Inclusion Criteria

DISEASE CHARACTERISTICS:

- Histologically confirmed primary or recurrent extremity melanoma

- Stage IIIB or IIIC disease

- Patients with stage IIIC disease must have had regional lymph nodes
previously removed

- Disease to be treated by regional therapy must be distal to the planned site of
tourniquet placement

- Bidimensionally measurable disease by caliper or radiological method

- Must have identifiable target lesions for disease assessment

- Patients with a single lesion must have archived tumor tissue available for
research analysis

- No stage IV disease

- No known brain metastasis

- Patients with neurological symptoms must have undergone a CT scan or MRI of the
brain within the past 4 weeks to exclude brain metastasis

PATIENT CHARACTERISTICS:

- ECOG or Zubrod performance status 0-1

- Life expectancy > 6 months

- Hemoglobin ≥ 9.0 g/dL

- WBC ≥ 3,000/mm^3

- ANC ≥ 1,500/mm^3

- Platelet count ≥ 100,000/mm^3

- Total bilirubin ≤ 1.5 x upper limit of normal (ULN)

- ALT and AST ≤ 2.5 x ULN

- INR < 1.5 or PT/PTT normal

- Creatinine ≤ 1.5 x ULN

- Not pregnant or nursing

- Negative serum pregnancy test

- Fertile patients must use effective contraception

- Must have a palpable femoral or axillary pulse in the extremity to be treated

- No cardiac disease, including any of the following:

- NYHA class III or IV congestive heart failure

- Unstable angina (i.e., angina symptoms at rest) or new onset angina within the
past 3 months

- Myocardial infarction within the past 6 months

- No cardiac ventricular arrhythmias requiring antiarrhythmic therapy

- No uncontrolled hypertension, defined as systolic blood pressure (BP) > 150 mm Hg or
diastolic BP > 90 mm Hg, despite optimal medical management

- No known HIV infection

- No chronic hepatitis B or C

- No active clinically serious infection > CTCAE grade 2

- No thrombotic or embolic events (e.g., cerebrovascular accident or transient ischemic
attacks) within the past 6 months

- No signs or symptoms of vascular insufficiency (i.e., any history of blood clots or
other ischemic peripheral vascular disease)

- No evidence or history of bleeding diathesis or coagulopathy

- No pulmonary hemorrhage or bleeding event ≥ CTCAE grade 2 within the past 4 weeks

- No other hemorrhage or bleeding event ≥ CTCAE grade 3 within the past 4 weeks

- No serious nonhealing wound, ulcer, or bone fracture

- No significant traumatic injury within the past 4 weeks

- No condition that impairs the patient's ability to swallow whole pills

- No malabsorption problem

- No known history of allergic reactions and/or hypersensitivity to melphalan,
sorafenib tosylate, or any other agent used in the study

- No psychiatric condition or diminished capacity that would compromise giving informed
consent, or interfere with study compliance

- No history of other malignancies, except for any of the following:

- Adequately treated basal cell or squamous cell carcinoma of the skin

- Curatively treated in situ carcinoma of the uterine cervix, prostate cancer, or
superficial bladder cancer

- Other curatively treated solid tumor with no evidence of disease for ≥ 5 years

PRIOR CONCURRENT THERAPY:

- Recovered from prior therapy

- No prior sorafenib tosylate

- Prior melphalan via isolated limb infusion allowed

- No antineoplastic therapy, radiotherapy, or any other investigational drug within the
past 4 weeks

- No major surgery or open biopsy within the past 4 weeks

- No concurrent Hypericum perforatum (St. John wort) or rifampin

- Concurrent anti-coagulation treatment with warfarin or heparin allowed