ABSTRACT
Indeed, much of the debate and controversy about management of clinically negative lymph nodes in melanoma patients has subsided at this point for three reasons. First, the long-term results of the Intergroup Surgical Trial have demonstrated convincingly that patients who have intermediate thickness, nonulcerated melanomas have a statistically improved cure rate with elective lymph-node dissection. Second, SLN biopsy represents a technological advance that has, for the most part, supplanted the need for elective lymph-node dissection in most patients. Third, research about prognostic factors predicting the risk of nodal metastases and survival outcome has reached a point of
agreement that has fostered a major revision of the melanoma staging classification.
