Malignant Melanoma: Staging and Treatment of Localized and Advanced Disease.

For most solid tumors, including melanoma, the most powerful predictor of recurrence and survival is the presence or absence of regional lymph node metastases. For patients with melanoma and stage III disease, the five-year survival decreases 40% compared to patients without nodal metastases. With the approval of interferon alfa-2b as the first effective adjuvant therapy for the high risk for recurrence melanoma population, one can argue that patients with a defined rate of nodal metastases (tumor thickness >1 mm) should have a nodal staging procedure as part of their primary therapy. Lymphatic mapping with sentinel lymph node (SLN) biopsy is the least morbid method to obtain this information.