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Outcome of localised blastemal-type Wilms tumour patients treated according to intensified treatment in the SIOP WT 2001 protocol, a report of the SIOP Renal Tumour Study Group (SIOP-RTSG)
European Journal of Cancer (2015) 51, 993– 994
Available at www.sciencedirect.com
ScienceDirect journal homepage: www.ejcancer.com
Letter to the Editor
Outcome of localised blastemal-type Wilms tumour patients treated according to intensified treatment in the SIOP WT 2001 protocol, a report of the SIOP Renal Tumour Study Group (SIOP-RTSG) Daniel M. Green ⇑ Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN, United Sates Received 27 January 2015; accepted 5 March 2015 Available online 26 March 2015
To the editor: Van den Heuvel-Eibrink and colleagues report that intensified therapy improved the outcome of patients treated on the SIOP WT 2001 compared to historical patients treated on SIOP 93-01 [1]. The authors acknowledge the difficulty encountered in identifying blastemal type histology in nephrectomy specimens obtained after pre-nephrectomy chemotherapy but provide no data regarding intra- or inter-rater reliability for making this diagnosis. Graphs of event-free survival are provided in Fig. 1 for those with stage I disease (panel C) and for stages II and III disease combined (panel E). However the graphs representing the SIOP WT 2001 patients include more than those who received the modified (intensified) therapy prescribed in SIOP WT 2001. For example, panel C indicates that 69 SIOP WT 2001 stage I blastemal type histology patients were treated with the combination of actinomcyin D, vincristine and doxorubicin (AVD). Examination of q
DOI of original article: 10.1016/j.ejca.2014.12.011.
⇑ Address: Department of Epidemiology and Cancer Control, St.
Jude Children’s Research Hospital, 262 Danny Thomas Way, Mail Stop 735, Memphis, TN 38105-2794, United Sates. Tel.: +1 901 595 5915; fax: +1 901 595 5785. E-mail address: [email protected] http://dx.doi.org/10.1016/j.ejca.2015.03.005 0959-8049/Ó 2015 Elsevier Ltd. All rights reserved.
Table 4 indicates that only 58 such patients were treated with AVD. Similarly panel E indicates that 122 SIOP WT 2001 stage II and III blastemal type histology patients were treated with the high risk regimen which consisted of cyclophosphamide, carboplatinum, VP-16 and doxorubicin (CCED). However review of Table 4 indicates that that only 104 such patients were treated with this regimen. In the absence of analyses indicating that those stage I blastemal type histology patients treated with AVD on SIOP WT 2001 had event-free survival statistically superior to that of stage I blastemal type histology patients treated with vincristine and actionmycin D on SIOP 93-01, and that those with stage II and III blastemal type histology treated with CCED on SIOP WT 2001 has event-free survival superior to that of stage II and III blastemal type histology patients treated with AVD on SIOP 93-01, the conclusion that intensified therapy has improved the outcome for patients with blastemal type histology must be considered tentative. Additional data regarding the consistency of the diagnosis of blastemal type histology after serial, blinded review by the same pathologists and across national groups will be helpful.
994
D.M. Green / European Journal of Cancer 51 (2015) 993–994
Dr. Green has no potential conflicts of interest, including specific financial interests, relationships or affiliations relevant to the subject of this manuscript. Conflict of interest statement None declared.
Reference [1] van den Heuvel-Eibrink MM, van Tinteren H, Bergeron C, et al. Outcome of localised blastemal-type Wilms tumour patients treated according to intensified treatment in the SIOP WT, Protocol, a report of the SIOP Renal Tumour Study Group (SIOP-RTSG). Eur J Cancer 2001. http://dx.doi.org/10.1016/ j.ejca.2014.12.011, Published online: January 13, 2015.
Available at www.sciencedirect.com
ScienceDirect journal homepage: www.ejcancer.com
Letter to the Editor
Outcome of localised blastemal-type Wilms tumour patients treated according to intensified treatment in the SIOP WT 2001 protocol, a report of the SIOP Renal Tumour Study Group (SIOP-RTSG) Daniel M. Green ⇑ Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN, United Sates Received 27 January 2015; accepted 5 March 2015 Available online 26 March 2015
To the editor: Van den Heuvel-Eibrink and colleagues report that intensified therapy improved the outcome of patients treated on the SIOP WT 2001 compared to historical patients treated on SIOP 93-01 [1]. The authors acknowledge the difficulty encountered in identifying blastemal type histology in nephrectomy specimens obtained after pre-nephrectomy chemotherapy but provide no data regarding intra- or inter-rater reliability for making this diagnosis. Graphs of event-free survival are provided in Fig. 1 for those with stage I disease (panel C) and for stages II and III disease combined (panel E). However the graphs representing the SIOP WT 2001 patients include more than those who received the modified (intensified) therapy prescribed in SIOP WT 2001. For example, panel C indicates that 69 SIOP WT 2001 stage I blastemal type histology patients were treated with the combination of actinomcyin D, vincristine and doxorubicin (AVD). Examination of q
DOI of original article: 10.1016/j.ejca.2014.12.011.
⇑ Address: Department of Epidemiology and Cancer Control, St.
Jude Children’s Research Hospital, 262 Danny Thomas Way, Mail Stop 735, Memphis, TN 38105-2794, United Sates. Tel.: +1 901 595 5915; fax: +1 901 595 5785. E-mail address: [email protected] http://dx.doi.org/10.1016/j.ejca.2015.03.005 0959-8049/Ó 2015 Elsevier Ltd. All rights reserved.
Table 4 indicates that only 58 such patients were treated with AVD. Similarly panel E indicates that 122 SIOP WT 2001 stage II and III blastemal type histology patients were treated with the high risk regimen which consisted of cyclophosphamide, carboplatinum, VP-16 and doxorubicin (CCED). However review of Table 4 indicates that that only 104 such patients were treated with this regimen. In the absence of analyses indicating that those stage I blastemal type histology patients treated with AVD on SIOP WT 2001 had event-free survival statistically superior to that of stage I blastemal type histology patients treated with vincristine and actionmycin D on SIOP 93-01, and that those with stage II and III blastemal type histology treated with CCED on SIOP WT 2001 has event-free survival superior to that of stage II and III blastemal type histology patients treated with AVD on SIOP 93-01, the conclusion that intensified therapy has improved the outcome for patients with blastemal type histology must be considered tentative. Additional data regarding the consistency of the diagnosis of blastemal type histology after serial, blinded review by the same pathologists and across national groups will be helpful.
994
D.M. Green / European Journal of Cancer 51 (2015) 993–994
Dr. Green has no potential conflicts of interest, including specific financial interests, relationships or affiliations relevant to the subject of this manuscript. Conflict of interest statement None declared.
Reference [1] van den Heuvel-Eibrink MM, van Tinteren H, Bergeron C, et al. Outcome of localised blastemal-type Wilms tumour patients treated according to intensified treatment in the SIOP WT, Protocol, a report of the SIOP Renal Tumour Study Group (SIOP-RTSG). Eur J Cancer 2001. http://dx.doi.org/10.1016/ j.ejca.2014.12.011, Published online: January 13, 2015.