Kristoff (UAE Team Emirates) claimed the 212.5km race ahead of Matthews (Sunweb) with Oliver Naesen (AG2R), third.
“This is a race that is particularly adapted to me,” Kristoff said. “This edition had more climbing than normal and I knew it’d be harder.
"In the second loop, I didn’t feel so strong and I was about dropped, but thanks to [Oliviero] Troia and [Filippo] Ganna, I was able to hang in there.
“In the last two laps on the traditional circuit, my feelings changed and I began to believe in the win. The team worked very well from the start and in the final with Team Quick-Step to bring in the escapees.
In the sprint, the Belgian team took control of the situation until Gaviria made a mistake on the last curve, which certainly helped things.
“It’s great to return and win after my last win back in February, and great to have made part of the race’s history with a fourth consecutive win.”
A seven-rider break went at 30km but failed to sustain itself and another suffered a similar fate after it broke away with 25km to go in a race that was always set to finish in a sprint.
Quick-Step Floors controlled the closing kilometres for its sprinter Fernando Gaviria but after he misjudged a late bend the other sprinters pounced at the opportunity.
Naesen launched his sprint on the long home straight and Matthews then looked to have the edge but it was who Kristoff who timed his run perfectly to repeat as champion.
"We did a good team effort today," Matthews said. "We had the plan to make it a little bit harder in the middle of the race and that’s exactly what we did.
"We had all of the guys there to support me until the final climb when I made my move. The group got caught with 20 kilometres to go and from there I just focused on my sprint, seeing what I had left.
"It was a pretty crazy little final circuit but I ended up coming in second. All in all, it was a really good team effort today and I think second is a good result.”