Reviewer’s report
Title: 
Role Of Ovarian Metastases In Colorectal Cancer (ROMIC): a Dutch
study protocol to evaluate the effect of prophylactic salpingo-oophorectomy in
postmenopausal women
Version: 
0 
Date: 
01 Jun 2022
Reviewer: 
Robin Crawford
Reviewer's report:
Thank you for asking me to review the manuscript. The study is certainly
relevant both to those treating CRC and those treating OC. The study has already
been open for two years
Comments:
1) No mention has been made about covid and its effect on the trial and what the
investigators are doing in response.
2) There is no mention of Lynch syndrome. In England there has been reflex
testing for lynch syndrome in CRC and this would if positive put the woman at
risk of >10% for OC. If positive then a discussion around PSO has a complete
different significance
3) I cannot comment on the statistics and the power calculation
4) I disagree with setting the lower age limit at 60 years when the authors state
that the risk is higher for younger women. Given the Dutch guidance it would be
appropriate to collect information on the cohort aged 50-59 years so as to inform
better the lower age group.
5) There is no detail of the gynaecological surgery as to the completeness of
removing the tubes and ovaries, the methods/techniques used, whether a
gynaecologist would do this part of the surgery, details of the pathology as to
only sampling macroscopic lesions or whether more detailed pathology review (
with more sections) is undertaken.
If these points are taken into account then this will be a very useful trial
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