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On multivariable analysis, lymphovascular invasion (LVI) of the primary tumor, two or more involved nodes, and 1mm nodal deposit were independently associated with higher rates of nodal relapse. Nodal recurrence is a primary driver of early disease relapse for patients with SLN-positive melanoma who do not undergo CLND in the era of effective adjuvant systemic therapy. LVI, ≥ 2 nodes, or 1mm nodal disease identifies patients at particularly high risk of nodal relapse. 1 mm nodal disease identifies patients at particularly high