Given the emerging benefit of neoadjuvant immune checkpoint inhibitors in selected patients with cutaneous melanoma, when should lymph node basin ultrasound or cross-sectional imaging (CT/PET) be considered prior to wide local excision (WLE) with or without sentinel lymph node biopsy (SLNB) in patients with clinically node-negative disease?

We usually would argue for cross-sectional imaging for T4 tumors and above. In the end, it will be clinical gestalt. If the pathologist confirms "no dermal attachment", then it is an argument for doing cross-sectional imaging. There is no guidance or evidence to support the idea that imaging for thi...

As the current neoadjuvant IO data for melanoma are mainly from SWOG 1801 and NADINA trials, I would say the main patient population to focus on baseline staging scans (i.e., PET or CT) would be those with resectable stage III or IV disease. As it’s not possible to know whether lymph nodes have micr...