We read with interest the commentary made by Dr Badruddoja.
We humbly think that the title does reflect the contents of the article, including the search for factors predictive of the pattern of failure.
It seems that Dr Badruddoja was eager to present his personal view that elective lymph basin dissection causes immunological and other shortcomings. Thus, in his opinion, it is responsible for higher rate of systemic failures. While this may or may not be correct, this was not a part of our study, so we cannot comment on it.
Gutman H, Schachter J, Nathansohn N. Patterns of Recurrence in Patients With Melanoma After Radical Lymph Node Dissection—Reply. Arch Surg. 2006;141(11):1145-1146. doi:10.1001/archsurg.141.11.1145-b