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Correspondence |

Sentinel Node Biopsy: Facts to Clear the Alleged Clouds—Reply

Urbà González, MD, PhD
Arch Dermatol. 2008;144(5):687. doi:10.1001/archderm.144.5.687-a.
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I would like to thank the authors for replying to my critical appraisal1 of their article on the relevant lymphadenectomy trial.2 Their contribution will help to disseminate the important idea that SNB in melanoma is widely accepted as standard care despite the present lively debate on its utility for patients.

Despite the authors' attempted disqualification of my commentary, it is very easy to determine that their article is a paradigm of reporting results selectively. The authors do not mention the primary outcome in the abstract conclusions, and they do not emphasize it in any part of the article. In addition, the lack of enough and consistent supporting evidence that lymphadenectomy after SNB has a positive impact on survival (compared with lymphadenectomy of clinical nodal metastases) is also obscured when the authors overstate the importance of the potentially very misleading subgroup analysis. All of these facts have also been pointed out very clearly in other excellent critical comments by other colleagues from dermatology3 and surgery.4,5

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