Title: The effect of cardiovascular disease on the perioperative period of radical surgery in
elderly rectal cancer
Version: 1 Date: 17 Feb 2024
Reviewer's report:
In this paper, the authors discuss the affection of comorbidity for postoperative complication
of elderly patients with rectal cancer. The main contribution of the paper seems to be that the
authors show elderly rectal cancer patients with cardiovascular disease are more likely to develop
severe complications after radical surgery. I recommend that this paper would be accepted after
revision as follows.
Major comments
The good points of this study are that the purpose of the analysis is straightforward and the
conclusions are clear.
It is easy to imagine that patients with cardiovascular comorbidities have a higher risk of
developing perioperative complications, which has been well demonstrated in previous studies.
In this sense, it lacks novelty. Therefore, we propose the following revisions.
First, before this analysis, factors that are likely to cause postoperative complications should
be extracted in the cohort before the main analysis by PSM, and cardiovascular comorbidities
should be included among them. The authors should focus on cardiovascular comorbidity after
examining the difference in odds ratios compared to other factors.
In the case of rectal cancer patients under 75 years of age (younger age), how much of an impact
cardiovascular comorbidity has on the development of complications should also be mentioned;
if there is no difference between patients under 75 years of age and those over 75 years of age,
the analysis of this study would be not meaningful. The difference odds ratios between young
patients and elderly patients should still be shown.
Cardiovascular comorbidities also vary in type and severity, including hypertension,
arrhythmias, ischemic heart disease, and thrombosis, and so on, as mentioned in the manuscript.
Clinical question what we really want to know is whether or not there is difference risks among
the cardiovascular comorbidities. Therefore, additional analysis of the risk of complications for
each type of cardiovascular comorbidity is needed.
Minor comments
Title: The authors focused on rectal cancer, so “CRC” should be changed to “rectal cancer.”
Title: The effect of cardiovascular disease on the perioperative period of radical surgery in
elderly rectal cancer
Version: 1 Date: 17 Feb 2024
Reviewer's report:
In this paper, the authors discuss the affection of comorbidity for postoperative complication
of elderly patients with rectal cancer. The main contribution of the paper seems to be that the
authors show elderly rectal cancer patients with cardiovascular disease are more likely to develop
severe complications after radical surgery. I recommend that this paper would be accepted after
revision as follows.
Major comments
The good points of this study are that the purpose of the analysis is straightforward and the
conclusions are clear.
It is easy to imagine that patients with cardiovascular comorbidities have a higher risk of
developing perioperative complications, which has been well demonstrated in previous studies.
In this sense, it lacks novelty. Therefore, we propose the following revisions.
First, before this analysis, factors that are likely to cause postoperative complications should
be extracted in the cohort before the main analysis by PSM, and cardiovascular comorbidities
should be included among them. The authors should focus on cardiovascular comorbidity after
examining the difference in odds ratios compared to other factors.
In the case of rectal cancer patients under 75 years of age (younger age), how much of an impact
cardiovascular comorbidity has on the development of complications should also be mentioned;
if there is no difference between patients under 75 years of age and those over 75 years of age,
the analysis of this study would be not meaningful. The difference odds ratios between young
patients and elderly patients should still be shown.
Cardiovascular comorbidities also vary in type and severity, including hypertension,
arrhythmias, ischemic heart disease, and thrombosis, and so on, as mentioned in the manuscript.
Clinical question what we really want to know is whether or not there is difference risks among
the cardiovascular comorbidities. Therefore, additional analysis of the risk of complications for
each type of cardiovascular comorbidity is needed.
Minor comments
Title: The authors focused on rectal cancer, so “CRC” should be changed to “rectal cancer.”
Please review this paper.
user
Title: The effect of cardiovascular disease on the perioperative period of radical surgery in
elderly rectal cancer
Version: 1 Date: 17 Feb 2024
Reviewer's report:
In this paper, the authors discuss the affection of comorbidity for postoperative complication
of elderly patients with rectal cancer. The main contribution of the paper seems to be that the
authors show elderly rectal cancer patients with cardiovascular disease are more likely to develop
severe complications after radical surgery. I recommend that this paper would be accepted after
revision as follows.
Major comments
The good points of this study are that the purpose of the analysis is straightforward and the
conclusions are clear.
It is easy to imagine that patients with cardiovascular comorbidities have a higher risk of
developing perioperative complications, which has been well demonstrated in previous studies.
In this sense, it lacks novelty. Therefore, we propose the following revisions.
First, before this analysis, factors that are likely to cause postoperative complications should
be extracted in the cohort before the main analysis by PSM, and cardiovascular comorbidities
should be included among them. The authors should focus on cardiovascular comorbidity after
examining the difference in odds ratios compared to other factors.
In the case of rectal cancer patients under 75 years of age (younger age), how much of an impact
cardiovascular comorbidity has on the development of complications should also be mentioned;
if there is no difference between patients under 75 years of age and those over 75 years of age,
the analysis of this study would be not meaningful. The difference odds ratios between young
patients and elderly patients should still be shown.
Cardiovascular comorbidities also vary in type and severity, including hypertension,
arrhythmias, ischemic heart disease, and thrombosis, and so on, as mentioned in the manuscript.
Clinical question what we really want to know is whether or not there is difference risks among
the cardiovascular comorbidities. Therefore, additional analysis of the risk of complications for
each type of cardiovascular comorbidity is needed.
Minor comments
Title: The authors focused on rectal cancer, so “CRC” should be changed to “rectal cancer.”
assistant