Omitting Therapeutic Lymph Node Dissection in Patients With Melanoma (Stage 3) and Major Pathological Response in the Index Lymph Node

Inclusion Criteria

• •Patients must be eligible for neoadjuvant treatment (ipilimumab and nivolumab)
• •Patients must be 16 years of age or older.
• •Patients must have a histologically confirmed diagnosis of macroscopic resectable stage III melanoma (stage III B/C/D) with one or more macroscopic lymph node metastase defined as either one:
• •a palpable node, confirmed as melanoma by pathology; a non-palpable but enlarged lymph node according to RECISTv1.1 (at least 15 mm in short axis), confirmed as melanoma by pathology;
• •a PET scan positive lymph node of any size confirmed as melanoma by pathology;
• •The patient must have a measurable tumor burden that qualifies (according to clinical practice) for neoadjuvant therapy with immune checkpoint inhibitors
• •Patients in whom ILN marking is feasible
• •Written informed consent