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I am glad that my editorial elicited such a passionate response from Cochran and Thompson. Education is achieved only through an exchange of ideas.
We always advise our dermatology residents and medical students to use a newly proposed therapy quickly before its efficacy is disproved by prospective trials! Such was the case with elective lymph node dissections for patients with melanoma a few decades ago, until prospective trials failed to confirm the expected therapeutic benefit of these procedures. Such is also the case with the therapeutic role of SNB procedures for melanoma today. The recent MSLT-1 Trial1 finally has given us evidence that the procedure does not improve overall survival for patients who undergo the procedure compared with patients who do not undergo the procedure.
Kanzler MH. Lymphatic Mapping and Sentinel Node Biopsy: The Data Unclouded by Speculation—Reply. Arch Dermatol. 2008;144(5):688-689. doi: