Journal Review in Surgical Oncology: Melanoma

Behind The Knife: The Surgery Podcast

Education, Science, Health & Fitness, Medicine

4.8 • 1.4K Ratings

🗓️ 16 February 2026

⏱️ 36 minutes

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Summary

Join the Behind the Knife Surgical Oncology Team as we discuss the PRADO and NADINA randomized control trials regarding neoadjuvant therapy in Stage III melanoma with macroscopic nodal disease!

Hosts:

Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center.

Daniel Nelson, DO, FACS (@usarmydoc24) is Surgical Oncologist/HPB surgeon at Kaiser LAMC in Los Angeles.

Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a 2ndYear Surgical Oncology fellow at MD Anderson.

Beth (Elizabeth) Barbera, MD (@elizcarpenter16) is a General Surgery physician in the United States Air Force station at RAF Lakenheath.

Joe (Joseph) Broderick, MD, MA (@joebrod5) is a General Surgery research resident between his second and third year at Brooke Army Medical Center.

Galen Gist, MD (@gistgalen) is a General Surgery research resident between his second and third year at Brooke Army Medical Center.

Learning Objectives:

- Evaluate the role of Completion Lymph Node Dissection (CLND) in patients with positive sentinel lymph nodes, specifically citing the lack of melanoma-specific survival benefit vs. the improvement in regional disease control demonstrated in the MSLT-II trial.

- Determine the appropriate surgical excision margins for primary cutaneous melanoma, comparing the outcomes of 1 cm versus 2 cm margins as analyzed in the MINT trial (Lancet 2019).

- Analyze the impact of adjuvant systemic therapy (Anti-PD1/Immunotherapy) on recurrence-free survival in patients with resected high-risk Stage III melanoma.

References:

Reijers, I.L.M., Menzies, A.M., van Akkooi, A.C.J. et al. Personalized response-directed surgery and adjuvant therapy after neoadjuvant ipilimumab and nivolumab in high-risk stage III melanoma: the PRADO trial. Nat Med 28, 1178–1188 (2022). https://doi.org/10.1038/s41591-022-01851-x

Christian U. Blank et al. Neoadjuvant nivolumab plus ipilimumab versus adjuvant nivolumab in macroscopic, resectable stage III melanoma: The phase 3 NADINA trial.. J Clin Oncol 42, LBA2-LBA2(2024). DOI:10.1200/JCO.2024.42.17_suppl.LBA2

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Transcript

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0:00.0	Behind the Night, the Surgery Podcast, relevant and engaging content designed to help you dominate the day.
0:17.0	Hi, everyone.
0:22.6	Welcome back to another journal article review with your surgical and ecology team.
0:26.6	Our whole team can make it today due to conflicting schedules.
0:29.0	We'll move forward to having them next time.
0:31.3	Let's start up with some quick introductions.
0:33.6	I'm Joe Brodery, I'm a research resident at Brookarming Medical Center.
0:37.1	I'm Gaila Liesk. I'm also a research resident at Brookhavent Medical Center. I'm Joe Brodery, I'm a research resident at Brookharmine Medical Center. I'm Gaileneley, yes. I'm also a research resident at Brookhury Medical Center.
0:41.3	I'm Tim Breil and I'm a surgical oncologist at Brookharmine Medical Center.
0:45.7	Okay, both get started.
0:47.5	Today we're covering two trials in melanoma, the Prado and Medina trial,
0:51.8	both of which investigate the efficacy of neodygrain treatment and
0:55.0	macroscopic nodal melanoma, that's stage 3B through D disease, as well as the use of
1:00.9	response to certain treatment plants. The earlier landmark trials, MSLT1 and MSLT2 were covered in a
1:06.4	great BTK episode released in September 2022 by our UT Southwestern team. These trials established
1:12.5	the treatment approach for intermediate thickness melanoma with a positive set-known lymphobiasy,
1:16.9	showing that while these patients benefited from sentin-lein lipinobiasy, they don't necessarily need
1:21.4	a completion lymphinidisection. So with that background, Dr. Riehlin, can you start us off by setting
1:26.3	the stage for these two trials?
1:28.9	Yeah, so, you know, a lot of things have changed in melanoma because of effective medical therapy.
1:34.2	So when I was the resident, it was like, if you had node positive melanoma or God forbid metastatic melanoma, it was just a desicence.
1:41.7	There was really not much that could be done.
	...

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