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

Ketty Peris, Maria Concetta Fargnoli, Iris Zalaudek, Claus Garbe, Teresa Amaral, Axel Hauschild, Petr Arenberger, Lars Bastholt, Veronique Bataille, Veronique Del Marmol, Brigitte Dréno, Jean-Jacques Grob, Christoph Höller, Roland Kaufmann, Aimilios Lallas, Celeste Lebbé, Josep Malvehy, Mark Middleton, David Moreno-Ramirez, Philippe SaiagAlexander J. Stratigos, Ricardo Vieira, Alexander M.M. Eggermont

Research output: Contribution to journalArticle

34 Citations (Scopus)


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.
Original languageEnglish
Pages (from-to)141-158
Number of pages18
JournalEuropean Journal of Cancer
Publication statusPublished - 2020


  • AJCC classification
  • Combined Modality Therapy
  • Confocal reflectance microscopy
  • Consensus
  • Cutaneous melanoma
  • Dermatoscopy
  • Diagnostic Imaging
  • European Union
  • Follow-up examinations
  • Humans
  • Imaging diagnostics
  • Interdisciplinary Communication
  • Melanoma
  • Mutation testing
  • Neoplasm Staging
  • Practice Guidelines as Topic
  • Primary diagnosis
  • Sequential digital dermatoscopy
  • Total body photography


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