Reviewer ’s report  
 
Title: Case report: term birth after fertility -sparing treatments for stage IB1 small c ell 
neuroendocrine carcinoma of the cervix  
 
Version: 0 Date: 26 Apr 2017  
 
Reviewer: Jesus Salvador Jiménez López  
 
Reviewer's report:  
 
Please include all comments for the authors in this box rat her than uploading your report as an 
attachment. Please only upload as attachments annotated versions of manuscripts, graphs, 
supporting materials or other aspects of your report which cannot be included in a text format.  
 
 
 
Please overwrite this text when a dding your comments to the authors.  
 
 
Revisión: Case report: term birth after fertility -1 sparing treatments for stage IB1 small cell 
neuroendocrine carcinoma of the cervix  
 
 
 
Abstract:  
 
- It seems to us that the abstract is well presented, with an adequate exte nsion and 
emphasizing the relevance of its case.  
 
 
 
 
Background  
 
- Error line 74, respectively.5  respectively [5]  
 
 
- In general they make a good contextualization of the subject. It is somewhat incomplete 
because they introduce the concept of neoadjuvant chemot herapy, but the authors 
mention it very much above and the relevance of such therapy in these tumors is not 
clear.  
 
 
 
 
Case presentation  
 
- Association of SCNEC with HPV 18 has been described. We considered that the authors 
should mention whether the patient ha d performed a previous cytology study, whether it 
was performed after the finding and whether HPV PCR was performed.  
 
 
- The neuroendocrine lung tumor has a high rate of metastasis to the CNS, which is why 
some authors advocate a guided exploration of CNS in patients with SCNEC and even 
prophylactic cranial irradiation. It is important to justify the absence of a more deta iled 
neurological study and should refer to the fact that the patient had NO clinical suggestion 
of CNS involvement at any time.  
 
 
 
 
We have a number of issues that we believe authors should include in the text.  
 
- Was there any more tumor marker? Only Ca125? W hy Ca125 and not others?  
 
 
- Did you consider the possibility of sentinel lymph node?  
 
 
- Why not perform a technique for ovocitaria preservation? Especially knowing that a 
chemotherapy treatment is going to be done.  
 
 
- What kind of follow -up was done to the pa tient?  
 
 
- Since when was pregnancy allowed?  
 
 
 
Conclusion  
 
- Regarding the comment on line 155 on QT only in stadiums> IIA. QT has been proposed 
as an adjuvant treatment for all stages, not only advanced (Ref Neuroendocrine Tumors 
of the Gynecologic Tract: A So ciety of Gynecologic Oncology (SGO) clinical 
document).  
 
 
 
- On the trachelectomy, the data presented are about cancer of the cervix with other 
histologies. This should be specified very clearly since this is NOT a recurrence in cases 
of neuroendocrine tumor s that have a higher recurrence rate. We believe this needs to be 
clarified  
 
 
- Although there are no studies designed to compare QT vs QTRT, there is some 
descriptive article about it (Prognostic factors in FIGO stage IB -IIA small cell 
neuroendocrine carci noma of the uterine cervix surgically treated: results of a multi -
center retrospective Korean study. Factors in neuroendocrine small cell cervical 
carcinoma: a multivariate analysis.)  
 
We believe that the authors should include it in their discussion  
 
 
- Perhaps they should justify more why only adjuvant QT and non QTRT, what made them opt 
for this alternative, the reason was because they posed a more conservative behavior ?.  
 
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments t o the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments 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 comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manus cript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, fu nding, 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 any 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 competing interests in relation to this paper?  
 
If you can answer no to al l 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'  
  
I agree to the open peer review policy of the journal. I understand that my n ame will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made availa ble under a n Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal