Title: Epidemiology and prognostic analysis of patients with pancreatic  signet ring cell
carcinoma: a population-based study
Version: 1 Date: 08 Aug 2022
Reviewer's report:
In this study, the Authors  determined the epidemiological characteristics , the prognostic
impact of surgery, radiotherapy, and chemotherapy in patients with pancreatic signet ring cell
carcinoma. A total of 585 patients with PSRCC were collected from a SEER database.  The
Authors concluded that: 1)PSRCC is a highly malignant tumor that predominates in elderly, male
and black patients.2) About 67% patients with PSRCC had distant metastasis at diagnosis, and
the overall prognosis was poor. 3)The 1-, 2-, and 5-year observed survival rates were only 20.1%,
8.3%, and 3.4%, respectively. 4)Timely diagnosis, surgery and chemotherapy are effective at
improving the prognosis. 5) Married patients were associated with better outcomes.
PSRCC is a rare tumor and, obviously, relevant information about its biological behaviour
are lacking. However, I find difficult to believe that this study provides special findings to
characterize PSRCC because several informations from SEER database are missing.
- Grade of the tumor is unknown in more than half of the patients, lymph node status is unknown
in 81% of patients, primary site of tumor is reported as "others" in 28.5%, tumor size is unknown
in 202 patients (34.5%).
-Surprisingly, chemotherapy administration is unknown or not performed in 55% of patients.
-Stage of the tumor is reported to be "regional" in 158 patients: this term is unclear.
-In the section Results, line 158, it is reported that 112 patients underwent lymphadenectomy
while in line 164, surgery was performed in 100 patients.  Moreover, It is not reported the type
of surgery, in particular  the rate of pancreatic resection, unique operation that allow adequate
lymphadenectomy.
- The reason of better prognosis in married patients should be clarified.
Title: Epidemiology and prognostic analysis of patients with pancreatic  signet ring cell
carcinoma: a population-based study
Version: 1 Date: 08 Aug 2022
Reviewer's report:
In this study, the Authors  determined the epidemiological characteristics , the prognostic
impact of surgery, radiotherapy, and chemotherapy in patients with pancreatic signet ring cell
carcinoma. A total of 585 patients with PSRCC were collected from a SEER database.  The
Authors concluded that: 1)PSRCC is a highly malignant tumor that predominates in elderly, male
and black patients.2) About 67% patients with PSRCC had distant metastasis at diagnosis, and
the overall prognosis was poor. 3)The 1-, 2-, and 5-year observed survival rates were only 20.1%,
8.3%, and 3.4%, respectively. 4)Timely diagnosis, surgery and chemotherapy are effective at
improving the prognosis. 5) Married patients were associated with better outcomes.
PSRCC is a rare tumor and, obviously, relevant information about its biological behaviour
are lacking. However, I find difficult to believe that this study provides special findings to
characterize PSRCC because several informations from SEER database are missing.
- Grade of the tumor is unknown in more than half of the patients, lymph node status is unknown
in 81% of patients, primary site of tumor is reported as "others" in 28.5%, tumor size is unknown
in 202 patients (34.5%).
-Surprisingly, chemotherapy administration is unknown or not performed in 55% of patients.
-Stage of the tumor is reported to be "regional" in 158 patients: this term is unclear.
-In the section Results, line 158, it is reported that 112 patients underwent lymphadenectomy
while in line 164, surgery was performed in 100 patients.  Moreover, It is not reported the type
of surgery, in particular  the rate of pancreatic resection, unique operation that allow adequate
lymphadenectomy.
- The reason of better prognosis in married patients should be clarified.
Please review this paper.
user
Title: Epidemiology and prognostic analysis of patients with pancreatic  signet ring cell
carcinoma: a population-based study
Version: 1 Date: 08 Aug 2022
Reviewer's report:
In this study, the Authors  determined the epidemiological characteristics , the prognostic
impact of surgery, radiotherapy, and chemotherapy in patients with pancreatic signet ring cell
carcinoma. A total of 585 patients with PSRCC were collected from a SEER database.  The
Authors concluded that: 1)PSRCC is a highly malignant tumor that predominates in elderly, male
and black patients.2) About 67% patients with PSRCC had distant metastasis at diagnosis, and
the overall prognosis was poor. 3)The 1-, 2-, and 5-year observed survival rates were only 20.1%,
8.3%, and 3.4%, respectively. 4)Timely diagnosis, surgery and chemotherapy are effective at
improving the prognosis. 5) Married patients were associated with better outcomes.
PSRCC is a rare tumor and, obviously, relevant information about its biological behaviour
are lacking. However, I find difficult to believe that this study provides special findings to
characterize PSRCC because several informations from SEER database are missing.
- Grade of the tumor is unknown in more than half of the patients, lymph node status is unknown
in 81% of patients, primary site of tumor is reported as "others" in 28.5%, tumor size is unknown
in 202 patients (34.5%).
-Surprisingly, chemotherapy administration is unknown or not performed in 55% of patients.
-Stage of the tumor is reported to be "regional" in 158 patients: this term is unclear.
-In the section Results, line 158, it is reported that 112 patients underwent lymphadenectomy
while in line 164, surgery was performed in 100 patients.  Moreover, It is not reported the type
of surgery, in particular  the rate of pancreatic resection, unique operation that allow adequate
lymphadenectomy.
- The reason of better prognosis in married patients should be clarified.
assistant