Review for 10.1186/s12876-023-02697-4 (2023)

Reviewer’s report
Title: 
Determining the survival benefit of postoperative radiotherapy in patients
with pT1-3N1M0 rectal cancer undergoing total mesorectal excision: a
retrospective analysis
Version: 
2 
Date: 
31 Jan 2023
Reviewer's report:
"PEER REVIEWER ASSESSMENTS: 
OBJECTIVE - Full research articles: is there a clear objective that addresses one
or several testable research questions? (Brief or other article types: is there a
clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols)
appropriate for the objective?
Yes - the approach is appropriate
EXECUTION - Are the experiments and analyses performed with sufficient
technical rigor to allow confidence in the results?
No - there are minor issues
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results
reasonable and not overstated?
No - there are minor issues
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your
concerns sufficiently for you to now recommend the work as a technically sound
contribution? If not, can further revisions be made to make the work technically
sound?
Probably - with minor revisions
PEER REVIEWER COMMENTS: 
GENERAL COMMENTS: Relevant question about the additional value of
radiotherapy in a selected group of rectal cancer patients.
REQUESTED REVISIONS: 
What percentage of patients in the database did not receive neo-adjuvant therapy
which should have been giving according to the pTNM? In other words, in how
many patients an incorrect cTNM was diagnosed?
They also should mention potential selection bias. Patients might not have
undergone neoadjuvant treatment because of comorbidity or because of higher
surgical risk after neoadjuvant treatment.
Is there also a group of patients in the database who did not receive any adjuvant
treatment despite having pT1-3N1M0 rectal cancer? Was there any cancer-
specific survival difference between these groups? In other words, was there
better survival in the neoadjuvan treatment group?
The authors should put the findings into perspective with regards to the new
radiological (pretreatment) criteria for rectal cancer (i.e. proximal or distal from
the sigmoid take-off)."
Declaration of competing interests
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paper?
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interests' below. If your reply is yes to any, please give details below.
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recommendation.
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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?
No
Are the methods sufficiently described to allow the study to be repeated?
No
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
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No