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Showed that removing all the remaining lymph nodes after a positive sentinel node does not help patients live longer, ending a routine operation.
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.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
1,939 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Melanoma-specific survival at 3 yearsprimary | Completion dissection | - | 86% | - | - | link |
| Observation | - | 86% |
Shares Society of Surgical Oncology, Sentinel lymph node biopsy.
Shares Society of Surgical Oncology, Melanoma.
Shares Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work, Surgery and radiotherapy cure most, get least.
Shares Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work, Sentinel lymph node biopsy.
Shares Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work, Sentinel lymph node biopsy, Surgery and radiotherapy cure most, get least.
Shares Stage III melanoma (after surgery), Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work, Melanoma.
Shares Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work, Sentinel lymph node biopsy.
Shares Sentinel lymph node biopsy, Melanoma.