Please see here to access the Clinical Practice Guidelines for the Management of Melanoma in Australia and New Zealand (2008). Note this resource was developed, reviewed or revised more than five years ago. It no longer represents the National Health and Medical Research Council's position on the matters contained therein. An updated version of this guideline is in progress. This PDF has been made available for reference purposes only.
Note: These guidelines are undergoing a staged revision and updating process. As they are completed and ratified by the Working Party, finalised chapters are being published on this wiki site. Please see the list of clinical questions for the scope of the complete revision currently in progress.
If you wish to be kept informed about public consultation periods, please contact guidelines (at) cancer.org.au.
Contents: Published questions
Note that this guidelines revision is being undertaken as a staged process. These questions have been finalised and are not open for review and public consultation.
- What are the genetic determinants of high risk for new primary melanomas?
- What validated models integrate genetic and clinical risk factors into an overall measurement of high risk from new primary melanoma?
- What interventions have been shown to provide clinical benefit in those assessed to be at high risk of new primary melanomas?
- What are the clinical features of melanoma and how do atypical melanomas present?
- Diagnostic aids for melanoma
- What is the role of dermoscopy in melanoma diagnosis?
- What is the role of sequential digital dermoscopy imaging in melanoma diagnosis?
- What is the role of automated instruments in melanoma diagnosis?
- What is the role of confocal microscopy in melanoma diagnosis?
- What is the role of skin surface imaging (total body photography) in the early diagnosis of patients at high risk of developing melanoma?
- What type of biopsy should be performed for a pigmented lesion suspicious for melanoma?
- What clinical information should the clinician give the pathologist to aid diagnosis of melanoma?
- What are the recommended safety margins for radical excision of primary melanoma (in situ)?
- What are the recommended safety margins for radical excision of invasive melanomas
- When is a sentinel node biopsy indicated?
- Should all patients with a positive sentinel lymph node biopsy have a complete node dissection?
- Primary desmoplastic and neurotropic melanomas
- What are the most effective treatment/management interventions to improve outcomes in patients with lentigo maligna?
- What investigations should be performed following a diagnosis of primary cutaneous melanoma for asymptomatic stage I and II patients?
- What investigations should be performed when in transit and/or regional node disease (stage III melanoma) is diagnosed?
- What investigations should be performed when stage IV melanoma is diagnosed?
- Follow up after initial definitive treatment for each stage of melanoma
- Ideal settings, duration and frequency of follow-up for melanoma patients
Treatment of satellite and in-transit metastases
Appropriate treatment of macroscopic nodal metastases
- What is the appropriate treatment of macroscopic (i.e. detectable clinically or by ultrasound) nodal metastases?
- What is the role of adjuvant systemic therapy in patients with resected stage II and stage III melanoma?
- Does systemic drug therapy improve progression-free and/or overall survival in unresectable stage IIIC and stage IV melanoma?
- For patients with distant metastases (other than brain metastases), when is radiotherapy indicated?
- Is adjuvant radiotherapy of value following resection of involved lymph nodes?