Melanoma treatment depends on the exact melanoma subtype, primary-tumor pathology, stage, lymph-node and distant-metastasis status, molecular findings, prior treatment and resectability. German university skin-cancer centers publish multidisciplinary pathways ranging from surgery and structured follow-up to immune-checkpoint therapy, mutation-guided targeted treatment and clinical studies for selected advanced disease. International patients should send the complete pathology and current staging evidence before choosing a center or asking for one drug or procedure.
Start with expert pathology and stage
The treatment pathway changes substantially between a localized primary melanoma, regional nodal disease and unresectable or metastatic melanoma. A useful German review should include the original pathology, excision details and current imaging rather than only the diagnosis name.
Surgery remains central for resectable local disease
Charité and Freiburg document modern tumor surgery within specialist skin-tumor programs. The required excision and any further surgical staging depend on the pathology and clinical stage, and reconstructive planning can become relevant for tumors in anatomically sensitive areas.
Sentinel-node and nodal decisions are stage-dependent
Regional lymph-node assessment can influence staging and subsequent treatment. The indication for sentinel-node biopsy or another nodal procedure should be decided from primary-tumor risk features and the current guideline-based melanoma pathway rather than performed automatically for every skin melanoma.
Tumor-board review matters when the pathway becomes complex
Heidelberg and Charité describe interdisciplinary skin-cancer tumor-board structures. For stage III, stage IV, unusual melanoma subtypes, recurrent disease or uncertain sequencing, multidisciplinary review helps coordinate dermatology, surgery, oncology, radiology, pathology, radiation oncology and other specialties.
Immunotherapy is a major systemic-treatment pathway
Freiburg, Heidelberg and Charité publish immune-based treatment for advanced melanoma and current clinical studies in perioperative and advanced settings. The exact regimen depends on stage, prior therapy, comorbidities, toxicity risk and current approvals, so treatment should not be selected from a static drug list.
Targeted therapy depends on molecular findings
Freiburg documents mutation-guided oral targeted therapy for selected melanoma patients. Molecular results such as BRAF status can therefore affect systemic-treatment options and should be included in an international review when already available.
Clinical trials can be relevant in selected disease settings
Charité and Heidelberg publish active melanoma studies across perioperative and advanced-treatment settings. Trial availability changes quickly and eligibility is narrow, so a current official trial page is more useful than a permanent promise that one experimental therapy will be available.
Records to send before travelling
The specialist center should be able to reconstruct the melanoma pathology, prior surgery, stage and systemic-treatment history before proposing a visit.
- Primary melanoma pathology report including Breslow thickness and ulceration when reported
- Reports from excision, re-excision and lymph-node procedures
- Pathology slides or blocks if expert review is requested
- Current CT, PET/CT or MRI images in DICOM format when staging has been performed
- Molecular testing such as BRAF status when available
- Previous immunotherapy, targeted therapy, radiotherapy or chemotherapy details
- History of treatment-related immune or other serious toxicities
- Current medication and relevant autoimmune or transplant history
- A clear question about surgery, adjuvant therapy, metastatic treatment, second opinion or trial eligibility
Plan long-term surveillance and toxicity follow-up
Melanoma follow-up can include skin examination, lymph-node assessment, imaging and monitoring for late treatment effects depending on stage and prior therapy. Before returning home, define which surveillance will remain in Germany and which can be transferred to a dermatology or oncology team locally.
Sources and review
This guide was last source-reviewed on 2026-08-30.
- Skin Tumor Center Charité – melanoma and interdisciplinary skin-cancer care — Charité – Universitätsmedizin Berlin ↗
- Current melanoma clinical studies — Charité – Universitätsmedizin Berlin ↗
- Skin Tumor Center – diagnostics and treatment — University Medical Center Freiburg ↗
- Dermato-oncology – immunotherapy and targeted therapy — University Medical Center Freiburg ↗
- Heidelberg Skin Tumor Center – patient care and tumor board — Heidelberg University Hospital ↗
- Heidelberg current melanoma clinical studies — Heidelberg University Hospital ↗