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Removing all the remaining lymph nodes after a positive sentinel node did not improve melanoma survival compared with ultrasound surveillance and caused far more lymphoedema, ending routine completion dissection.
Phase 3 trial of 1,939 patients with sentinel node-positive melanoma randomised to immediate completion lymph node dissection or nodal observation with ultrasound.
Three-year melanoma-specific survival was 86 percent in both groups; dissection improved regional disease control and gave prognostic information but caused lymphoedema in 24 versus 6 percent.
Patients with a positive sentinel node are now managed with surveillance and adjuvant systemic therapy rather than completion dissection.
Shares Stage III melanoma (after surgery), New England Journal of Medicine.
Shares Stage III melanoma (after surgery), New England Journal of Medicine.
Shares Stage III melanoma (after surgery), New England Journal of Medicine.
Shares Stage III melanoma (after surgery), New England Journal of Medicine.