Title: Development and validation of a nomogram for predicting early recurrence in patients
undergoing different courses of postoperative adjuvant transarterial chemoembolisation
Version: 1 Date: 28 Mar 2025
Reviewer's report:
This study constructs and validates a nomogram for predicting early recurrence (<2 years)
in high-risk hepatocellular carcinoma (HCC) patients undergoing postoperative adjuvant
transarterial chemoembolization (PA-TACE). Key findings include:
1. Identification of five independent predictors: tumor diameter, multiplicity, satellite nodules,
aspartate transaminase (AST) levels, and PA-TACE course (1–6 cycles).
2. The nomogram demonstrated robust discrimination (C-index: 0.722; 12-month AUROC:
0.842) and calibration, with no significant differences in adverse events across PA-TACE
courses except for higher allergy rates in 5–6 cycles.
3. Increased PA-TACE courses were independently associated with reduced early recurrence
risk, challenging prior assumptions about optimal treatment frequency.
Recommendations for Revision:
1. Median follow-up duration unreported; 24-month AUROC decreased to 0.768, raising
concerns about long-term predictive stability. External validation in diverse populations is
absent. It is recommended that the authors expand on the discussion of the study's limitations
in the manuscript
2. “AUROC” is used interchangeably with “ROC AUC” (e.g. abstract and text) and should be
harmonised as “AUC”.
Title: Development and validation of a nomogram for predicting early recurrence in patients
undergoing different courses of postoperative adjuvant transarterial chemoembolisation
Version: 1 Date: 28 Mar 2025
Reviewer's report:
This study constructs and validates a nomogram for predicting early recurrence (<2 years)
in high-risk hepatocellular carcinoma (HCC) patients undergoing postoperative adjuvant
transarterial chemoembolization (PA-TACE). Key findings include:
1. Identification of five independent predictors: tumor diameter, multiplicity, satellite nodules,
aspartate transaminase (AST) levels, and PA-TACE course (1–6 cycles).
2. The nomogram demonstrated robust discrimination (C-index: 0.722; 12-month AUROC:
0.842) and calibration, with no significant differences in adverse events across PA-TACE
courses except for higher allergy rates in 5–6 cycles.
3. Increased PA-TACE courses were independently associated with reduced early recurrence
risk, challenging prior assumptions about optimal treatment frequency.
Recommendations for Revision:
1. Median follow-up duration unreported; 24-month AUROC decreased to 0.768, raising
concerns about long-term predictive stability. External validation in diverse populations is
absent. It is recommended that the authors expand on the discussion of the study's limitations
in the manuscript
2. “AUROC” is used interchangeably with “ROC AUC” (e.g. abstract and text) and should be
harmonised as “AUC”.
Please review this paper.
user
Title: Development and validation of a nomogram for predicting early recurrence in patients
undergoing different courses of postoperative adjuvant transarterial chemoembolisation
Version: 1 Date: 28 Mar 2025
Reviewer's report:
This study constructs and validates a nomogram for predicting early recurrence (<2 years)
in high-risk hepatocellular carcinoma (HCC) patients undergoing postoperative adjuvant
transarterial chemoembolization (PA-TACE). Key findings include:
1. Identification of five independent predictors: tumor diameter, multiplicity, satellite nodules,
aspartate transaminase (AST) levels, and PA-TACE course (1–6 cycles).
2. The nomogram demonstrated robust discrimination (C-index: 0.722; 12-month AUROC:
0.842) and calibration, with no significant differences in adverse events across PA-TACE
courses except for higher allergy rates in 5–6 cycles.
3. Increased PA-TACE courses were independently associated with reduced early recurrence
risk, challenging prior assumptions about optimal treatment frequency.
Recommendations for Revision:
1. Median follow-up duration unreported; 24-month AUROC decreased to 0.768, raising
concerns about long-term predictive stability. External validation in diverse populations is
absent. It is recommended that the authors expand on the discussion of the study's limitations
in the manuscript
2. “AUROC” is used interchangeably with “ROC AUC” (e.g. abstract and text) and should be
harmonised as “AUC”.
assistant