Sentinel node staging of primary melanoma by the "10% rule": pathology and clinical outcomes.

Background: Surgical staging of clinically node-negative primary melanoma involves identification and removal of "sentinel" lymph nodes (SLNs). Although some suggest removal of only the "hottest" SLN, the "10% rule" dictates that nodes are removed until the background count is 10% or less of the count of the "hottest" node.

Methods: To determine the utility of the 10% rule, a university database of clinically node-negative melanomas surgically staged by using this rule was examined.