Title: A novel pN3 gastric cancer staging system with superior prognostic utility based upon
the examination of over 31 lymph nodes: a propensity score-matching analysis
Version: 1 Date: 24 Jul 2021
Reviewer:  Ju-li Lin
Reviewer's report:
In this study, pTxN3M0 GC patients from SEER database with advanced GC were selected to
evaluate the relationship between prognosis and the numbers of examined and metastatic lymph
nodes. The authors compared the prognosis of GC patients under different T stages according
to different numbers of examined lymph nodes, and optimized the original AJCC TNM staging
system. It was proved that the optimized novel TNM staging system had a better prognostic
assessment ability. At the same time, there are several deficiencies need to be improved in this
study#
1. Compared with the AJCC TNM staging system, the prognostic assessment advantage of the
novel TNM staging system did exist but is not significant. Please highlight the significance of
this study in the Discussion section.
2. Please clearly indicate which population was being analyzed in the specific survival curve
in Fig.3 and Fig.4.
3. What were the authors' principles for selecting clinicopathological features for PSM analysis?
4. I suggest the authors make a decision curve analysis to further evaluate the novel TNM staging
system for making clinical decision.
5. Finally, the English quality of the manuscript is mediocre and needs grammatical adjustments.
Title: A novel pN3 gastric cancer staging system with superior prognostic utility based upon
the examination of over 31 lymph nodes: a propensity score-matching analysis
Version: 1 Date: 24 Jul 2021
Reviewer:  Ju-li Lin
Reviewer's report:
In this study, pTxN3M0 GC patients from SEER database with advanced GC were selected to
evaluate the relationship between prognosis and the numbers of examined and metastatic lymph
nodes. The authors compared the prognosis of GC patients under different T stages according
to different numbers of examined lymph nodes, and optimized the original AJCC TNM staging
system. It was proved that the optimized novel TNM staging system had a better prognostic
assessment ability. At the same time, there are several deficiencies need to be improved in this
study#
1. Compared with the AJCC TNM staging system, the prognostic assessment advantage of the
novel TNM staging system did exist but is not significant. Please highlight the significance of
this study in the Discussion section.
2. Please clearly indicate which population was being analyzed in the specific survival curve
in Fig.3 and Fig.4.
3. What were the authors' principles for selecting clinicopathological features for PSM analysis?
4. I suggest the authors make a decision curve analysis to further evaluate the novel TNM staging
system for making clinical decision.
5. Finally, the English quality of the manuscript is mediocre and needs grammatical adjustments.
Please review this paper.
user
Title: A novel pN3 gastric cancer staging system with superior prognostic utility based upon
the examination of over 31 lymph nodes: a propensity score-matching analysis
Version: 1 Date: 24 Jul 2021
Reviewer:  Ju-li Lin
Reviewer's report:
In this study, pTxN3M0 GC patients from SEER database with advanced GC were selected to
evaluate the relationship between prognosis and the numbers of examined and metastatic lymph
nodes. The authors compared the prognosis of GC patients under different T stages according
to different numbers of examined lymph nodes, and optimized the original AJCC TNM staging
system. It was proved that the optimized novel TNM staging system had a better prognostic
assessment ability. At the same time, there are several deficiencies need to be improved in this
study#
1. Compared with the AJCC TNM staging system, the prognostic assessment advantage of the
novel TNM staging system did exist but is not significant. Please highlight the significance of
this study in the Discussion section.
2. Please clearly indicate which population was being analyzed in the specific survival curve
in Fig.3 and Fig.4.
3. What were the authors' principles for selecting clinicopathological features for PSM analysis?
4. I suggest the authors make a decision curve analysis to further evaluate the novel TNM staging
system for making clinical decision.
5. Finally, the English quality of the manuscript is mediocre and needs grammatical adjustments.
assistant