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adjuvant anatomical Ann Surg axillary Balch CM biopsy Cancer chemotherapy Clin clinical stage cutaneous melanoma dacarbazine diagnosis distant metastases dose DTIC dysplastic nevus ELND evaluation growth pattern head and neck histologic immunotherapy incidence incision intransit metastases lentigo maligna lentigo maligna melanoma lesions level of invasion lymph node dissection lymphadenectomy lymphatic lymphocytic malignant mela malignant melanoma McCarthy WH McGovern VJ mela melanocytic melanoma cells melanoma patients melphalan metastases metastatic disease metastatic melanoma Milton GW multifactorial analysis muscle nevi nevus nodal metastases nodular melanoma noma number of patients Oncol pathologic patients with stage pectoralis minor muscle pigmented primary lesion primary melanoma prognostic factors radiation therapy recurrence regional lymph nodes regional nodes regional perfusion regression risk scan Shaw HM skin Soong S-j stage I melanoma subcutaneous subgroups superficial spreading surgery surgical treatment survival rates symptoms Table tients tissue trunk tumor thickness ulceration