Title: Development of Predictive Models for Pathological Response Status in Breast Cancer
after Neoadjuvant Therapy Based on Peripheral Blood Inflammatory Indexes
Version: 0 Date: 21 Aug 2024
Reviewer:  Antonio Bandala-Jacques
Reviewer's report:
Dear authors - I have reviewed your manuscript and offer the following comments and
suggestions
INTRODUCTION
A) As an overall style recommendation, a period ',' should go before the quoting brackets. I.e
Text.[1], not Text [1].
B) Overall, the introduction is well written and the objectives are clear
METHODS AND MATERIALS
C) Did you include all histological subtypes of breast cancer?
D) For your inclusion criteria (3), did you mean "received"?
E) I see that your study design is a retrospective cohort. Yet, you mention that patients gave
written informed consent for participation. By definition, you have assembled the cohort after
follow-up occurred. How was informed consent obtained then?
F) Was one of your inclusion criteria the timing between finishing NAT and the surgical
procedures? One would expect that this might be associated to DpCR
G) In All patients followed up until 30 January 2024, you forgot the verb
H) For "Disease-free survival (DFS) was defined as the interval between diagnosis and either
breast cancer recurrence, death from any cause, or the date of the final follow-up"
By definition, at diagnosis, participants are not disease-free. DFS should be the interval between
when a participants is first seen without disease until recurrence or death
https://www.cancer.gov/publications/dictionaries/cancer-terms/def/disease-free-survival
Therefore, all participants who have residual disease after NAT and surgery should be excluded
I) Did you assess model calibration? If so, you should include in the methods
RESULTS
J)Table 1 should spell-out all abbreviations in the footnote, and exclude abbreviations not used.
You spell-out DpCR, but it is not used in Table 1
K) Some variables should also be included, either in table or text, in continuous form, such as
age and BMI
L) you mention that "The observed differences in survival between each two groups were
statistically significant. Thus, DpCR represents a subgroup with a distinct prognosis, making it
scientifically meaningful to study it separately from T-NpCR."
This statement might not be true. The log-rank test tests the null hypothesis that all survivals are
the same. Therefore, log-rank test here is only saying that at least one of the curves is statistically
significantly different (expected with the inclusion of the TpCT group). I would run a model
specifically comparing DpCR to NpCT and comment if it was also statistically significant (most
likely yes, and I would only mention in the text)
M) The use of 4 decimals for AUCs might be excessive
DISCUSSION
N) Since your most important terms all have similar abbreviations (T-NpCR, TpCR, T-NpCR),
the manuscript would benefit if you occasionally spell them out again, as I found myself
constantly going back to the methods for the definitions
O) What is bPCR? I can't find this in prior sections
P) I suggest you avoid using the phrase "In this study", as it is unclear if you are referencing
your own study, or one of your citations