A researcher at the MRA conference again confirmed that a full node dissection is most likely overkill. Often she feels that the melanoma cells have already escaped. Quality of life is a huge concern with a full node dissection whereas some folks may have to live a very limited life due to lymphedema and mobility issues. So it appears to me that adjuvant therapy may play a bigger role. We now have the PD1 drug opdivo and soon will have Keytruda approved for stage 3A and up. That may create a bigger quality of life issue deciding who should watch and wait and others who may experience serious side effects.