Complications vary by treatment. The main complications from wide local excision are superficial: infection, wound dehiscence, and cosmetic defect. Risk of tumor recurrence after excision with appropriate margins is low. Complications of SNB are also local in nature: infection, seroma, injury to nerves, and dehiscence. The risk of lymphedema is minimal in the head and neck lymphatic basins.
The most important prognostic factors are primary tumor thickness, ulceration, and lymph node status. This is reflective of the AJCC TNM staging for melanoma (Table 1), where advancing stage corresponds with worsening prognosis (7). After biopsy and SNB, most patients can be given general prognostic counseling.
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