Title: Entero-Vascular Fistula Following Radiotherapy in a Patient with Recurrent Cervical
Cancer Post-Pelvic Exenteration: a case report
Version: 2 Date: 22 Feb 2025
Reviewer:  Shi-Fu Hu
Reviewer's report:
dear authors#
The manuscript presents a case report of an entero-vascular fistula following radiotherapy in
a patient with recurrent cervical cancer post-pelvic exenteration. The case is well-documented
and provides valuable insights into the severe complications that can arise following pelvic
exenteration and radiotherapy. The manuscript is generally well-written and organized, but there
are some areas that could be improved to enhance clarity and accuracy.
Title
The title is clear and accurately reflects the content of the manuscript. It appropriately highlights
the main finding of the case report.
Abstract
The abstract is concise and provides a good summary of the case. However, it could benefit
from a more detailed description of the key findings and their implications. For example,
the conclusion could emphasize the importance of careful management strategies for patients
undergoing pelvic exenteration and radiotherapy.
Introduction
The introduction provides a good background on pelvic exenteration and its complications.
However, it could be strengthened by including more recent literature on the topic. For instance,
the authors could mention any recent advancements in surgical techniques or adjuvant therapies
that have improved outcomes for patients with recurrent cervical cancer.
Case Presentation
The case presentation is detailed and provides a clear description of the patient's history,
treatment, and complications. However, some sections could be clarified:
Timeline of Events: The timeline of the patient's hospitalization and treatment could be presented
in a more organized manner to help readers follow the sequence of events more easily.
Discussion
The discussion is comprehensive and provides a good analysis of the case in the context of
existing literature. However, some points could be expanded:
Comparison with Literature: The authors could provide a more detailed comparison of their
case with previously reported cases of entero-vascular fistula following pelvic exenteration and
radiotherapy.
Management Strategies: The discussion could include more details on the current management
strategies for entero-vascular fistula and any emerging treatments that could be beneficial for
such patients.
Conclusions
The conclusions are clear and emphasize the importance of recognizing and managing severe
complications following pelvic exenteration and radiotherapy. However, the authors could
suggest specific areas for future research or clinical practice to address these complications more
effectively.
References
The references are comprehensive and up-to-date. However, the authors should ensure that all
references are properly formatted according to the journal's guidelines.
Essential Work for Revision
Clarify Timeline: The timeline of the patient's hospitalization and treatment should be presented
more clearly, possibly using a table or a timeline graphic.
Expand Discussion: The discussion could be expanded to include a more detailed comparison
with previous cases and a discussion of current management strategies for entero-vascular
fistula.
Proofread: The manuscript should be proofread to ensure there are no grammatical errors or
typos.
Recommendation
The manuscript is of good quality and presents an important case report. With the suggested
revisions, it could be ready for acceptance. I recommend that the authors address the points
mentioned above and resubmit the manuscript for further consideration.
Conclusion
Overall, the manuscript provides valuable insights into the severe complications that can
arise following pelvic exenteration and radiotherapy for recurrent cervical cancer. With some
revisions to improve clarity and completeness, it could be a strong contribution to the literature.
Sincerely,