Authors’ Reply: Letter to the Editor Regarding “Yttrium-90 Radioembolization for Unresectable Combined Hepatocellular-Cholangiocarcinoma”

Authors’ Reply: Letter to the Editor Regarding “Yttrium-90 Radioembolization for Unresectable... Cardiovasc Intervent Radiol (2017) 40:1480 DOI 10.1007/s00270-017-1708-z LETTE R T O T HE EDI T OR Authors’ Reply: Letter to the Editor Regarding ‘‘Yttrium-90 Radioembolization for Unresectable Combined Hepatocellular- Cholangiocarcinoma’’ 1 1 David S. Wang Daniel Y. Sze Received: 18 May 2017 / Accepted: 19 May 2017 / Published online: 26 May 2017 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2017 We thank the authors for their thoughtful comments on our was achieved with radioembolization. Since there is no article ‘‘Yttrium-90 Radioembolization for Unre- known cure and no standard of care for unre- sectable Combined Hepatocellular-Cholangiocarcinoma’’ sectable cHCC-CC, it is likely that future research, even [1] and appreciate the opportunity to address their prospective work, will also be subject to these limitations. concerns. Lastly, we thank the authors for identifying the dis- We agree with the authors that other therapies received crepancy between Table 1 and Figure 2B. In our cohort, before and after radioembolization are a limitation of this three patients demonstrated macrovascular invasion. The study, as acknowledged and reviewed in the Discussion correct version of Figure 2B is updated in an erratum section of our paper. Moreover, many clinical studies, linked to the original article (doi:10.1007/s00270-017- including prospective randomized controlled trials, are 1701-6). subject to these confounders. Since there are no manage- Compliance with Ethical Standards ment guidelines for unresectable combined hepatocellular- cholangiocarcinoma (cHCC-CC), it is to be expected that Conflict of interest D. Sze is on the medical or scientific advisory cHCC-CC patients undergo a variety of therapies of boards for Boston Scientific, Inc., Koli Medical, Inc., RadiAction Medical, Inc.; is a consultant for Amgen, Inc., BTG International, unknown efficacy. We detailed all other therapies for each Inc., EmbolX, Inc., W.L. Gore & Associates, Inc., and Viralytics, individual patient to provide readers the context necessary Inc.; receives institutional research support from Merit Medical, Inc., to interpret the reported outcomes data. Furthermore, in our and W. L. Gore, Inc.; and owns equity interest in Confluent Medical, assessment of response to radioembolization, we mini- Inc., and Proteus Digital Health, Inc. mized the confounding effects of prior treatments, when applicable, by using the cross-sectional imaging study Reference which showed disease progression after prior treatments as the ‘‘baseline’’ imaging study. We also minimized the 1. Chan LS, Sze DY, Poultsides GA, Louie JD, Mohammed MAA, effects of subsequent treatments after radioembolization by Wang DS. Yttrium-90 radioembolization for unresectable com- reporting best hepatic imaging response, since patients who bined hepatocellular-cholangiocarcinoma. Cardiovasc Intervent underwent additional therapies mostly did so after disease Radiol. 2017. doi:10.1007/s00270-017-1648-7. progression occurred after stable disease or partial response & David S. Wang davidwang@stanford.edu Division of Interventional Radiology, Stanford University School of Medicine, 300 Pasteur Drive, H3630, Stanford, CA 94305-5642, USA http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png CardioVascular and Interventional Radiology Springer Journals

Authors’ Reply: Letter to the Editor Regarding “Yttrium-90 Radioembolization for Unresectable Combined Hepatocellular-Cholangiocarcinoma”

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Publisher
Springer Journals
Copyright
Copyright © 2017 by Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE)
Subject
Medicine & Public Health; Imaging / Radiology; Cardiology; Nuclear Medicine; Ultrasound
ISSN
0174-1551
eISSN
1432-086X
D.O.I.
10.1007/s00270-017-1708-z
Publisher site
See Article on Publisher Site

Abstract

Cardiovasc Intervent Radiol (2017) 40:1480 DOI 10.1007/s00270-017-1708-z LETTE R T O T HE EDI T OR Authors’ Reply: Letter to the Editor Regarding ‘‘Yttrium-90 Radioembolization for Unresectable Combined Hepatocellular- Cholangiocarcinoma’’ 1 1 David S. Wang Daniel Y. Sze Received: 18 May 2017 / Accepted: 19 May 2017 / Published online: 26 May 2017 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2017 We thank the authors for their thoughtful comments on our was achieved with radioembolization. Since there is no article ‘‘Yttrium-90 Radioembolization for Unre- known cure and no standard of care for unre- sectable Combined Hepatocellular-Cholangiocarcinoma’’ sectable cHCC-CC, it is likely that future research, even [1] and appreciate the opportunity to address their prospective work, will also be subject to these limitations. concerns. Lastly, we thank the authors for identifying the dis- We agree with the authors that other therapies received crepancy between Table 1 and Figure 2B. In our cohort, before and after radioembolization are a limitation of this three patients demonstrated macrovascular invasion. The study, as acknowledged and reviewed in the Discussion correct version of Figure 2B is updated in an erratum section of our paper. Moreover, many clinical studies, linked to the original article (doi:10.1007/s00270-017- including prospective randomized controlled trials, are 1701-6). subject to these confounders. Since there are no manage- Compliance with Ethical Standards ment guidelines for unresectable combined hepatocellular- cholangiocarcinoma (cHCC-CC), it is to be expected that Conflict of interest D. Sze is on the medical or scientific advisory cHCC-CC patients undergo a variety of therapies of boards for Boston Scientific, Inc., Koli Medical, Inc., RadiAction Medical, Inc.; is a consultant for Amgen, Inc., BTG International, unknown efficacy. We detailed all other therapies for each Inc., EmbolX, Inc., W.L. Gore & Associates, Inc., and Viralytics, individual patient to provide readers the context necessary Inc.; receives institutional research support from Merit Medical, Inc., to interpret the reported outcomes data. Furthermore, in our and W. L. Gore, Inc.; and owns equity interest in Confluent Medical, assessment of response to radioembolization, we mini- Inc., and Proteus Digital Health, Inc. mized the confounding effects of prior treatments, when applicable, by using the cross-sectional imaging study Reference which showed disease progression after prior treatments as the ‘‘baseline’’ imaging study. We also minimized the 1. Chan LS, Sze DY, Poultsides GA, Louie JD, Mohammed MAA, effects of subsequent treatments after radioembolization by Wang DS. Yttrium-90 radioembolization for unresectable com- reporting best hepatic imaging response, since patients who bined hepatocellular-cholangiocarcinoma. Cardiovasc Intervent underwent additional therapies mostly did so after disease Radiol. 2017. doi:10.1007/s00270-017-1648-7. progression occurred after stable disease or partial response & David S. Wang davidwang@stanford.edu Division of Interventional Radiology, Stanford University School of Medicine, 300 Pasteur Drive, H3630, Stanford, CA 94305-5642, USA

Journal

CardioVascular and Interventional RadiologySpringer Journals

Published: May 26, 2017

References

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