Review for 10.1186/s12876-022-02440-5 (2022)

Reviewer’s report
Title: 
Total neoadjuvant therapy for locally advanced gastric cancer and esophagogastric junction
adenocarcinoma: Study protocol for a prospective, multicenter, single-arm, phase II clinical trial
Version: 
0 
Date: 
07 Jun 2022
Reviewer's report:
The authors aimed to present the study protocol for a prospective, multicenter, single-arm, phase II trial on
Total neoadjuvant therapy for locally advanced gastric cancer and esophagogastric junction
adenocarcinoma. In general, the concept of the study is presented adequately - the Introduction, Aim,
Materials and Methods and Discussion seem to follow the baseline. However, specific points need to be
addressed:
- the English language requires substantial improvement - spelling, abbreviations (eg. lack of
IMRT/VMAT explanation) and grammar need to be double-checked.
- The surgical treatment has to be described in more detail, including the type of resection (approach:
open/laparoscopic/robotic, abdominal/transhiatal +/- thoracoscopy/thoracotomy; total/subtotal/proximal
gastrectomy +/- esophagectomy; type of GI tract reconstruction)
- The statement "Laparoscopy is an invasive operation with poor patient acceptance, and it prolongs the
interval time to the therapy" is an overstatement. The yield of staging laparoscopy may reach up to 40%,
depending on histology (eg.10.1002/jso.25711). Therefore this statement should be smoothened. 
- There is a clear benefit of preoperative radiotherapy in oesophagal / EGJ cancers. However, the rationale
for neoadjuvant radiotherapy, specifically in gastric cancer, should be explained in more detail, e.g. do
authors predict the same response for preoperative treatment in EGJ and distal gastric tumours?
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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?
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