Title: Completion Node Dissection for Sentinel Node-Positive Melanoma: Can a Systematic Review Bring One Discussion to a Close While Leaving the Broader Conversation Still Open?
Abstract: The Annals of Surgical Oncology usually does not commission an editorial focused on an educational review article.However, in this editorial, we have been asked to do just that.In this editorial, we explore beyond the clinical content of ''The Role of Completion Lymph Node Dissection (CLND) for Sentinel Lymph Node (SLN)-Positive Melanoma'' by Hieken and colleagues, and consider the process and methods used to perform this review. 1he initial results of two randomized phase 3 clinical trials designed to explore the role of CLND in patients with a tumor-involved SLN-the DeCOG-SLT 2 and the Multicenter Selective Lymphadenectomy II (MSLT-II) 3 -have inspired numerous commentaries, from the editorial published concomitantly with MSLT-II 4 to the recent editorial by Rand and Faries 5 in this journal.Importantly, our objective is not to debate further the role of CLND in SLNpositive melanoma, nor is it to delineate clinical guidelines.Rather, we aim to illuminate the potential advantages and limitations of a well-performed systematic review.Although it is appropriate to prioritize relevant and wellexecuted prospective, randomized clinical trials as key components of the evidence base, a well-conducted systematic review also may play a role in helping to digest, prioritize, and shape a better understanding of the broader spectrum of peer-reviewed evidence related to a specific clinical theme.