Review for 10.1186/s12876-021-01886-3 (2021)

Reviewer’s report
Title: 
Relation between body composition and severe diarrhea in patients treated
with preoperative chemoradiation with capecitabine for rectal cancer: a single-
centre cohort study
Version: 
0 
Date: 
08 Jun 2021
Reviewer's report:
Patients with LARC treated with concomitant chemoradiation with capecitabine
from January 2009 until July 2015 were retrospectively reviewed.Female
patients undergoing preoperative chemoradiation, 65 years and older, were at
increased risk of developing severe diarrhea. There was no association with body
composition adjusted for gender, age, or renal function. Anatomical structure is
considered to be the cause of many women. Women have a larger and wider
pelvis than men and may have more small intestines that enter the radiation field.
This can be inferred from the fact that female patients who have undergone
hysterectomy in the past are at high risk of developing diarrhea. Patients at high
risk need to be treated with caution.
major
1, How do the patients adjust their capecitabine or radiation levels for diarrhea?
2, What is the relationship between people with low skeletal muscle density and
people with low skeletal muscle mass?
3, Authors should analyze whether patients with recurrent rectal cancer were
receiving chemotherapy or radiation therapy for the first time.
4, Authors should analyze correlation between abdominal surgery history and
diarrhea.
5, Which do you think is the main cause of severe diarrhea, radiation or
chemotherapy?
minor
1, What kind of population are patients with a high risk for local recurrence?
2, Why was the total cross-sectional area measured in the 3rd lumbar vertebra?
3, How does the frequency of diarrhea change depending on the presence or
absence of hysterectomy even if the age is adjusted?
4, Authors should consider cases of radiation-only diarrhea.
5, What is the degree of diarrhea with primary rectal cancer and recurrence?
Publons Reviewer Recognition
. Springer Nature can send verification of this
review directly to Publons (a subsidiary of Clarivate Analytics). If you would
like to take advantage of this service, please click on the “Yes” option below.
Your name, email address, title of the reviewed manuscript, name of the journal,
and date of your review submission (the “Review Data”) will then be transmitted
to Publons after the final decision on the manuscript has been made. If you have
already registered at Publons, they will notify you of the receipt of this review
and update your profile 
as per your settings and their policy. If you are not
registered with Publons, you will receive an email from them asking you to
register in order for them to be able to recognize your review on your new
profile page. Publons may use the Review Data to generate derivative metadata
for the benefit of Publons and you as a reviewer, carefully considering the
sensitivity of such information. For example, Publons may verify your record as
a reviewer by updating your profile published on its webservice if you have
registered for such service or help editors to identify candidate reviewers. Please
find the details of processing in Publons’ privacy policy
https://publons.com/about/terms
Yes
Declaration of competing interests
Please complete a declaration of competing
interests, considering the following questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
I declare that I have no competing interests' below.
Reviewer Publication Consent.
 I agree for my report to be made available
under an Open Access Creative Commons CC-BY License (
http://creativecommons.org/licenses/by/4.0
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the
editorial office before completing the review.
If you wish, you can include your
name in your published report. Please note you must decide whether to include
your name at the start of the process and confirm this decision whenever
prompted. If you change your decision later, we will not be able to publish your
name.
I agree to the terms of the CC-BY 4.0 license; please 
do not
 publish my name
with my report. (default)
Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes