In recent years, several breakthroughs have been made in the clinical treatment of melanoma, and melanoma has become the malignant tumor with the fastest changing treatment paradigm among all malignant tumors. In order to meet the rapid development of melanoma treatment and to make the clinical practice of melanoma in China more standardized and internationalized, the Melanoma Expert Committee has updated and added more contents after multidisciplinary expert discussion and repeated extensive consultation, and compiled the “China Melanoma Diagnosis and Treatment Guidelines (2015 Edition)”, hoping to provide the latest and most practical evidence-based medical evidence for clinical oncologists in China. We hope to provide the latest and most practical evidence-based clinical practice for Chinese oncologists. The specific updates are as follows. 1. Epidemiology This guideline updates the global and domestic incidence of melanoma from 2011 to 2012. The overall situation shows that the incidence rate and mortality rate of melanoma in China are low, but have shown a rapid increase in recent years; while the incidence rate of melanoma in most European and American countries is also on the rise, the mortality rate of melanoma is basically stable and does not show an increase in mortality rate with the rise in incidence rate, indicating that there is still a large gap between the diagnosis and treatment of melanoma in China and the West. 2. pathology, diagnosis and surgical part The importance of microsatellite foci has been added to the pathology diagnosis. 2013 Pathology Society of America defines microsatellite foci as tiny metastatic lesions in the dermal reticular layer, lipid membrane or vasculature with a diameter greater than 0.05 mm and more than 0.3 mm from the primary lesion. It predicts a very high risk of local or systemic metastasis, and patients with microsatellite foci should be staged as stage N2c, with a prognosis similar to that of stage IIIB patients. Previous guidelines recommend that all patients with positive anterior lymph node biopsies require regional lymph node dissection. A recent Rotterdam study showed that patients with tumors <0.1 mm in diameter in the sentinel lymph nodes had a 5-year survival rate of 91%, so these patients do not require further regional lymph node dissection, as detailed in this guideline. Ultrasound or CT can be used to determine whether regional lymph nodes are metastatic, and this guideline further gives ultrasound diagnostic recommendations for lymph node metastasis: peripheral blood supply, loss of echogenicity in the central area (loss of target ring structure) and sphere-like changes. The sensitivity and positive compliance rates for the three were 77% and 52%, 60% and 65%, 30% and 96%, respectively, and 82% if all three were present at the same time. < p=""> For carcinoma in situ, the incision margin was changed from 0.5 cm to 0.5~1 cm. primary foci in the skin of the head and neck, and parotid lymph node metastasis was found clinically or microscopically, parotidectomy and cervical lymph node dissection in the drainage area were recommended. 3, adjuvant treatment section Although the results of adjuvant treatment with CTLA-4 monoclonal antibody were reported in 2014, the treatment group reduced the risk of recurrent metastasis by 25% compared with the observation group, with no significant improvement compared with the historical data of high-dose interferon. Given the high price of CTLA-4 monoclonal antibody and the lack of comparative efficacy with the current standard of care interferon, this guideline does not include CTLA-4 monoclonal antibody as adjuvant therapy and still recommends high-dose interferon as an adjuvant treatment option for high-risk cutaneous melanoma. The adjuvant radiotherapy aspect has been modified based on the results of an Australian study. The requirements for regional metastatic radiotherapy are to meet any of 1) the patient’s LDH to be below 1.5 times the upper limit of normal; and 2): ≥1 parotid metastatic lymph node or ≥2 cervical or axillary metastatic lymph nodes or ≥3 inguinal metastatic lymph nodes or ≥3 cm maximum diameter of cervical or axillary metastatic lymph nodes or ≥4 cm maximum diameter of inguinal metastatic lymph nodes or lymph node extranodal invasion. The expert group generally recognized the significance of adjuvant radiotherapy in improving the local control rate, but the side effects brought by radiotherapy and the trend of possible reduction of overall survival shown in some clinical trials make the application of adjuvant radiotherapy still controversial. For the treatment of patients with metastasis or locally advanced disease, intra-tumoral drug injection is added to this guideline. The mechanism of action is local ablation of tumor and induction of systemic anti-tumor immunity, and promising drugs include T-VEC and PV-10. The treatment of advanced melanoma has been greatly modified in this guideline, which is subdivided according to genetic mutation and rapid progression of disease. For patients with genetic mutations and rapid progression, it is recommended to use individualized targeted drugs for rapid tumor reduction first, followed by immune-targeted therapy, and for patients with slow progression, it is recommended to use immune-targeted therapy first; for patients with genetic wild-type and rapid progression, it is recommended to use cytotoxic drugs combined with anti-angiogenic drugs first, followed by immune-targeted therapy for rapid tumor reduction, and for patients with slow progression, it is recommended to consider Immune-targeted therapy should be considered first, followed by cytotoxic drugs. The addition of albumin-binding paclitaxel to the cytotoxic class of drugs. The recommendation was based on a phase III randomized multicenter clinical trial. For individualized targeted therapy, BRAFV600 inhibitor alone or BARF V600 inhibitor combined with MEK inhibitor is recommended for patients with BRAF V600 mutation; for patients with CKIT mutation, CKIT inhibitor is still recommended. In the choice of immune-targeted therapy, a combination of PD-1 monoclonal antibody monotherapy and combined CTLA-4 monoclonal antibody was added, and the combination was labeled more recommended for patients with low PD-L1 expression. The recommendation is based on an updated clinical study reported in 2015. 5. Other types This guideline adds a new process for the diagnosis and treatment of mucosal melanoma and uveal melanoma, the former including head and neck mucosa, gastrointestinal tract and genitourinary mucosa melanoma. There is no uniform staging for mucosal melanoma except for head and neck. The general principle is early surgical excision, postoperative adjuvant chemotherapy may be given, and late treatment is the same as for cutaneous melanoma. Uveal melanoma is a special category of melanoma with uniform staging, but the prognosis is poor, and the progress of its surgery, adjuvant therapy and systemic therapy is slower. This guideline aims to be comprehensive, standardized and internationalized, but in practice, treatment plans need to be developed according to local medical level, patients’ own characteristics, concomitant diseases and economic situation.