The authors would like to thank Dr. Sarrah Idrees and Dr. Sabaretnam Mayilvaganan for their kind interests to our article and responding with this letter.

  1. 1.

    In our study, we reanalyzed the relationship between gender-specific multifocality and central compartment lymph-node (CCLN) metastasis. We found that central compartment lymph-node metastasis was more common in female gender-specific multifocality than male gender, but no statistically significant difference was found.

  2. 2.

    On this important question, the pathology reports were re-examined. Aggressive subtype rates of PTC cases: Diffuse sclerosing variant was found in 5.4%, tall cell variant in 7.3%, and solid variants in 2.3%. Statistical analysis to associate these aggressive subtypes of papillary thyroid cancer with multifocality and central lymph-node metastasis did not find a significant association.

  3. 3.

    Eighteen of 52 patients with Papillary Thyroid Microcarcinoma (PTMC) underwent prophylactic CCLN dissection, and the proportion of PTMC patients with CCLN metastases was 25%.