Comment

As noted by the authors of this retrospective comparative study of radiotherapy and cryotherapy, the conclusions must be considered in light of the non-comparability of the groups. This study was retrospective, and shows a selection bias inasmuch as the severity and extent of a lesion often determines its initial therapy. A higher proportion of broad and thick lesions were thus treated in the radiotherapy group. Considering the radiotherapy group alone, however, may be informative in that poor healing was significantly related to age >90 years, a field irradiation diameter >4 cm, and a radiotherapy dose >3000 cGy. In view of their risk for poor healing, the authors suggested that patients meeting these criteria require cautious consideration in determining their candidacy for radiotherapy.

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