Neoadjuvant Immunotherapy Using PD-1 Inhibitors for Resectable Stage III Cutaneous Melanoma-Different…

Cohort studyAnnals of surgery· Jul 2026

Neoadjuvant Immunotherapy Using PD-1 Inhibitors for Resectable Stage III Cutaneous Melanoma-Different Outcomes Between Patients With Lymph Node and In-transit Metastases.

Ellen Krabbe, Anne Huibers, Ana Carneiro … Roger Olofsson Bagge

Skin Cancer & MelanomaCohort studyTreatmentQ1IF 6.2

In-transit melanoma metastases show far lower pathological response than lymph node metastases

Neoadjuvant Immunotherapy Using PD-1 Inhibitors for Resectable Stage III Cutaneous Melanoma-Different Outcomes Between Patients With Lymph Node and In-transit Metastases.

Ellen Krabbe … Roger Olofsson Bagge

Annals of surgery · Jul 2026

Background

Neoadjuvant immunotherapy has emerged as the preferred treatment strategy for patients with resectable stage III melanoma.

Purpose

The aim of this study was to evaluate neoadjuvant immunotherapy in a population-based cohort of patients with stage III melanoma with a specific focus on patients with ITM.

Methods

Were stratified into 3 groups, LN metastasis only, ITM only, and concurrent LN and ITM involvement.

n = 212 patients

Results

immune therapy shrinks skin metastases far less than lymph node ones

HR by subgroup · 95% CI

More results

Event-free survival and locoregional recurrence-free interval were significantly inferior in patients with ITM compared with LN metastases.

More results

In multivariable Cox regression analyses, ITM was associated with a higher risk of events for event-free survival (HR 2.00; 95% CI: 1.08-3.71; P =0.028) and locoregional recurrence-free interval (HR 4.41; 95% CI: 1.76-11.02; P =0.002).

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Conclusion

The lower pathological response rate and inferior event-free survival observed in patients with ITM compared with LN metastases, together with an increased risk of locoregional recurrence, but no difference in distant metastasis-free survival, suggest that ITM may represent a biologically distinct disease phenotype with a higher propensity for locoregional treatment failure.

Neoadjuvant Immunotherapy Using PD-1 Inhibitors for Resectable Stage III Cutaneous Melanoma-Different Outcomes Between Patients With Lymph Node and In-transit Metastases.

Neoadjuvant Immunotherapy Using PD-1 Inhibitors for Resectable Stage III Cutaneous Melanoma-Different Outcomes Between Patients With Lymph Node and In-transit Metastases.

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