Reply to comment on: The diagnostic accuracy and clinical utility of pediatric renal tumor biopsy: Report of the UK experience in the SIOP UK WT2001 trial

How we approach paediatric renal tumour core needle biopsy in the setting of preoperative chemotherapy: A Review from the SIOP Renal Tumour Study Group

“…However, the size of WT at presentation is dependent on the healthcare setting 24 ; therefore, caution should be used when interpreting data from individual countries or centres. Analysis of a single‐centre series suggested a volume cutoff of 70 ml as having good discriminatory value to identify RCC 25 . Unpublished data from a much larger GPOH series with more cases of RCC suggest that overall a tumour volume under 61 ml has a 90% sensitivity for RCC but 51% specificity, but in children above 7 years, an 80 ml cutoff is associated with a 90% sensitivity and a 61% specificity and no child between 7 and 10 years of age had an RCC >200 ml (N. Graf unpublished data).…”

Renal cell carcinoma in children and adolescents: a retrospective study of a French–Italian series of 93 cases

“…4 Because RCC incidence increases with advancing patient age in respect to WT, in general a needle core biopsy is strongly recommended in children above 10 years of age prior to any medical treatment. [27][28][29][30] Accurate tumour classification is required to avoid unnecessary pre-operative chemotherapy and possibly perform nephron-sparing surgery in smaller RCCs, which has been shown to have a good outcome in small paediatric series. 31,32 Accurate diagnosis may also allow the inclusion of patients in trials addressing the role of targeted therapies in patients with metastatic or unresectable disease.…”