Randomized Controlled Trial of Selective Index Lymph Node Resection Versus Therapeutic Lymph Node Dissection After Neoadjuvant Immunotherapy for Stage IIIB-D Melanoma

Publication date: Jun 30, 2025

The goal of this clinical trial is to demonstrate that there is no difference (non-inferiorty) in the 2 year recurrence-free survival (RFS) between 2 different surgical approaches for clinical Stage III melanoma. Following 6 weeks of standard neaodjuvant immunotherapy, patients will undergo either selective index lymph node resection (ILN) (identified at baseline as the largest affected lymph node) or the standard of care therapeutic lymph node dissection (TLND). The secondary aims are to assess if patients who are managed without TLND will have a reduction in surgical complications (less wound problems & lymphoedema), an improved quality of life, at a lower healthcare utilisation.

Concepts Keywords
Australia Adverse events
Breastfeeding Healthcare economics
Cancer Neoadjuvant
Daily Non-inferiority
Randomized Quality of life
Randomised controlled trial
Surgical morbidity

Semantics

Type Source Name
disease MESH Melanoma
pathway KEGG Melanoma
disease MESH recurrence
disease MESH complications
disease MESH metastases
drug DRUGBANK Nivolumab
drug DRUGBANK Pembrolizumab
drug DRUGBANK Cemiplimab
drug DRUGBANK Ipilimumab
disease MESH contraindication
disease MESH malignancies
disease MESH Basal cell carcinoma
pathway KEGG Basal cell carcinoma
disease MESH Carcinoma in situ
disease MESH breast carcinoma
disease MESH cervical cancer
disease MESH Prostatic intraepithelial neoplasia
disease MESH hyperplasia
disease MESH autoimmune disease
drug DRUGBANK Prednisone
disease MESH pituitary insufficiency
disease MESH Hepatitis B
pathway KEGG Hepatitis B
drug DRUGBANK Hepatitis B Vaccine (Recombinant)
disease MESH infection
disease MESH Hepatitis C
pathway KEGG Hepatitis C
disease MESH morbidity

Original Article

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