Introduction:
Twenty years ago, surgery was the centerpiece of treatment for cutaneous melanoma, including for resectable stage III and IV patients. The arrival of effective systemic therapies in the early 2010s has led to the abandonment of less effective traditional chemotherapeutic agents, a reduction in surgical excision margins, and a smaller set of indications for lymph node dissection. A more recent shift has been from adjuvant to neo-adjuvant immunotherapy for resectable macroscopic stage III melanoma. The speed at which the field is progressing, and the frequency of important publications on the topic, mean that regular review articles are useful to the scientific and wider community to keep abreast of this rapidly changing environment. PubMed and Cochrane databases were used to perform the literature search.

Areas covered:
We have contextualized the emergence of ipilimumab and nivolumab in the adjuvant and neo-adjuvant treatment of resectable stage III melanoma with discussion of pivotal studies, and how they influence the current guidelines.

Expert opinion:
The future is looking brighter for patients with Stage III melanoma. The pendulum has swung away from radical surgery, and toward less invasive procedures and bespoke systemic treatment options based on tumor characteristics, patient factors, and response to neo-adjuvant therapy.