We read “Outcomes of event-free survival in patients with Wilms tumor undergoing preoperative
chemotherapy. Analysis of lymph-node yield in a single-center cohort” by Flores et al.
[
[1]
] The article piqued our interest, as studies observing the lymph node yield and its
correlation with event free survival (EFS) in Wilms tumor patients from a center that
follows (SIOP) protocols has been reported infrequently. Perhaps this is the only
published study to observe outcomes with respect to lymph node involvement, after
Jereb et al. [
- Flores P.
- Cadario M.
- Strambach J.
- Sanjuanelo M.
- Saleme J.M.
- Paz E.
- et al.
Outcomes of event-free survival in patients with Wilms tumor undergoing preoperative
chemotherapy. Analysis of lymph-node yield in a single-center cohort.
J Pediatr Urol. 2020. [internet]Available from:; https://doi.org/10.1016/j.jpurol.2020.11.027
[2]
] Most of the studies reported were from the centres that followed NWTS/COG protocols,
which described Lymph Node Yield (LNY) in a setting of up front surgery [
3
,
4
,
5
,
6
].To read this article in full you will need to make a payment
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References
- Outcomes of event-free survival in patients with Wilms tumor undergoing preoperative chemotherapy. Analysis of lymph-node yield in a single-center cohort.J Pediatr Urol. 2020. [internet]Available from:; https://doi.org/10.1016/j.jpurol.2020.11.027
- Lymph node invasion and prognosis in nephroblastoma.Cancer. 1980 Apr; 45: 1632-1636
- Lymph node involvement in wilms tumor: results from national wilms tumor studies 4 and 5.J Pediatr Surg. 2012; 47: 700-706
- How many lymph nodes are enough? Assessing the adequacy of lymph node yield for staging in favorable histology wilms tumor.J Pediatr Surg. 2019 Nov; 54: 2331-2335
- Nodal evaluation in wilms' tumors: analysis of the national cancer data base.Ann Surg. 2010 Mar; 251: 559-565
- Patterns of lymph node sampling and the impact of lymph node density in favorable histology Wilms tumor: an analysis of the national cancer database.2017https://doi.org/10.1016/j.jpurol.2017.09.025 (Available from:)
- Position paper: rationale for the treatment of wilms tumour in the UMBRELLA SIOP-RTSG 2016 protocol.Nat Rev Urol. 2017; 14: 743-752
- Surgery-related factors and local recurrence of wilms tumor in national wilms tumor study 4.Ann Surg. 1999; 229 (Report No.: 2): 292-297
- Preoperative chemotherapy and local stage III in nephroblastoma.Transl Pediatr. 2014; 3: 4-11
- Is the number of lymph nodes (ln) sampled at wilmstumour (wt) nephrectomy predictive for detection of the regional extention of the disease.in: International society of paediatric oncology, SIOP XXXVI congress meeting oslo, Norway. 16–19 September 2004
- Patient selection and technical aspects for laparoscopic nephrectomy in Wilms tumor.Surg Oncol. 2019 Jun; 29: 14-19
Article info
Publication history
Published online: January 24, 2021
Accepted:
December 15,
2020
Received:
December 12,
2020
Identification
Copyright
© 2021 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
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Access this article on ScienceDirectLinked Article
- Outcomes of event-free survival in patients with Wilms tumor undergoing preoperative chemotherapy. Analysis of lymph-node yield in a single-center cohortJournal of Pediatric UrologyVol. 17Issue 2
- PreviewThe clinical value of lymph node sampling in Wilms tumor (WT) lies in its ability to accurately determine lymph node (LN) involvement. LN yield (LNY) is used as a valuable tool to measure LN retrieval, and a minimum of 6 LNs is one of the current recommendations. In patients who are managed with the SIOP strategy, preoperative chemotherapy decreases the retrieval of LN during surgery resulting in lower LNY values.
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- Response to letter to the Editor re 'Outcomes of event-free survival in patients with Wilms tumor undergoing preoperative chemotherapy. Analysis of lymph-node yield in a single-center cohort'Journal of Pediatric UrologyVol. 17Issue 2
- PreviewWe would like to thank you for your interest in our study. This article showed that patients treated according to the SIOP protocol with a lower LNY than suggested presented with acceptable survival outcomes and recurrence rates. As mentioned in the manuscript, we agree that our study has several limitations. First, as it was a single-center study, the conclusions were drawn based on the assessments of one group of surgeons. Second, due to the small size of the cohort no statistical results could be obtained when analyzing outcomes comparing the different histological subtypes, which would have been very useful.
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