Review for 10.1186/s12876-021-01995-z (2021)

Title: Clinical outcomes of surgical resection versus radiofrequency ablation in very-early#stage
hepatocellular carcinoma: A propensity score matching analysis
Version: 1 Date: 15 Oct 2021
Reviewer's report:
SPECIFIC COMMENTS
This manuscript is pleasurable and flowing; no major issues are appreciable.
Although language used is appropriate, I (I am not a native English speaker) recommend to
Authors to obtain a certified native speaker with proficiencies in the scientific-medical field to
complete properly this paper (if not jet done). Moreover, I recommend making a further revision
of the manuscript to fix some typing/language errors.
TITLE
The title is clear and direct. Personally, I believe it could be improved, for example: “Clinical
outcomes of surgical resection versus radiofrequency ablation in very-early#stage hepatocellular
carcinoma: A propensity score matching analysis”. If the editor agrees, the authors could
consider the change of the title.
KEYWORDS
Authors did not correctly report keywords from MeSH Browser. This is important, in my
personal opinion, in order to increase the traceability of this paper (and consequently the
possibility of the Journal to be cited by Readers and Stakeholders). For example: I did not find
“Surgical resection”; the authors could use “Surgical Procedures”.
ABSTRACT
The abstract is well structured and properly reflects the main text highlighting only the most
important aspects of this review; consequently, no major adjustments are needed. The only
suggestion is to introduce the nature of the study: retrospective.
INTRODUCTION
Although the introduction fits the context of the study, it is too concise. Sometime, many
concepts clearly explicated in an exhaustive introduction could help readers to become
passionate about reading the paper and using it as a reference.
I suggest a theme to the Authors concerning the sentence: “The detection rate of very-early-
stage HCC is increasing because of advances in surveillance technology for at-risk populations
[5].”. The introduction should be expanded with a comment on the new radiologic approach
to hcc diagnosis. In this regard cite and comment the papers a) Dig Dis. 2014;32(6):696-704.
doi: 10.1159/000368002. Epub 2014 Oct 29. PMID: 25376286.; b) J Gastroenterol Hepatol.
2016 Jan;31(1):69-80. doi: 10.1111/jgh.13150. PMID: 26312574. These studies highlighted new
imaging technology such as MRI with EOB and new diagnostic algorithm who will allow to
diagnose more smaller lesions during surveillance in the future.
MATERIALS & METHODS
Please specify which kind of contrast media did you performed in MRI.
RESULTS
Results remain clear and well-structured, and no further adjustments are needed.
DISCUSSION
The discussion section is well structured and clear, but I want to suggest to Authors to enrich
this section with some arguments that could easily be disclosed.
It is very important to introduce same sencences concerning the theme of the costs. In fact, in
other kind of treatment of HCC, such as chemoembolization (TACE), it was demonstrated that
DEB-TACE was more cost-effective than conventional TACE when a minimum willingness-to-
pay of about €2000-3500/QALY was accepted, mainly depending on shorter in-hospital stay and
better quality of life [Dig Liver Dis. 2016 Jul;48(7):798-805. doi: 10.1016/j.dld.2016.03.031.
Epub 2016 May 20. PMID: 27263056.]. please, could the author cite this article and discuss it
to introduce the concept of cost-effectiveness also for RFA and SR?
TABLES & FIGURES
Tables are satisfactory and they correctly match the quality standard of this Journal.
From a stylistic point of view, I suggest to the authors to slightly improve Tables adopting the
same style for all of them.