Treatment for Regionally Advanced and In-transit Melanoma

Regionally advanced and in-transit melanomas refer to melanoma that has spread beyond the primary tumor site and before the draining lymph node. Treatment options resemble both earlier stages in that surgery can be used, and later stages in that systemic therapy can be used. If the melanoma is limited to one extremity, regional treatment includes isolated limb perfusion and isolated limb infusion. In addition, intralesional therapy can be used to bring good effect while minimizing systemic side effects. This chapter discusses these treatment options and when they might be considered.