Dear Editor
We are deeply grateful to Dr. Ilker Sengul and Dr. Demet Sengul for their careful consideration of our article.(1) We feel honored by their interest in our work, particularly given their recognized expertise in this field. Below we present our considerations regarding the comments they kindly provided.
Indeed, the use of total tumor diameter (TTD) as a potential marker of tumor behavior in multifocal papillary thyroid microcarcinoma (PTMC) has been a subject of ongoing debate in the literature. Studies using different methodologies and patient populations have reported variable findings regarding its prognostic significance.(2,3)
In our aforementioned study there was no association between TTD—or other parameters considered markers of tumor behavior—and the proposed outcomes.(1) Several factors may account for this, including the rigorous selection of our sample in accordance with the inclusion criteria, as well as certain methodological limitations which are discussed in a specific paragraph of the original article.(1) Therefore, we agree that studies with more robust designs and larger sample sizes are needed to further investigate this issue, and to more precisely define the role of TTD in the management of multifocal PTMC. We also agree that the observed association between the number of metastatic lymph nodes and greater initial aggressiveness is very interesting.(1) Because this parameter has previously been associated with recurrence-free survival in PTMC,(4) its use in the risk assessment of relevant cases should indeed be considered.
We would like to conclude by once again thanking Dr. Ilker Sengul and Dr. Demet Sengul for their constructive comments, which have contributed to advancing discussion on this important topic.
DATA AVAILABILITY
After publication, data will be available from the authors upon request—this condition is justified in the manuscript.
REFERENCES
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Data Availability Statement
After publication, data will be available from the authors upon request—this condition is justified in the manuscript.