Reviewer ’s report  
 
Title: The effect of written information and counselling by an advanced practice nurse on  
resilience in women with vulvar neoplasia during six months after surgical treatment and the  
influence o f social support, recurrence, and age: A secondary analysis of a multicenter 
randomized  controlled trial, WOMAN -PRO -II 
 
Version: 0 Date: 07 Dec 2019  
 
Reviewer: Agnese Maria Chiara Rapisarda  
 
Reviewer's report:  
 
I read with great interest the Manuscript titled "The effect of written i nformation and counseling 
by an APN on resilience in women with vulvar neoplasia during six months after surgical 
treatment and the influence of social support, recurrence, and age: A secondary analysis of a 
multicenter randomized controlled trial, WOMAN -PRO-II" (BMWH -D-19-00780), which falls 
within the aim of BMC Women's Health.  
The topic is interesting, methodology is accurate, and conclusions are supported by the data 
analysis. Nevertheless, authors should improve the discussion citing relevant and novel  key 
articles about the topic.  
 
Authors should consider the following recommendations:  
 
-  I really appreciated the novelty of the topic. However, I suggest further improving the 
discussion about surgical management of vulvar cancer, referring to the follo wing articles about 
the topic: Updates Surg. 2015 Dec;67(4):367 -71. doi: 10.1007/s13304 -015-0303 -6; Curr Opin 
Obstet Gynecol. 2014 Feb;26(1):9 -17. doi: 10.1097/GCO.0000000000000033.  
- The management of women affected by gynecological cancers needs a partic ular attention even 
to the preservation of an appropriate quality of life and sexual function, which risk to be severely 
impaired by surgical/chemo/radio treatments. I would discuss this point, at least briefly, referring 
to: Hum Fertil (Camb). 2018 Apr;21 (1):35 -38. doi: 10.1080/14647273.2017.1339365; 
Ecancermedicalscience. 2017 Feb 8;11:ed62. doi: 10.3332/ecancer.2017.ed62.  
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the a uthors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your commen ts to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comme nts to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the fo llowing 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 a ny 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 c ompeting 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.  
 
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on my report to the authors and, if the manuscript is accepted for publication, my named report  
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I agree to the open peer review policy of the journal