IN 1960 we published a study of malignant melanomas of the skin which showed that it was possible to forecast with reasonable accuracy which cases would ultimately develop regional node metastases if initial treatment were limited to wide local excision of the primary lesion.1 Our paper presented a classification of all primary lesions based on the depth of dermal invasion. Since that time a substantial number of additional cases have been added to the series and have confirmed our original conclusions. It is the object of this paper to present the findings in this enlarged series and also to consider the optimum treatment of cases presenting both before and after development of regional metastases.
Interest has grown in the classification of malignant melanomas by depth of dermal invasion2-5 and several articles on the subject have recently been published. Unfortunately the classification used in each article has varied somewhat