8005 Introduction: The SN procedure has become a widely used staging procedure for stage I/II melanoma patients. We previously reported on the high SN+ identification rate with the use of the EORTC MG group pathology protocol (van Akkooi et al., Eur J Cancer: 2006, in press). Because only approximately 20% of SN positive patients have additional non-SN lymph node involvement in the cLND specimen, we have proposed to identify a SN+ patient group, which can be spared a cLND. Therefore further microanatomic analyses of the metastatic SNs has been performed to identify patient/tumor or SN factors which predict DFS and OS as well as additional non-SN nodal positivity. Methods: 262 stage I/II pts were included into the SN database between 10/97 and 5/04. 77 were SN+ (29%). 74 pts had SN material for re-evaluation in this study. Microanatomic analysis categorized a.o. the location of tumor cells; subcapsular, parenchymal (or combined), multifocal or extensive; the Starz classification and the measurement of the amount of tumor load (in mm). Tumor load was quantified by size: <0.1mm (single melanoma cells), 0.1 - 1.0mm, >1.0mm. DFS, OS and additional non-SN positivity was calculated for all the microanatomic analyses. Results: Mean/Median Breslow was 3.5/3.0 (0.8 - 12.0) mm, mean/median FU was 35/30 (6 - 81) months. There were no signif. differences in OS or additional non-SN positivity for the different loc. of involvement. The estimated 5yr OS rates were 100%, 63% and 35% for the different groups of tumor load, <0.1mm, 0.1 - 1.0mm, >1.0mm respectively (Figure)(P=0.03). There were no patients with add. non-SN positivity in the group with involvement <0.1mm. On multivariate analysis the tumor load was the most important prognostic factor for DFS (P=0.005) and OS (P=0.03). DFS, OS and add. non-SN positivity of all other analyses will be presented at the meeting. Conclusions: It is questionable whether SN with onlysingle cells involvement (<0.1mm) should be considered positive. Dist. mets are exceedingly rare (1/16 = 6.3%) and was identical to the SN- patient pop., and non-sentinel node involvement was not observed at all. These patients should probably not undergo add. LND and may not be considered stage III patients. No significant financial relationships to disclose.