Correspondence Exchange on Vyas et al 2025
Two published letters responding to Vyas et al 2025 - ICG-only SLNB in Head and Neck Melanoma. Stats cited in the response letter were checked against the primary paper — all confirmed accurate (see Fact-Check Log); note that “29 patients” refers specifically to the pre-planned ICG-only group (31 total including radiocolloid-failure cases).
Response letter
🔗 https://doi.org/10.1016/j.bjps.2025.07.017
Dear Editor,
We commend Vyas et al. for their timely and methodologically robust study… The study’s most compelling strength is its demonstration of 100% intraoperative nodal detection and metastasis identification using ICG across 29 patients, even in anatomically complex regions like the periparotid and supraclavicular basins… radiocolloid lymphoscintigraphy and blue dye yielded lower detection rates (85% and 80%, respectively)… The 7.1% rate of metastasis in nodes undetected by SPECT-CT in this study highlights the importance of validating ICG’s sensitivity through recurrence-based follow-up studies.
Author reply
🔗 https://doi.org/10.1016/j.bjps.2025.08.008
Dear Editor,
We would like to express our sincere appreciation to the authors of the letter… We are actively undertaking a longitudinal follow-up study to determine nodal recurrence rates… We have initiated both simulation-based training using cadaveric models and a visiting surgeon programme… We are currently conducting ongoing studies to assess the feasibility of ICG-alone SLNB in [trunk and limb] regions.
My take
Useful for the Discussion: shows the field is actively debating exactly the two limitations this case report can speak to — recurrence-based validation and generalisability beyond head/neck to truncal melanoma.