The Melanoma Letter Winter 2017, Vol. 35, No. 3

In this issue of The Melanoma Letter, Dr. Mark Faries, who participated in both Multicenter Selective Lymphadenectomy Trials and led MSLT-II, explores what those trials found, the latter published just this year. In a nutshell, while MSLT-I found that SLNB may indeed confer an overall survival advantage in a small subset of patients, MSLT-II’s “practice-changing” findings showed that immediately removing the rest of the nodes (CLND) after a positive SLNB confers no overall survival advantage compared with watching and waiting until the nodes become clinically detectable. Based on these findings, CLND after a positive SLNB could soon fade into memory, much like ELND and 5 cm margins. Meanwhile, Dr. Faries offers considerable food for thought about the significant benefits offered by SLNB and CLND other than overall survival — enough possibly to keep the controversies about these techniques alive a while longer.