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Leong et al,¹ in their article "Discordancy Between Clinical Predictions vs Lymphoscintigraphic and Intraoperative Mapping of Sentinel Lymph Node Drainage of Primary Melanoma" recently published in the ARCHIVES, make several conclusive statements that are in no way supported by their article. Since these statements could result in harm to patients, I think it is very important that my concerns be aired.

The authors convincingly show that the drainage of the lymphatics is capricious and does not follow clinically predicted behavior. They go on, however, to state that based on this finding, wide local excision of malignant melanomas should be reserved until sentinel node harvesting is completed. There is no scientific basis for this statement in their article or in the literature at large.

The authors did not study lymphatic drainage before and after wide local excision of melanoma. No one else has either; this is a study that has yet . . . [Full Text of this Article]

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