Current treatment of locoregional recurrence of melanoma.

Surgical resection is the mainstay of therapy for locoregional recurrence of melanoma and the best chance for long-term cure in patients with locoregional recurrence of melanoma. In addition to true local recurrence at the site of the primary lesion, locoregional relapse can occur as regional nodal disease or as satellite or in-transit metastases, which may be unresectable and can present significant treatment challenges. Options for unresectable locoregional recurrence include regional hyperthermic isolated limb perfusion or isolated limb infusion, topical therapies, intralesional injection therapies, laser ablation, radiation therapy, and systemic therapy. Given the risk of further relapse and the negative impact on prognosis and overall survival after locoregional recurrence of melanoma, most patients should be considered for aggressive locoregional therapy.