French updated recommendations in Stage I to III melanoma treatment and management
As knowledge continues to develop, regular updates are necessary concerning recommendations for practice. The recommendations for the management of melanoma stages I to III were drawn up in 2005. At the request of the Societe Francßaise de Dermatologie, they have now been updated using the methodology for recommendations proposed by the Haute Autorite de Sante in France.
In practice, the principal recommendations are as follows: for staging, it is recommended that the 7th edition of AJCC be used. The maximum excision margins have been reduced to 2 cm. Regarding adjuvant therapy, the place of interferon has been reduced and no validated emerging medication has yet been identified.
Radiotherapy may be considered for patients in Stage III at high risk of relapse. The sentinel lymph node technique remains an option. The initial examination includes routine ultrasound as of Stage II, with other examinations being optional in stages IIC and III. A shorter strict follow-up period (3 years) is recommended for patients, but with greater emphasis on imaging.