The progress and innovation in research lie in peer scrutiny and we welcome the opportunity to explain further the reasoning in our study design and analysis [1]. We thank the authors for their insight and recommendations. Prospective randomized trials are unwarranted, considering that complete excision is the established treatment modality. Prospective studies with observational design are, however, lacking but may be unfeasible with rare diseases [2]. Therefore, this brings up the need for a validated and prospectively maintained database or registry for lipoblastoma (LB) and lipoblastomatosis (LBM). The search strategies were developed with the support of an academic medical librarian with experience at the National Library of Medicine. Thank you for pointing out that the search strategies missed the two terms “lipoblastomatoses” and “infantile lipoma” in the Supplementary file. These two terms do not affect the final number of eligible studies in the original article. As seen in the published supplementary file, our EMBASE search strategy included the truncated term “lipoblastom*”, which covers the term “lipoblastomatoses” and thus was not included. Searching the term in EMBASE also yielded zero articles (similarly with PubMed). A search of “infantile lipoma” in PubMed on March 23rd 2020, yielded only five articles (EMBASE identified four of these articles). The five articles (consisting mainly of review articles and case reports) did not meet our eligibility criteria, and most were found in the original searches. A search in the MeSH database found no additional terms under the MeSH tree for lipoblastoma. However, we greatly apologize for the oversight in the text, and the term “infantile lipoma” is supposed to be “fetal lipoma” in the text, as correctly shown in the Supplementary file. A corrigendum request has been submitted. Regarding the data extraction, we strived to ensure that each study was reviewed with double checks in our original process. Multiple data claims highlighted in their letter were inconsistent or incorrectly reported from the original paper and included original texts. For Cappellesso et al. [3], the numbers of 3/3 (and thus 0/27 as the original sample size with follow-up is 30) can be found in the Table and the discussion of the article (page 67), which indicates that all 3 recurrent cases had incomplete excision. In Chung & Enzinger [4], the total number of recurrence was 5 according to Table 3 and page 487 of the study (not 31 recurrences as the authors incorrectly stated in their letter) and recorded as such in Table 3 of our study. The number of patients with followup was 25 as seen on page 487 and in Table 3 of the original text (this was not recorded as the number of recurrences as incorrectly stated in their letter) [4]. For Coffin et al. [5], the histology types are noted on page 1706. Follow-up data This reply refers to the comment available online at https ://doi. org/10.1007/s0038 3-020-04663 -7.

中文翻译：

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回复给编辑的信

研究的进步和创新在于同行审查，我们欢迎有机会进一步解释我们研究设计和分析中的推理[1]。我们感谢作者的洞察力和建议。考虑到完全切除是既定的治疗方式，前瞻性随机试验是没有根据的。然而，缺乏观察性设计的前瞻性研究，但可能对罕见疾病不可行[2]。因此，这就需要一个经过验证和前瞻性维护的脂肪母细胞瘤 (LB) 和脂肪母细胞瘤病 (LBM) 数据库或注册表。搜索策略是在一位在国家医学图书馆有经验的学术医学图书馆员的支持下制定的。感谢您指出搜索策略遗漏了补充文件中的“脂肪母细胞瘤病”和“婴儿脂肪瘤”两个术语。这两个术语不影响原始文章中符合条件的研究的最终数量。如已发布的补充文件所示，我们的 EMBASE 搜索策略包括截断的术语“lipoblastom*”，该术语涵盖了术语“lipoblastomatoses”，因此未包括在内。在 EMBASE 中搜索该术语也产生了零篇文章（与 PubMed 类似）。2020 年 3 月 23 日在 PubMed 中搜索“婴儿脂肪瘤”，只得到了五篇文章（EMBASE 确定了其中的四篇）。五篇文章（主要由综述文章和病例报告组成）不符合我们的资格标准，大多数是在原始搜索中找到的。在 MeSH 数据库中搜索在 MeSH 树下没有发现脂肪母细胞瘤的其他术语。然而，我们对文本中的疏忽深表歉意，并且文本中的“婴儿脂肪瘤”一词应该是“胎儿脂肪瘤”，正如补充文件中正确显示的那样。已提交更正请求。关于数据提取，我们努力确保在我们的原始流程中对每项研究进行双重检查。他们信中强调的多项数据声明与原始论文不一致或错误报告，并包括原始文本。对于卡佩莱索等人。[3]，3/3 的数字（因此 0/27 作为原始样本大小与后续是 30）可以在表和文章的讨论（第 67 页）中找到，这表明所有 3复发病例切除不全。在涌& Enzinger [4]，根据表 3 和研究的第 487 页，复发总数为 5（不是作者在信中错误说明的 31 次复发），并记录在我们研究的表 3 中。如第 487 页和原文表 3 所示，随访患者数为 25（这并未记录为他们信中错误陈述的复发次数）[4]。对于 Coffin 等人。[5]，组织学类型在第 1706 页注明。 后续数据 本回复参考 https://doi 在线提供的评论。org/10.1007/s0038 3-020-04663 -7。如第 487 页和原文表 3 所示，随访患者数为 25（这并未记录为他们信中错误陈述的复发次数）[4]。对于 Coffin 等人。[5]，组织学类型在第 1706 页注明。 后续数据 本回复参考 https://doi 在线提供的评论。org/10.1007/s0038 3-020-04663 -7。如第 487 页和原文表 3 所示，随访患者数为 25（这并未记录为他们信中错误陈述的复发次数）[4]。对于 Coffin 等人。[5]，组织学类型在第 1706 页注明。 后续数据 本回复参考 https://doi 在线提供的评论。org/10.1007/s0038 3-020-04663 -7。