Title: Comparison of Prognostic Outcomes between Endoscopic Submucosal Dissection and
Surgical Treatment for Early Gastric Cancer: A Retrospective Cohort Study
Version: 3 Date: 28 Jan 2024
Reviewer:  Kohei Yamanouchi
Reviewer's report:
I appreciate your response to my previous comment.
Additionally, I need a response to the following comment.
1. About (2) Intraoperative Assessment in the Pathological investigation methods section, the
authors describe "During ESD and surgical procedures, real-time intraoperative assessments
were made to confirm and further detail the depth of invasion. During ESD and surgical
procedures, real-time intraoperative assessments were made to confirm and further detail the
depth of invasion”. How do you assess intramucosal or SM invasive cancer in real time during
ESD and surgery? It should be described whether it can be determined by gross or endoscopic
findings.
2. The authors classify the depth of cancer as M1 to M3 and SM1 to SM3. Which guidelines are
these depth criteria taken from? For example, in Japanese gastric cancer guidelines, intramucosal
gastric cancer is described M and SM invasive cancer is SM1 or SM2 according to the distance
of invasion.
3. As reviewer 1 commented, the description of SM depth levels still seems inadequate. Only
M and SM1 cases are included in Table 1, in contrast, there is no case of SM2 and SM3. It
seems unnatural.
4. The authors describe in Response 7 that "We have provided further detailed explanations in
the inclusion and exclusion criteria, emphasizing that all cases We have provided further detailed
explanations in the inclusion and exclusion criteria, emphasizing that all cases underwent
curative resection and explicitly excluding cases from the ESD group that were later included
in the surgery group”. In addition, non-curative resection is mentioned in the Exclusion criteria
section in the revised manuscript. On the other hand, in Table 1, there are 32.1% of cases of
vascular invasion in the ESD group, which we consider to be inconsistent because it seems to
fall under the category of ESD non-curative resection.
5. About survival time in the Results section, how many cases who were only followed up
without additional surgical resection in the ESD groups (262 cases). The authors should clearly
state this.
Title: Comparison of Prognostic Outcomes between Endoscopic Submucosal Dissection and
Surgical Treatment for Early Gastric Cancer: A Retrospective Cohort Study
Version: 3 Date: 28 Jan 2024
Reviewer:  Kohei Yamanouchi
Reviewer's report:
I appreciate your response to my previous comment.
Additionally, I need a response to the following comment.
1. About (2) Intraoperative Assessment in the Pathological investigation methods section, the
authors describe "During ESD and surgical procedures, real-time intraoperative assessments
were made to confirm and further detail the depth of invasion. During ESD and surgical
procedures, real-time intraoperative assessments were made to confirm and further detail the
depth of invasion”. How do you assess intramucosal or SM invasive cancer in real time during
ESD and surgery? It should be described whether it can be determined by gross or endoscopic
findings.
2. The authors classify the depth of cancer as M1 to M3 and SM1 to SM3. Which guidelines are
these depth criteria taken from? For example, in Japanese gastric cancer guidelines, intramucosal
gastric cancer is described M and SM invasive cancer is SM1 or SM2 according to the distance
of invasion.
3. As reviewer 1 commented, the description of SM depth levels still seems inadequate. Only
M and SM1 cases are included in Table 1, in contrast, there is no case of SM2 and SM3. It
seems unnatural.
4. The authors describe in Response 7 that "We have provided further detailed explanations in
the inclusion and exclusion criteria, emphasizing that all cases We have provided further detailed
explanations in the inclusion and exclusion criteria, emphasizing that all cases underwent
curative resection and explicitly excluding cases from the ESD group that were later included
in the surgery group”. In addition, non-curative resection is mentioned in the Exclusion criteria
section in the revised manuscript. On the other hand, in Table 1, there are 32.1% of cases of
vascular invasion in the ESD group, which we consider to be inconsistent because it seems to
fall under the category of ESD non-curative resection.
5. About survival time in the Results section, how many cases who were only followed up
without additional surgical resection in the ESD groups (262 cases). The authors should clearly
state this.
Please review this paper.
user
Title: Comparison of Prognostic Outcomes between Endoscopic Submucosal Dissection and
Surgical Treatment for Early Gastric Cancer: A Retrospective Cohort Study
Version: 3 Date: 28 Jan 2024
Reviewer:  Kohei Yamanouchi
Reviewer's report:
I appreciate your response to my previous comment.
Additionally, I need a response to the following comment.
1. About (2) Intraoperative Assessment in the Pathological investigation methods section, the
authors describe "During ESD and surgical procedures, real-time intraoperative assessments
were made to confirm and further detail the depth of invasion. During ESD and surgical
procedures, real-time intraoperative assessments were made to confirm and further detail the
depth of invasion”. How do you assess intramucosal or SM invasive cancer in real time during
ESD and surgery? It should be described whether it can be determined by gross or endoscopic
findings.
2. The authors classify the depth of cancer as M1 to M3 and SM1 to SM3. Which guidelines are
these depth criteria taken from? For example, in Japanese gastric cancer guidelines, intramucosal
gastric cancer is described M and SM invasive cancer is SM1 or SM2 according to the distance
of invasion.
3. As reviewer 1 commented, the description of SM depth levels still seems inadequate. Only
M and SM1 cases are included in Table 1, in contrast, there is no case of SM2 and SM3. It
seems unnatural.
4. The authors describe in Response 7 that "We have provided further detailed explanations in
the inclusion and exclusion criteria, emphasizing that all cases We have provided further detailed
explanations in the inclusion and exclusion criteria, emphasizing that all cases underwent
curative resection and explicitly excluding cases from the ESD group that were later included
in the surgery group”. In addition, non-curative resection is mentioned in the Exclusion criteria
section in the revised manuscript. On the other hand, in Table 1, there are 32.1% of cases of
vascular invasion in the ESD group, which we consider to be inconsistent because it seems to
fall under the category of ESD non-curative resection.
5. About survival time in the Results section, how many cases who were only followed up
without additional surgical resection in the ESD groups (262 cases). The authors should clearly
state this.
assistant