Lymph nodes and the melanoma surgeon: re-defining a long-term relationship.

Surgeons now have an enhanced ability to stage patients with clinically localized cutaneous melanoma using sentinel lymph node biopsy. Despite this, the weight of clinical evidence is tilting in favor of a measured approach to pre-emptive lymph node removal. Careful consideration of whether traditional surgical approaches to the regional nodes, whether done in the name of 'staging' or pre-emptive removal of a potential site of relapse, really 'benefit' the patient is paramount for optimal care.