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 cutaneous melanoma diagnosis and treatment, based on the systematic literature reviews and the experts' experience. Cutaneous melanomas are excised with one to 2-cm safety margins. Sentinel lymph node dissection shall be performed as a staging procedure in patients with tumor 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 can be proposed in stage III/completely resected stage IV patients and are primarily anti-PD-1, independent of mutational status, or alternatively dabrafenib plus trametinib for BRAF mutant patients. In distant metastases (stage IV), either resected or not, systemic treatment is always 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 stage IV melanoma with 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 harboring a BRAF-V600 E/K mutation, this therapy shall be offered as second-line therapy. 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.

1st Department of Dermatology Aristotle University Thessaloniki Greece

1st Department of Dermatology University of Athens School of Medicine Andreas Sygros Hospital Athens Greece

Center for Dermatooncology Department of Dermatology Eberhard Karls University Tuebingen Germany

Department of Dermatology and Venereology Centro Hospitalar Universitário de Coimbra Coimbra Portugal

Department of Dermatology Erasme Hospital Université Libre de Bruxelles Brussels Belgium

Department of Dermatology Maastricht University Medical Center Maastricht Netherlands

Department of Dermatology Medical University of Vienna Austria

Department of Dermatology University Hospital Schleswig Holstein Campus Kiel Kiel Germany

Department of Dermatology Venereology and Allergology Frankfurt University Hospital Frankfurt Germany

Department of Dermatovenereology 3rd Faculty of Medicine Charles University Prague Czech Republic

Department of Oncology Odense University Hospital Odense Denmark

Dermatology Clinic Maggiore Hospital University of Trieste Trieste Italy

Dermatology Department CHU Nantes CIC 1413 CRCINA University Nantes Nantes France

Dermatology Department Elias University Hospital Carol Davila University of Medicine and Pharmacy Bucharest Romania

Dermatology Department of Biotechnological and Applied Clinical Sciences University of L'Aquila L'Aquila Italy

Dermatology Unit University of Modena and Reggio Emilia Modena Italy

Institute of Dermatology Università Cattolica Rome Italy; Fondazione Policlinico Universitario A Gemelli IRCCS Rome Italy

Medical and Surgical Dermatology Service Hospital Universitario Virgen Macarena Sevilla Spain

Melanoma Institute Australia The University of Sydney and Royal North Shore and Mater Hospitals Sydney New South Wales Australia

Melanoma Unit Department of Dermatology Hospital Clinic IDIBAPS Barcelona Spain

Mount Vernon Cancer Centre Northwood United Kingdom

Shupyk National Medical Academy of Postgraduate Education Kiev Ukraine

The University of Manchester Oxford Rd Manchester M13 9PL United Kingdom

Twin Research and Genetic Epidemiology Unit School of Basic and Medical Biosciences King's College London London SE1 7EH United Kingdom

Université Paris Cite AP HP Department of Dermatology INSERM U 976 Hôpital Saint Louis Paris France

University Department of Dermatology Marseille France

University Department of Dermatology Université de Versailles Saint Quentin en Yvelines APHP Boulogne France

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