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Letters to the Editor
February 15, 2010

Impact of Margin Status on Laser Surgery for Early Glottic Cancer—Reply

Arch Otolaryngol Head Neck Surg. 2010;136(2):209-210. doi:10.1001/archoto.2009.222

In reply

We thank Wang for his interest in our article. The “anomalies” he points out are attributable to the fact that 30 (10.9%) patients were not treated as per protocol. This unfortunately is a fact of life. As stated in the article, we included all patients in the multivariate analysis, erecting a complex “margin variable” defined by 3 characteristics: margin status, whether second surgery was performed, and whether RT was administered. This approach was adopted to enable inclusion of all recruited patients. Wang refers to the “confusing” fact that the 33 patients with close or positive margins, no radicalization, but given RT also included 5 patients with negative margins. These 5 patients were in fact protocol violators and were overtreated.

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