Summary In this episode of Melanoma Matters, hosts Sapna Patel and James Larkin welcome surgical oncologist Mark Faries to discuss the evolution of surgical practices in melanoma, particularly focusing on sentinel lymph node biopsy and the implications of recent clinical trials. They explore the historical context of lymph node surgeries, the significance of nomograms in predicting patient outcomes, and the latest NCCN guidelines regarding clinic l stage II melanoma. They also delve into the emerging role of neoadjuvant therapies and the planned MSLT-3 trial, exploring the balance between effective treatment and minimizing surgical interventions. The discussion highlights the importance of staging information and the potential immunosuppressive effects of surgery, concluding with reflections on the collaborative nature of oncology care. Takeaways The significance and historical context of sentinel lymph node biopsy in melanoma treatment. NCCN recommendations are evolving regarding sentinel lymph node biopsies. Neoadjuvant therapies are changing the surgical landscape. MSLT-3 aims to explore less invasive surgical options. Surgery has immunosuppressive effects that need consideration. Accurate staging information is a factor in decisions about treatment. Collaboration between surgical and medical oncologists is fun! Keywords melanoma, surgical oncology, lymph nodes, sentinel lymph node biopsy, MSLT trials, adjuvant therapy, nomograms, NCCN guidelines, neoadjuvant therapy, immune suppression Titles Navigating Melanoma: Insights from Surgical Oncology The Evolution of Sentinel Lymph Node Surgery Sound Bites "No tumor is resistant to formaldehyde." "Surgery is the gold standard." "We need that staging information." Chapters 00:00 Introduction and Welcome to Special Guest, Mark Faries 06:06 The Evolution of Lymph Node Surgery 09:07 MSLT Trials: Insights and Outcomes 11:59 Current Practices in Sentinel Lymph Node Biopsy 15:02 Adjuvant Therapy and Its Implications 21:09 NCCN Guidelines and Clinical Stage II Disease 24:19 MSLT-3: A New Era in Melanoma Surgery 26:52 The Role of Immune Suppression with Surgery