# MSLT-II

Source: https://onco.cc/trials/mslt-ii/  
OnCo record `mslt-ii` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Showed that removing all the remaining lymph nodes after a positive sentinel node does not help patients live longer, ending a routine operation.

## Summary

MSLT-II, trial NCT00297895 sponsored by the John Wayne Cancer Institute and the NCI and reported in 2017, showed that removing all the remaining lymph nodes after a positive sentinel node in melanoma does not help patients live longer, ending a routine operation. It randomised 1,939 sentinel-node-positive patients to immediate completion dissection or ultrasound surveillance, found identical melanoma-specific survival at three years, and showed that dissection improved regional control only at the cost of lymphoedema in about a quarter of patients against six percent. Practice changed worldwide to nodal surveillance, and how best to use adjuvant and neoadjuvant systemic therapy in its place is the open question.

## Fields

- Kind: Trial
- Status: positive
- Last checked: 2026-09-07
- Registry id: NCT00297895
- Phase: 3
- Setting: Sentinel-node-positive melanoma: immediate completion lymph node dissection vs ultrasound surveillance
- Sponsor: John Wayne Cancer Institute / NCI
- Enrolled: 1939
- Result: No melanoma-specific survival benefit; lymphoedema 24% vs 6%.
- Outcomes: Melanoma-specific survival at 3 years: Completion dissection 86% vs Observation 86%
- Replication: DeCOG-SLT (Germany) reached the same conclusion.

## Sources

- ClinicalTrials.gov NCT00297895: https://clinicaltrials.gov/study/NCT00297895
- NEJM 2017: https://www.nejm.org/doi/full/10.1056/NEJMoa1613210

## Connected records

- cancers: [Melanoma](https://onco.cc/cancers/melanoma/), [Stage III melanoma (after surgery)](https://onco.cc/cancers/stage-iii-melanoma/)
- technologies: [Sentinel lymph node biopsy](https://onco.cc/technologies/sentinel-node/), [Ultrasound](https://onco.cc/technologies/ultrasound/)
- people: [Mark B. Faries](https://onco.cc/people/mark-faries/)
- key papers: [MSLT-II: completion lymph node dissection or observation for sentinel-node metastasis in melanoma](https://onco.cc/key-papers/paper-mslt-ii-faries-nejm-2017/)
- bottlenecks: [Metastasis is understood least and studied last](https://onco.cc/bottlenecks/b-metastasis-biology/), [Surgery and radiotherapy cure most, get least](https://onco.cc/bottlenecks/b-surgery-radiation-innovation/)
- institutions: [Society of Surgical Oncology](https://onco.cc/institutions/sso/)
- roadmaps: [Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work](https://onco.cc/roadmaps/surgery-roadmap/)

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