{"entity":{"id":"mslt-ii","kind":"trial","name":"MSLT-II","aka":[],"tldr":"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.","status":"positive","asOf":"2026-09-07","links":[{"label":"ClinicalTrials.gov NCT00297895","url":"https://clinicaltrials.gov/study/NCT00297895"},{"label":"NEJM 2017","url":"https://www.nejm.org/doi/full/10.1056/NEJMoa1613210"}],"tags":[],"related":[],"cancers":["melanoma","stage-iii-melanoma"],"sections":[],"technologies":["sentinel-node","ultrasound"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":["mark-faries"],"bottlenecks":[],"keyPapers":["paper-mslt-ii-faries-nejm-2017"],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT00297895","phase":"3","setting":"Sentinel-node-positive melanoma: immediate completion lymph node dissection vs ultrasound surveillance","sponsor":"John Wayne Cancer Institute / NCI","result":"No melanoma-specific survival benefit; lymphoedema 24% vs 6%.","started":"2004-09-30","startedType":"actual","yearReported":2017,"enrolled":1939,"enrolledBasis":"registry","outcomes":[{"endpoint":"Melanoma-specific survival at 3 years","primary":true,"unit":"%","arms":[{"name":"Completion dissection","value":86},{"name":"Observation","value":86}],"source":"https://www.nejm.org/doi/full/10.1056/NEJMoa1613210"}],"replication":"DeCOG-SLT (Germany) reached the same conclusion."},"route":"/trials/mslt-ii/","neighbours":{"cancer":[{"id":"melanoma","kind":"cancer","name":"Melanoma","route":"/cancers/melanoma/"},{"id":"stage-iii-melanoma","kind":"cancer","name":"Stage III melanoma (after surgery)","route":"/cancers/stage-iii-melanoma/"}],"technology":[{"id":"sentinel-node","kind":"technology","name":"Sentinel lymph node biopsy","route":"/technologies/sentinel-node/"},{"id":"ultrasound","kind":"technology","name":"Ultrasound","route":"/technologies/ultrasound/"}],"person":[{"id":"mark-faries","kind":"person","name":"Mark B. Faries","route":"/people/mark-faries/"}],"paper":[{"id":"paper-mslt-ii-faries-nejm-2017","kind":"paper","name":"MSLT-II: completion lymph node dissection or observation for sentinel-node metastasis in melanoma","route":"/key-papers/paper-mslt-ii-faries-nejm-2017/"}],"bottleneck":[{"id":"b-metastasis-biology","kind":"bottleneck","name":"Metastasis is understood least and studied last","route":"/bottlenecks/b-metastasis-biology/"},{"id":"b-surgery-radiation-innovation","kind":"bottleneck","name":"Surgery and radiotherapy cure most, get least","route":"/bottlenecks/b-surgery-radiation-innovation/"}],"institution":[{"id":"sso","kind":"institution","name":"Society of Surgical Oncology","route":"/institutions/sso/"}],"roadmap":[{"id":"surgery-roadmap","kind":"roadmap","name":"Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work","route":"/roadmaps/surgery-roadmap/"}]}}