OBJECTIVES: Melanoma is the first mortality cause by skin cancer. The more advanced stages prognosis is remaining poor. The MELODY study had as primary objectives to describe the disease characteristics, treatment modalities/outcomes, and resources use in patients with unresectable Stage III-Stage IV (UNRSIII-SIV) melanoma. METHODS: MELODY was a 3-country (France, Italy, UK) longitudinal, retrospective, observational survey. In the French cohort, 10 expert Dermatology departments had to register all melanomas seen between July 2005 and June 2006. The UNRSIII-SIV cases, with minimum 2-month follow-up, were extracted for detailed description of the disease characteristics, treatments (systemic, local, supportive care) and outcomes and resource use, until 1 May 2008 or death. RESULTS: In France, 1224 patients (pts) were registered, in which 278 UNRSIII-SIV cases were extracted. At initial diagnosis, 34/1224 pts (2.8%) were UNRSIII-SIV; 253 pts (91%) received systemic treatment while 230 (91%) had a chemotherapy of any line. In first line systemic (n=249), 198 pts (80%) were treated outside clinical trials, in whom 119 (60%) were on dacarbazine (D) and 35 (18%) on fotemustine (F) monotherapy; complete/partial response was noted for 21 pts (11%), with 2.9-month median response duration , median of  progression-free survival (PFS) was 2.8 months [2.6; 3.5]. In second line, 159 pts (57%) were treated, in whom 139 (87%) outside of clinical trials, with 75 (54%) on F, and 16 (12%) on D; median PFS was 2.5 months [2.1; 3.9]. In case of systemic treatment/supportive care, there was a median of 20 [11; 30] hospitalisation days (13 [6; 22] days for first line systemic) and 3 [1; 6] outpatient visits (1.5 [1.0; 5.0] for first line systemic). CONCLUSIONS: In the French cohort of MELODY, chemotherapy treatments gave modest results in terms of complete/partial response and PFS, at a high cost of resource use, highlighting the unmet medical need.