Question: Does elective lymph node dissection (ELND) decrease overall mortality in patients with melanoma and no clinically detectable regional metastases?

Data Sources: MEDLINE (1966-February 2001) and EMBASE (1974-February 2001) using the recommended Cochrane Collaboration search strategy with the MeSH (medical subject headings) terms "melanoma" and "elective lymph node." Data were also gathered from selected conference proceedings, the Controlled Trials Register from the Cochrane Library (issue 4, 2000), and unpublished data from contacted authors.

Study Selection: Randomized controlled trials comparing ELND with delayed lymphadenectomy at the time of clinical recurrence. Patients had to have histologically diagnosed skin melanoma without clinically detectable regional lymph node metastases.