Title: A novel nomogram and risk stratification system predicting the cancer-specific survival of
patients with gastric neuroendocrine carcinoma: A study based on SEER database and external
validation
Version: 1 Date: 06 Jun 2023
Reviewer's report:
The study presents the results of a study aimed to develop and validate a nomogram to predict 1-,
3-, and 5-year CSS for GNEC patients after surgical resection, which presented better predictive
ability than the 8th AJCC TNM staging system.
Comments and criticisms on the paper:
1. It is important to note that this study is retrospective in nature. Therefore it has inherent
limitations, such as potential selection bias, incomplete data, and the inability to establish
causality. Although the study design is appropriate for constructing and validating a nomogram
based on existing data, it is crucial to consider these limitations when interpreting the findings.
Therefore, I suggest less enthusiastic conclusion.
1. Sample Size: The paper mentions a total of 28 patients from a single hospital as the external
validation cohort, which is relatively small. A larger sample size would enhance the reliability
and generalizability of the results.
2. Generalizability: The external validation cohort consists of patients from a single hospital,
which may limit the generalizability of the findings. Including patients from multiple institutions
or different geographical locations would improve the external validity of the nomogram.
3. Given the limitations of the retrospective study design and the relatively small sample size,
it is prudent to exercise caution when interpreting the results. While the developed nomogram
shows promise in predicting the cancer-specific survival of postoperative GNEC patients,
further validation in larger prospective studies is warranted to confirm its predictive ability and
generalizability. It would be appropriate, instead of this little cohort of external validation, a
little cohort of external or even internal prospective validation to conclude that the nomogram
demonstrates potential as a predictive tool.
4. The clinical utility of this nomogram is not weel analyzed in the paper: it would be valuable
to discuss how the nomogram can be used in clinical practice to guide treatment decisions or
improve patient outcomes.
5. Limitations: The paper does not thoroughly discuss the limitations of the study. The
Authors wrote a very short paragraph on the limitation, without going in depth. Identifying and
addressing potential limitations, such as selection bias, missing data, or other sources of error,
would strengthen the interpretation and reliability of the results.
Title: A novel nomogram and risk stratification system predicting the cancer-specific survival of
patients with gastric neuroendocrine carcinoma: A study based on SEER database and external
validation
Version: 1 Date: 06 Jun 2023
Reviewer's report:
The study presents the results of a study aimed to develop and validate a nomogram to predict 1-,
3-, and 5-year CSS for GNEC patients after surgical resection, which presented better predictive
ability than the 8th AJCC TNM staging system.
Comments and criticisms on the paper:
1. It is important to note that this study is retrospective in nature. Therefore it has inherent
limitations, such as potential selection bias, incomplete data, and the inability to establish
causality. Although the study design is appropriate for constructing and validating a nomogram
based on existing data, it is crucial to consider these limitations when interpreting the findings.
Therefore, I suggest less enthusiastic conclusion.
1. Sample Size: The paper mentions a total of 28 patients from a single hospital as the external
validation cohort, which is relatively small. A larger sample size would enhance the reliability
and generalizability of the results.
2. Generalizability: The external validation cohort consists of patients from a single hospital,
which may limit the generalizability of the findings. Including patients from multiple institutions
or different geographical locations would improve the external validity of the nomogram.
3. Given the limitations of the retrospective study design and the relatively small sample size,
it is prudent to exercise caution when interpreting the results. While the developed nomogram
shows promise in predicting the cancer-specific survival of postoperative GNEC patients,
further validation in larger prospective studies is warranted to confirm its predictive ability and
generalizability. It would be appropriate, instead of this little cohort of external validation, a
little cohort of external or even internal prospective validation to conclude that the nomogram
demonstrates potential as a predictive tool.
4. The clinical utility of this nomogram is not weel analyzed in the paper: it would be valuable
to discuss how the nomogram can be used in clinical practice to guide treatment decisions or
improve patient outcomes.
5. Limitations: The paper does not thoroughly discuss the limitations of the study. The
Authors wrote a very short paragraph on the limitation, without going in depth. Identifying and
addressing potential limitations, such as selection bias, missing data, or other sources of error,
would strengthen the interpretation and reliability of the results.
Please review this paper.
user
Title: A novel nomogram and risk stratification system predicting the cancer-specific survival of
patients with gastric neuroendocrine carcinoma: A study based on SEER database and external
validation
Version: 1 Date: 06 Jun 2023
Reviewer's report:
The study presents the results of a study aimed to develop and validate a nomogram to predict 1-,
3-, and 5-year CSS for GNEC patients after surgical resection, which presented better predictive
ability than the 8th AJCC TNM staging system.
Comments and criticisms on the paper:
1. It is important to note that this study is retrospective in nature. Therefore it has inherent
limitations, such as potential selection bias, incomplete data, and the inability to establish
causality. Although the study design is appropriate for constructing and validating a nomogram
based on existing data, it is crucial to consider these limitations when interpreting the findings.
Therefore, I suggest less enthusiastic conclusion.
1. Sample Size: The paper mentions a total of 28 patients from a single hospital as the external
validation cohort, which is relatively small. A larger sample size would enhance the reliability
and generalizability of the results.
2. Generalizability: The external validation cohort consists of patients from a single hospital,
which may limit the generalizability of the findings. Including patients from multiple institutions
or different geographical locations would improve the external validity of the nomogram.
3. Given the limitations of the retrospective study design and the relatively small sample size,
it is prudent to exercise caution when interpreting the results. While the developed nomogram
shows promise in predicting the cancer-specific survival of postoperative GNEC patients,
further validation in larger prospective studies is warranted to confirm its predictive ability and
generalizability. It would be appropriate, instead of this little cohort of external validation, a
little cohort of external or even internal prospective validation to conclude that the nomogram
demonstrates potential as a predictive tool.
4. The clinical utility of this nomogram is not weel analyzed in the paper: it would be valuable
to discuss how the nomogram can be used in clinical practice to guide treatment decisions or
improve patient outcomes.
5. Limitations: The paper does not thoroughly discuss the limitations of the study. The
Authors wrote a very short paragraph on the limitation, without going in depth. Identifying and
addressing potential limitations, such as selection bias, missing data, or other sources of error,
would strengthen the interpretation and reliability of the results.
assistant