WEDNESDAY, Nov. 5, 2025 (HealthDay News) -- For patients with melanoma with two or more positive sentinel lymph nodes (SLNs), utilization of completion lymph node dissection (CLND) declined from 2012 to 2021, according to a study published online Nov. 1 in the Annals of Surgical Oncology.

Tyler P. Robinson, M.D., from the Indiana University School of Medicine in Indianapolis, and colleagues examined national trends of CLND use in patients with stage I to III melanoma with two or more positive SLNs. Of the 151,442 patients who underwent SLN biopsy, 5,440 (3.6 percent) had two or more positive SLNs.

The researchers found that in patients with two or more positive SLNs, CLND decreased from 73 percent in 2012 to 14 percent in 2021, while there was an increase seen in immunotherapy utilization, from 38 to 76 percent. The likelihood of undergoing CLND was increased for patients with two or more SLNs if they had melanoma in the head/neck region or ulcerated lesions (odds ratios [95 percent confidence intervals], 2.02 [1.39 to 2.95] and 1.42 [1.11 to 1.83], respectively). No difference was seen in three-year overall survival for those with two or more positive SLNs undergoing observation versus CLND (70.5 versus 70.8 percent; hazard ratio 1.03; 95 percent confidence interval, 0.77 to 1.37).

"The results of this study showing that overall survival between observation and CLND for patients with melanoma with two or more positive SLNs was not significantly different provides reassurance that the decision to observe the nodal basin, with adjuvant therapy, may lead to acceptable overall survival," the authors write.

One author disclosed ties to the biopharmaceutical industry.

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