How much we follow guidelines in surgery of melanoma: it's time to reflect!

A guideline is a statement by which to determine a course of action. Guidelines aim to streamline particular processes according to a set routine or sound practice.1 For definition, guidelines are recommended and not mandatory, accordingly they can be followed or not.1 Indeed, during the daily clinical practice, it is not always easy follow a specific guideline for a specific disease. This can be due to several factors: patient choice and/or choice of patient relatives, comorbidities, low medical update, absence of interdisciplinary discussion of clinical cases, medical negligence or, simply, because of the highlighted possibility of variability in interpretation of the guidelines, generating important critical issues. Consequently the question: “Why follow the guidelines, since they are recommendation and not obligation?” We could briefly list below some positive and negative reasons.