Retrospective review of 199 patients with malignant melanoma who had regional node dissection showed that the median survival rates of patients with histologically negative nodes was more than threefold higher than that of patients with histologically positive regional nodes. In the patients with positive nodes, survival was related to the number of nodes involved. Patients with one, two, and three or more positive lymph nodes had a tumor-free five-year survival rate of 41%, 30%, and 18%. Patients who required regional node dissection for positive palpable nodes in one month, one year, or longer than one year from the excision of the primary tumor had a median survival of 21.5, 22, and 44 months.