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June 9, 2017. The MSLT-II trial published this week in NEJM shows that completion dissection after positive sentinel biopsy in melanoma does not improve survival despite a big improvement in nodal control (92% vs 77%). This adds credence to last year's under-powered German trial to hopefully cap the long-held debate over the therapeutic benefit of more extensive lymph node dissections in melanoma. It likely comes down to the fact that nodal metastases are so strongly related to distant metastases that a completion dissection just isn't enough to change the disease course.