{"entity":{"id":"paper-mslt-ii-faries-nejm-2017","kind":"paper","name":"MSLT-II: completion lymph node dissection or observation for sentinel-node metastasis in melanoma","aka":[],"tldr":"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.","summary":"Phase 3 trial of 1,939 patients with sentinel node-positive melanoma randomised to immediate completion lymph node dissection or nodal observation with ultrasound.\n\nThree-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.","asOf":"2026-09-17","links":[{"label":"N Engl J Med 2017","url":"https://doi.org/10.1056/NEJMoa1613210"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/28591523/"}],"tags":[],"related":[],"cancers":["stage-iii-melanoma"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["mslt-ii"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["nejm"],"dependsOn":[],"notes":[],"journal":"New England Journal of Medicine","year":2017,"doi":"10.1056/NEJMoa1613210","pmid":"28591523","authors":"Faries MB, Thompson JF, Cochran AJ, et al.","paperType":"rct","findings":["Three-year melanoma-specific survival 86 percent in both groups.","Lymphoedema 24.1 percent vs 6.3 percent."],"whatItMeans":"Patients with a positive sentinel node are now managed with surveillance and adjuvant systemic therapy rather than completion dissection.","caveats":["Most patients had low-volume sentinel node disease; the trial was not powered for those with high nodal burden."],"changedPractice":true,"participants":1939},"route":"/key-papers/paper-mslt-ii-faries-nejm-2017/","neighbours":{"cancer":[{"id":"stage-iii-melanoma","kind":"cancer","name":"Stage III melanoma (after surgery)","route":"/cancers/stage-iii-melanoma/"}],"trial":[{"id":"mslt-ii","kind":"trial","name":"MSLT-II","route":"/trials/mslt-ii/"}],"journal":[{"id":"nejm","kind":"journal","name":"New England Journal of Medicine","route":"/journals/nejm/"}]}}