Comparing national guidelines for diagnosis and treatment of melanoma with international guidelines. What is missing?

Cutaneous melanoma represents currently a public health problem of worldwide importance. Curative potential in the early stages, the low survival rate in advanced stages, but also the young age of many patients at diagnosis, highlights the need for early detection and appropriate treatment for each case in order to minimize the risk of metastasis. In Romania more than a quarter of patients that are diagnosed with melanoma present advanced disease, stages III and IV AJCC (American Joint Committee on Cancer), with poor prognosis. Clinical guidelines for diagnosis and treatment are essential tools, based on evidence developed by experts in the field, which reflect the best data available at the time, meant to help clinicians treat melanoma cases. Although cutaneous melanoma represents an important health problem in our country, at the moment, Romania is one of the countries where a complete and periodically reviewed guideline for diagnosis and treatment of melanoma is lacking. Also, in the absence of a uniform approach of these cases in our country the risk of errors can be very high. We aim to review and compare the consensus guidelines of melanoma in USA (NCCN – National Comprehensive Cancer Network) and Europe (guidelines issued by ESMO – the European Society for Medical Oncology and the European guideline developed by EADO – the European Association of Dermato-Oncology and EORTC – European Organization of Research and Treatment of Cancer) with our guideline proposed by the National Health Ministry, presenting their indications in the treatment of the primary tumor, sentinel node biopsy, adjuvant therapy, chemotherapy and patient follow-up recommendations.