Review for 10.1186/s12876-024-03573-5 (2024)

Title: Prognostic Factors and Adjuvant Chemotherapy Efficacy in Stage I Gastric Cancer
Patients: A Retrospective Analysis
Version: 2 Date: 28 Nov 2024
Reviewer:  Yüksel Do#an
Reviewer's report:
What is New:
The study proposes a risk score system based on three independent factors (age #65 years,
pT2 stage, tumour diameter #5 cm). It outperforms conventional TNM staging in prognostic
differentiation.
It demonstrates that adjuvant chemotherapy (AC) does not confer a significant survival benefit,
particularly in patients with stage I gastric cancer (GC) without risk factors, and provides
information regarding its potential adverse effects in low-risk groups.
A detailed analysis of the types and timing of recurrences contributes to the understanding of
the progression of stage I GC, with particular emphasis on peritoneal spread within two years
postoperatively.
Criticisms:
The retrospective nature of the study limits its ability to establish causality by introducing
potential biases.
Although valuable, single-centre results may lack generalisability.
The robustness of conclusions regarding the effectiveness of AC is limited.
Suggestions:
Kindly Avoid redundancy in presenting statistical significance. For instance, when stating
"P<0.05," it is unnecessary to add "statistically significant.
• In the introduction, you mention "favorable prognosis" multiple times. Consider rephrasing to
maintain reader engagement.
• Example: Replace "Patients with stage I GC demonstrated a favorable prognosis following
curative resection" with "Stage I GC patients exhibited excellent long-term outcomes post-
curative resection."
• Some sentences are long and dense, making them harder to follow. Break them into shorter,
more concise statements.
• Example: Replace "Following surgical resection, patients were scheduled for follow-up
examinations to monitor for recurrence. These examinations occurred every 3-6 months during
the first two years and subsequently every 6-12 months over the following five years" with
"After surgical resection, follow-up was conducted every 3–6 months for the first two years and
every 6–12 months thereafter."
• Kindly Ensure consistency in verb tenses, especially when describing methods (past tense) and
findings (present tense).
• Example: Replace "Patients were evaluated based on 18 clinical and pathological
characteristics extracted from medical records" with "We evaluated patients based on 18 clinical
and pathological characteristics extracted from medical records."
•
• Kindly Replace "There was a nearly 30 percentage point disparity in the 5-year survival rates
among patients with varying numbers of these risk factors" with "A 30% difference in 5-year
survival rates was observed based on risk factor count."
• Kindly Add commas to improve readability, especially in lists.
• Example: Replace "Patients were scheduled for follow-up examinations to monitor for
recurrence" with "Patients were scheduled for follow-up examinations, including physical
exams, imaging tests, and endoscopies, to monitor for recurrence."
Overall, this study makes a significant contribution to the understanding of the prognosis of
stage I GC, but will need to be further validated and refined in future research.