|dc.description.abstract||Cutaneous melanoma is the malignancy derived from the melanocyte, the cell responsible
for pigmentation in humans. It is now the fifth most common cancer in men and the seventh most
common in women. When melanoma is apparently localized to the primary site, the aim of surgery is
to remove not only the primary but also sufficient surrounding tissue to eliminate clinically in
apparent malignant cell present in cutaneous lymphatics adjacent to the lesion and capable for local
growth and regional or distant spread.
In the natural course of melanoma, 3 different metastatic pathways have been well identified; these
include local extension, regional extension and distant extension. Approximately 15 % of patients with
primary melanomas and no palpable lymphadenopathy (clinical stage I or II), will be found to have
melanoma involving one or more sentinel lymph nodes (pathological stage III) when the nodes are
examined after staining. An analysis more than 1400 patients with surgically excised metastases of
regional lymph nodes showed a significantly lower survival rate among patients whit palpable nodal
metastases than among those with equal numbers of non palpable nodal metastase.
These findings suggest that removal of involved but nonpalpable lymph node could increase survival
and node merely change the pattern of recurrence||en_US