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Summary In this episode of Melanoma Matters, hosts James Larkin and Sapna Patel engage with Merrick Ross, a seasoned surgical oncologist, discussing his background, the evolution of surgical practice with regards to melanoma treatment, and the importance of multidisciplinary collaboration. They explore innovations in neoadjuvant therapy, the critical role of pathology in treatment decisions, and the future directions of surgical approaches in metastatic melanoma. They discuss the need for continuous adaptation and collaboration in the ever-evolving landscape of melanoma treatment. Keywords melanoma, surgical oncology, neoadjuvant therapy, multidisciplinary care, pathology, metastatic melanoma, melanoma treatment, melanoma surgery, immunotherapy, clinical trials Takeaways Merrick Ross shares his journey from Chicago to surgical oncology. Surgery for melanoma has evolved from a primary modality to a multimodal approach. Collaboration Collaboration Collaboration Neoadjuvant therapy Ultrasound imaging is more effective than cross-sectional imaging for assessing nodal basins. The role of pathology is crucial in understanding treatment responses and guiding future therapy. Surgical decisions should be tailored based on individual patient responses and disease characteristics. The need for less aggressive surgical interventions is highlighted as treatment evolves. Merrick emphasizes the importance of understanding tumor biology in surgical decision-making. The conversation underscores the collaborative nature of modern melanoma treatment. Sound Bites "We need to loop in the pathologist." "Surgery has evolved over time." "The decision to be aggressive or not is complex." Chapters 00:00 Merrick's upbringing 06:30 Evolution of Surgical Oncology for Melanoma 12:44 The Role of Sentinel Node Biopsy 18:35 Merrick waxes sentimental about neoadjuvant therapy 24:47 Collaboration Collaboration Collaboration 26:46 The Role of Pathology in Treatment Decisions 36:41 Surgical Considerations in Immunotherapy 39:44 A lovely closing anecdote about Merrick