Title: The Value of Systemic Inflammatory Response Index in Evaluating the Prognosis of
Postoperative Patients with Stage II Colon Cancer
Version: 2 Date: 12 May 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
1. Insufficient Control for Confounding Factors
There is no multivariate analysis to adjust for potential confounders (e.g., comorbidities,
nutritional status, exact chemotherapy compliance), which may independently affect prognosis.
Lack of stratification or sensitivity analysis based on high-risk features within stage II (e.g., T4
tumors, perforation, lymphovascular invasion).
2. Definition of Prognostic Groups
The classification of prognosis based solely on 3-year DFS without a detailed follow-up strategy
or verification methodology raises concerns about misclassification bias.
It is unclear whether all deaths were cancer-related or not (cause-specific mortality not
addressed).
3. Incomplete Justification and Discussion of SIRI
While SIRI is the focus, comparison with established inflammatory markers (e.g., PLR, LMR)
is limited.
Mechanistic discussion about how SIRI biologically links to tumor progression in colon cancer
is somewhat superficial and not supported by experimental data.
The cut-off value for high vs. low SIRI is not clearly stated or justified statistically (e.g., using
the ROC-derived Youden index).
4. Data Presentation Gaps
Tables and figures are missing, especially:
ROC curves with AUC values for all biomarkers.
Kaplan-Meier survival curves comparing SIRI groups.
The statistical section mentions ROC and AUC but does not present actual values for CEA,
CA19-9, NLR, etc., for comparison.
5. Language and Clarity
The manuscript contains grammatical issues and awkward phrasing, which can hinder
comprehension.
Redundancies exist in the background and discussion sections, making the narrative less concise.
The introduction lacks a clear research gap to emphasize the novelty of SIRI in stage II colon
cancer.
6. Ethics and Consent
Although informed consent was waived, the authors should mention how data confidentiality
was protected.
The approval number is cited, but it would be more transparent to specify that the waiver applied
to retrospective analysis only.
Title: The Value of Systemic Inflammatory Response Index in Evaluating the Prognosis of
Postoperative Patients with Stage II Colon Cancer
Version: 2 Date: 12 May 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
1. Insufficient Control for Confounding Factors
There is no multivariate analysis to adjust for potential confounders (e.g., comorbidities,
nutritional status, exact chemotherapy compliance), which may independently affect prognosis.
Lack of stratification or sensitivity analysis based on high-risk features within stage II (e.g., T4
tumors, perforation, lymphovascular invasion).
2. Definition of Prognostic Groups
The classification of prognosis based solely on 3-year DFS without a detailed follow-up strategy
or verification methodology raises concerns about misclassification bias.
It is unclear whether all deaths were cancer-related or not (cause-specific mortality not
addressed).
3. Incomplete Justification and Discussion of SIRI
While SIRI is the focus, comparison with established inflammatory markers (e.g., PLR, LMR)
is limited.
Mechanistic discussion about how SIRI biologically links to tumor progression in colon cancer
is somewhat superficial and not supported by experimental data.
The cut-off value for high vs. low SIRI is not clearly stated or justified statistically (e.g., using
the ROC-derived Youden index).
4. Data Presentation Gaps
Tables and figures are missing, especially:
ROC curves with AUC values for all biomarkers.
Kaplan-Meier survival curves comparing SIRI groups.
The statistical section mentions ROC and AUC but does not present actual values for CEA,
CA19-9, NLR, etc., for comparison.
5. Language and Clarity
The manuscript contains grammatical issues and awkward phrasing, which can hinder
comprehension.
Redundancies exist in the background and discussion sections, making the narrative less concise.
The introduction lacks a clear research gap to emphasize the novelty of SIRI in stage II colon
cancer.
6. Ethics and Consent
Although informed consent was waived, the authors should mention how data confidentiality
was protected.
The approval number is cited, but it would be more transparent to specify that the waiver applied
to retrospective analysis only.
Please review this paper.
user
Title: The Value of Systemic Inflammatory Response Index in Evaluating the Prognosis of
Postoperative Patients with Stage II Colon Cancer
Version: 2 Date: 12 May 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
1. Insufficient Control for Confounding Factors
There is no multivariate analysis to adjust for potential confounders (e.g., comorbidities,
nutritional status, exact chemotherapy compliance), which may independently affect prognosis.
Lack of stratification or sensitivity analysis based on high-risk features within stage II (e.g., T4
tumors, perforation, lymphovascular invasion).
2. Definition of Prognostic Groups
The classification of prognosis based solely on 3-year DFS without a detailed follow-up strategy
or verification methodology raises concerns about misclassification bias.
It is unclear whether all deaths were cancer-related or not (cause-specific mortality not
addressed).
3. Incomplete Justification and Discussion of SIRI
While SIRI is the focus, comparison with established inflammatory markers (e.g., PLR, LMR)
is limited.
Mechanistic discussion about how SIRI biologically links to tumor progression in colon cancer
is somewhat superficial and not supported by experimental data.
The cut-off value for high vs. low SIRI is not clearly stated or justified statistically (e.g., using
the ROC-derived Youden index).
4. Data Presentation Gaps
Tables and figures are missing, especially:
ROC curves with AUC values for all biomarkers.
Kaplan-Meier survival curves comparing SIRI groups.
The statistical section mentions ROC and AUC but does not present actual values for CEA,
CA19-9, NLR, etc., for comparison.
5. Language and Clarity
The manuscript contains grammatical issues and awkward phrasing, which can hinder
comprehension.
Redundancies exist in the background and discussion sections, making the narrative less concise.
The introduction lacks a clear research gap to emphasize the novelty of SIRI in stage II colon
cancer.
6. Ethics and Consent
Although informed consent was waived, the authors should mention how data confidentiality
was protected.
The approval number is cited, but it would be more transparent to specify that the waiver applied
to retrospective analysis only.
assistant