Hauschild  4 , Petr Arenberger  5 , Nicole Basset-Seguin  6 , Lars Bastholt  7 , Veronique Bataille  8 , Veronique Del Marmol  9 , Brigitte Dréno  10 , Maria C Fargnoli  11 , Ana-Maria Forsea  12 , Jean-Jacques Grob  13 , Christoph Höller  14 , Roland Kaufmann  15 , Nicole Kelleners-Smeets  16 , Aimilios Lallas  17 , Celeste Lebbé  6 , Bohdan Lytvynenko  18 , Josep Malvehy  19 , David Moreno-Ramirez  20 , Paul Nathan  21 , Giovanni Pellacani  22 , Philippe Saiag  23 , Alexander J Stratigos  24 , Alexander C J Van Akkooi  25 , Ricardo Vieira  26 , Iris Zalaudek  27 , Paul Lorigan  28 ; European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization for Research and Treatment of Cancer (EORTC)
Affiliations
Free article
Review

European consensus-based interdisciplinary guideline for melanoma. Part 1: Diagnostics: Update 2022

Claus Garbe et al. Eur J Cancer. 2022 Jul.
Free article

Abstract

Cutaneous melanoma (CM) is potentially the most dangerous form of skin tumor and causes 90% of skin cancer mortality. A unique collaboration of multi-disciplinary experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO) and the European Organization for 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 with dermatoscopy. If a melanoma is suspected, a histopathological examination is always required. Sequential digital dermatoscopy and full body photography can be used in high-risk patients to improve the detection of early melanoma. Where available, confocal reflectance microscopy can also improve clinical diagnosis in special cases. Melanoma shall be classified according to the 8th version of the American Joint Committee on Cancer classification. Thin melanomas up to 0.8 mm tumor thickness do not require further imaging diagnostics. From stage IB onwards, examinations with lymph node sonography are recommended, but no further imaging examinations. From stage IIC onwards whole-body examinations with computed tomography (CT) or positron emission tomography CT (PET-CT) in combination with brain magnetic resonance imaging 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 define 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 optimal requirements, but further studies may be considered. This guideline is valid until the end of 2024.

Keywords: AJCC classification; Confocal reflectance microscopy; Cutaneous melanoma; Dermatoscopy; Follow-up examinations; Imaging diagnostics; Mutation testing; Primary diagnosis; Sequential digital dermatoscopy; Total body photography.

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Conflict of interest statement

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 Philogen, grants and personal fees from Roche, grants and personal fees from Sanofi, outside the submitted work. Dr. Amaral reports intitutional grants and personal fees from Novartis, institutional grants from NeraCare, personal fees from BMS, institutional grants from Sanofi, institutional grants from SkylineDx, personal fees from CeCaVa, personal fees from Pierre Fabre, 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 Eisai, grants and personal fees from Immunocore, grants and personal fees from MerckPfizer, grants and personal fees from MSD/Merck, grants and personal fees from Novartis Pharma, grants and personal fees from Philogen, grants and personal fees from Pierre Fabre, grants and personal fees from Regeneron, grants and personal fees from Replimune, grants and personal fees from Roche, grants and personal fees from Sanofi-Genzyme, grants and personal fees from Seagen outside the submitted work. Dr. Arenberger reports personal fees from Amgen, personal fees from MSD, personal fees from Novartis, personal fees from BMS, grants and personal fees from Pfizer, personal fees from Sanofi, outside the submitted work. Dr Basset-Seguin has nothing to disclose. Dr. Bastholt reports personal fees for advisory boards from Bristol Myers-Squibb, Pierre Fabre, Merck MSD, Novartis and Roche, outside the submitted work. Dr. Bataille has nothing to disclose. Dr. del Marmol reports grants and personal fees from BMS, grants and personal fees from SANOFI, personal fees from Merck, grants and personal fees from almirall, personal fees from ABBVIE, personal fees from LEO pharma, personal fees from SUN Pharma, personal fees from Genzyme, 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, personal fees and non-financial support from Almirall, grants and personal fees from Leo Pharma, grants and personal fees from Janssen, grants, personal fees and non-financial support from Novartis, personal fees from Lilly, grants and personal fees from Sanofi, personal fees from UCB, personal fees from Abbvie, grants, personal fees and non-financial support from AMGEN, personal fees from Pierre Fabre, grants and personal fees from Galderma, personal fees from Sun Pharma, personal fees from BMS, personal fees from Kyowa Kyrin, personal fees from Pfizer, personal fees from MSD, outside the submitted work. Dr. Forsea has nothing to disclose. Dr. Grob reports personal fees from Amgen, personal fees from MSD, personal fees from Novartis, grants and personal fees from Pierre Fabre, grants and personal fees from BMS, personal fees from Philogen, personal fees from Roche, personal fees from Sanofi, outside the submitted work. Dr. Hoeller reports personal fees from Amgen, personal fees from Almirall, personal fees from BMS, personal fees from MSD, personal fees from Novartis, personal fees from Pierre Fabre, personal fees from Roche, personal fees from Sanofi, outside the submitted work. Dr. Kaufmann reports grants from Abbvie, grants from Almirall, grants from Amgen, grants from Astra Zeneca, grants from Biontech, grants from BMS, grants from BMS, grants from Celgene, grants from InflaRx, grants from Leo, grants from Lilly, grants from MSD, grants from Novartis, grants from Pfizer, grants from Pierre Fabre, grants from Regeneron, grants from Roche, grants from Sanofi, grants from UCB, outside the submitted work. Dr. Kelleners-Smeets has nothing to disclose. Dr. Lallas reports grants and personal fees from Sanofi, outside the submitted work. Dr. Lebbé 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. Lytvynenko has nothing to disclose. Dr. Malvehy reports grants and personal fees from Amgen, personal fees from MSD, grants and personal fees from Novartis, grants and personal fees from BMS, grants and personal fees from Almirall, personal fees from Sunpharma, personal fees from Pierre Fabre, outside the submitted work. Dr. Moreno-Ramirez has nothing to disclose. Dr. Nathan reports personal fees from BMS, personal fees from MSD, personal fees from Novartis, personal fees from Pfizer, grants and personal fees from Immunocore, personal fees from 4SC, outside the submitted work. Dr. Pellacani reports personal fees from Novartis, personal fees from Sanofi, grants from Novartis, instruments from 3Gen, 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 from Sanofi, personal fees from Janssen CILAG, personal fees and non-financial support from Novartis, grants from Genesis Pharma, grants from Abbvie, grants and personal fees from BMS, personal fees from Regeneron, grants from Leo-Pharma, grants from Lilly, outside the submitted work. Dr. van Akkooi reports grants and personal fees from Amgen, personal fees from Bristol-Myers Squibb, personal fees from Novartis, personal fees from MSD-Merck, grants and personal fees from Merck-Pfizer, personal fees from Pierre Fabre, personal fees from Sanofi, personal fees from Sirius Medical, personal fees from 4SC, outside the submitted work. Dr. Vieira reports personal fees from BMS, outside the submitted work. Dr. Zalaudek reports personal fees from Philogen, personal fees from MSD, personal fees from Novartis, personal fees from Sanofi, personal fees from La Roche Posay, personal fees from Sunpharma, personal fees from Biogena, personal fees from Cieffe Derma, outside the submitted work. Dr. Lorigan has nothing to disclose.

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