A unique collaboration of multidisciplinary experts from the European Dermatology Forum, the European Association of Dermato-Oncology and the European Organization for Research and Treatment of Cancer (EORTC) was formed to make recommendations on cutaneous melanoma diagnosis and treatment, based on systematic literature reviews and the experts' experience. Cutaneous melanomas are excised with 1- to 2-cm safety margins. Sentinel lymph node dissection shall be performed as a staging procedure in patients with tumour thickness ≥1.0 mm or ≥0.8 mm with additional histological risk factors, although there is as yet no clear survival benefit for this approach. Therapeutic decisions in stage III/IV patients should be primarily made by an interdisciplinary oncology team ("Tumor Board"). Adjuvant therapies in stage III/IV patients are primarily anti-PD-1, independent of mutational status, or dabrafenib plus trametinib for BRAF-mutant patients. In distant metastasis, either resected or not, systemic treatment is indicated. For first-line treatment, particularly in BRAF wild-type patients, immunotherapy with PD-1 antibodies alone or in combination with CTLA-4 antibodies shall be considered. In particular scenarios for patients with stage IV melanoma and a BRAF-V600 E/K mutation, first-line therapy with BRAF/MEK inhibitors can be offered as an alternative to immunotherapy. In patients with primary resistance to immunotherapy and harbouring a BRAF-V600 E/K mutation, this therapy shall be offered in second-line. Systemic therapy in stage III/IV melanoma is a rapidly changing landscape, and it is likely that these recommendations may change in the near future.

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基于欧洲共识的黑色素瘤跨学科指南。第2部分：治疗-更新2019。

来自欧洲皮肤病学论坛，欧洲皮肤肿瘤学会和欧洲癌症研究与治疗组织（EORTC）的多学科专家组成了独特的合作关系，根据系统的文献综述和对皮肤黑素瘤的诊断和治疗提出建议。专家的经验。切除皮肤黑色素瘤的安全距离为1到2厘米。对于尚有其他组织学危险因素的肿瘤厚度≥1.0mm或≥0.8mm的患者，应将前哨淋巴结清扫术作为分期手术，尽管该方法尚无明显的生存获益。III / IV期患者的治疗决策应首先由跨学科的肿瘤学小组（“肿瘤委员会”）做出。III / IV期患者的辅助治疗主要是抗PD-1（与突变状态无关），或BRAF突变患者的达布拉非尼加曲美替尼。在远处转移中，无论是否切除，都需要全身治疗。对于一线治疗，尤其是在BRAF野生型患者中，应考虑单独用PD-1抗体或与CTLA-4抗体联合进行免疫治疗。在IV期黑色素瘤和BRAF-V600 E / K突变患者的特殊情况下，可以使用BRAF / MEK抑制剂进行一线治疗，作为免疫治疗的替代方法。对于对免疫疗法有主要抵抗力且具有BRAF-V600 E / K突变的患者，应在第二线提供该疗法。III / IV期黑色素瘤的全身治疗是一个瞬息万变的环境，