The clinical implications of lymph node metastasis in patients with malignant melanoma remain serious. Five-year survival rate for clinical stage II disease is between 36% and 50% compared with more than a 80% 5-year survival rate for stage I melanoma. The purpose of this article is to review the known clinical and pathological risk factors for the development of lymph node metastasis in melanoma, to consider the prognostic significance of metastasis once it has occurred, and to discuss the histopathology and differential diagnosis of metastatic melanoma in lymph nodes. Our experience with selective lymphadenectomy for the detection of micrometastases is also presented.
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