RT Book, Section
A1 Zager, Jonathan S.
A2 Morita, Shane Y.
A2 Balch, Charles M.
A2 Klimberg, V. Suzanne
A2 Pawlik, Timothy M.
A2 Posner, Mitchell C.
A2 Tanabe, Kenneth K.
SR Print(0)
ID 1145756028
T1 The Surgical Management of Locoregionally Recurrent and in-Transit Melanoma
T2 Textbook of Complex General Surgical Oncology
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9780071793315
LK hemonc.mhmedical.com/content.aspx?aid=1145756028
RD 2024/04/16
AB Locoregional  recurrence  of  a  melanoma  is  defined  as  recurrence  in  or  around  a  scar  from  previous  melanoma  surgery,  or  satellite  or  in-transit  metastases.  The  American  Joint  Committee  on  Cancer  (AJCC)  groups  the  latter  two  (satellites  and  in-transit  recurrences)  in  the  most  recent  edition  of  the  melanoma  staging  manual  (AJCC  7th  edition)  as  a  component  of  nodal  (N)  staging.1  Satellite  metastases,  considered  intralymphatic  extensions  of  the  primary  tumor,  are  defined  as  occurring  within  2  cm  of  the  primary  tumor,  whereas  in-transit  metastases  are  defined  as  any  dermal  or  subcutaneous  metastases  2  cm  or  more  from  the  primary  tumor  but  not  beyond  the  draining  regional  node  basin.1  Although  satellite  metastases  and  local  recurrences  are  often  confused  in  clinical  practice,  a  true  local  recurrence  is  a  lesion  within  or  very  close  to  the  scar  from  previous  definitive  surgery,  whereas  satellite  metastases  are  somewhat  removed  from  the  scar  but  within  2  cm.  The  bottom  line  in  the  management  of  all  locoregional  recurrences,  however,  is  that  the  treatment  algorithms  are  usually  the  same.  Nevertheless,  these  patients  should  be  discussed  in  a  multidisciplinary  tumor  board  setting  whenever  possible.  Treatment  options  for  locoregionally  recurrent  melanoma  include  surgical  resection,  local  intra-tumoral  injections,  hyperthermic  isolated  limb  perfusion  (HILP),  isolated  limb  infusion  (ILI),  topical  therapies,  laser  ablation,  radiation  therapy,  and  systemic  therapies.2