Best practice guidelines for melanoma care goes digital

First-ever online guidelines adapting to rapid change in clinical management

Health professionals treating melanoma patients have access to the first in a series of new, wiki-based clinical recommendations with the launch today of electronic clinical practice guidelines for the diagnosis and management of melanoma.

The release of the renewed resource, in Sydney today (28 Oct) at the Australasian Melanoma Conference, marks the first time a melanoma management guideline has been published in a wiki format for continual electronic update.

The first in a comprehensive series of updated melanoma guidelines, it provides evidence-based recommendations on the recognition of melanomas, biopsy of suspicious lesions, when to perform sentinel node biopsy and margins for radical excision of primary melanomas.

The guidelines are being developed in partnership by Cancer Council Australia and Melanoma Institute Australia, with additional funding from the Skin Cancer College Australasia.

Chair of the project’s expert working group, Professor John Thompson AO, said the guidelines were the result of an exhaustive systematic review and public consultation process and were being launched at a time of rapid change in the management of melanoma.

“Things are moving quickly in melanoma management,” Professor Thompson said. “A comprehensive systematic review of the evidence was timely. “The publication of updated guidelines on Cancer Council Australia’s wiki platform means they can now be continually reviewed as new evidence becomes available.

Using wiki software also means that we can publish guidelines in sections as they are finalised, rather than waiting for large paper-based volumes to be printed and distributed.”

Professor Thompson said Australia and New Zealand had the world’s highest melanoma burden by a significant margin, with more than 17,000 cases diagnosed in the two countries each year and rising. “Extensive use of the new guidelines will help to ensure that clinicians have access to the latest evidence-based recommendations when diagnosing and caring for people with melanoma.”

One of the most significant changes in recommended practice in the new guideline was a strengthening of the evidence for sentinel node biopsy.

“The review found new evidence to support the use of sentinel node biopsy to accurately stage melanoma,” Professor Thompson said. “This is particularly important, given the advent of new effective but high-cost drugs that may be of value in appropriately staged patients.”

The guidelines will cover prevention, diagnosis, management and follow-up as well as special population groups such as children and pregnant women. The full set of guidelines is expected to be completed and published by early 2018.

The new set of guidelines are available at https://www.cancer.org.au/clinical-guidelines/skin-cancer/melanoma