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Table of Contents
LETTER TO EDITOR
Year : 2021  |  Volume : 4  |  Issue : 2  |  Page : 416-417

Authors' reply to Karmakar et al.


Tata Medical Center, Kolkata, West Bengal, India

Date of Submission20-May-2021
Date of Decision20-May-2021
Date of Acceptance21-May-2021
Date of Web Publication30-Jun-2021

Correspondence Address:
Sandip Ganguly
Department of Medical Oncology, Tata Medical Center, 14 Mar EW Arterial Road, Newtown, Kolkata - 700 160, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/crst.crst_114_21

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How to cite this article:
Ganguly S, Ghosh J, Biswas B. Authors' reply to Karmakar et al. Cancer Res Stat Treat 2021;4:416-7

How to cite this URL:
Ganguly S, Ghosh J, Biswas B. Authors' reply to Karmakar et al. Cancer Res Stat Treat [serial online] 2021 [cited 2021 Jul 24];4:416-7. Available from: https://www.crstonline.com/text.asp?2021/4/2/416/320301



We thank Karmakar et al.[1] for their interest in our article titled, “Non-small-cell lung cancer metastasis to unusual sites: A retrospective case series[2] and for raising meaningful queries. As rightly pointed out by Karmakar et al., in our study, we have reported the occurrence of metastases to unusual sites at baseline, whereas other studies have reported it to occur later during the disease course.[3] In our study, the skin and soft tissue were the most common unusual sites of metastases, and these included not only skin but also subcutaneous fat and visceral soft tissue. We disagree with Karmakar et al.'s statement that the skin lesions in our patients could have been other primary skin malignancies, as the observed lesions did not show the characteristic features of primary skin malignancies; moreover, the patients responded to lung cancer-directed therapies. Although biopsy is the gold standard for the confirmation of skin malignancies, skin metastases can be diagnosed in routine clinical practice based on the site and nature of the lesion and the temporal association between the onset of the disease and the skin lesion. In addition, treatment response can be used as a surrogate marker for the diagnosis of skin metastases.

We have reported the incidence of brain metastases to be only 12% in our study. This is the incidence of brain metastases only in those patients with lung cancer who had metastases to unusual sites and not in all patients with lung cancer. Further, we have mentioned that brain imaging was not routinely performed in all patients who had metastatic disease; brain imaging was reserved for those with neurological symptoms. With regard to Karmakar et al.'s comment about mentioning the extent of use of the various imaging modalities for the detection of metastases to unusual sites, we would like to clarify that this information has been described in the Materials and Methods section of the article.

We also disagree with their last comment about the need for histological confirmation, as it will lead to wastage of time and resources and cause a delay in treatment initiation. Thus, a detailed discussion with the radiologist holds the key to the detection of unusual sites of metastases and initiation of early treatment.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Karmakar S, Sharma P, Ameet H. Skin metastasis of lung Cancer: There's more to it than meets the eye. Cancer Res Stat Treat 2021;4:415-6.  Back to cited text no. 1
  [Full text]  
2.
Ganguly S, Ghosh J, Gehani A, Basu A, Chatterjee M, Dabkara D, et al. Non-small-cell lung cancer metastasis to unusual sites: A retrospective case series. Cancer Res Stat Treat. 2021;4:50-4.  Back to cited text no. 2
    
3.
Niu FY, Zhou Q, Yang JJ, Zhong WZ, Chen ZH, Deng W, et al. Distribution and prognosis of uncommon metastases from non-small cell lung cancer. BMC Cancer 2016;16:149.  Back to cited text no. 3
    




 

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