In Transit Metastasis as the Presentation of Cutaneous Melanoma

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • Patients presenting with this scenario:
    • Have a 50% to 75% chance of having other distant metastatic disease:
      • So the first step in management:
        • Is to assess for distant disease
      • In the absence of distant disease:
        • In patients with low-volume disease:
          • Resection is indicated:
            • If SNLB has not been performed:
              • SLNB should be strongly considered for prognostic and possible therapeutic benefit (Beasley)
        • Adjuvant treatment with PD-1:
          • Therapy should also be considered:
            • Given results of checkmate 238:
              • Which demonstrated 12-month recurrence-free survival of:
                • 70.5% in resected stage III melanoma patients receiving nivolumab (Weber).
  • References:
    • Beasley GM, Hu Y, Youngwirth L, et al. Sentinel lymph node biopsy for recurrent melanoma: A multicenter study. Ann Surg Oncol. 2017;24:2728-2733.
    • Weber J, Mandala M, Del Vecchio M, et al. Adjuvant nivolumab versus ipilimumab in resected stage III or IV melanoma. N Engl J Med. 2017;Sept 10.

Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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