Sentinel lymph node sampling is becoming routinely performed in the care of these patients and aids in staging of the disease. If the patient has a positive sentinel lymph node biopsy for metastatic melanoma, staging is performed based on positron emission tomography/computed tomography (PET/CT) scanning and magnetic resonance imaging (MRI) of the brain. Patients with metastatic disease to local lymph nodes only are offered a localized lymph node dissection and adjunctive therapy with interferon. Those with widespread metastatic disease are given various chemotherapeutic regimens or enrolled into clinical studies. The mortality rate for stage IV melanoma is very poor. Follow-up for melanoma patients is based on the stage of disease. The National Comprehensive Cancer Network/National Cancer Institute (NCCN/NCI) has published standardized guidelines for clinicians.
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