Title: Title: Risk factors for long-term survival in patients with ypN+M0 rectal cancer after
radical anterior resection
Version: 1 Date: 15 Oct 2021
Reviewer's report:
Thank you for the opportunity to review your manuscript. I understood this is the single-center
retrospective analysis to identify the risk factor for OS, DFS, and DSS in pN+M0 rectal cancer
patients. You concluded that ACEI had a negative and NLN had a positive effect on the long-
term outcome in the above-mentioned cohort. Several comments are listed below.
• I understood that reports on the risk factor of long-term survival in the group ypN+ are not
consistent; however, what are the real question and unsolved problems in clinical practice?
Clinically, what is troubling you that it is not evident and what would be helpful if it were
evident? You should clarify more about the motivation and purpose of this study in the
background section.
• The main concept of this study is unclear. Do you want to clarify the relationship between
ACEI and long-term results? Or do you want to prove the superiority of the proposed lymph
node-related index (e.g., LNR, LODDS, NLN, etc.) compared to the existing N staging of TNM
classification? What subject do you want to clarify, OS, DFS, or DSS? The sample size is too
small if you want to comprehensively analyze everything including the above. The main theme
of this study should be narrowed down, simplified, and focused on more. Besides, the sub-theme
should be transferred to supplementary tables and figures. Otherwise, your message through this
study will be difficult to convey to readers.
• The tables are needed to explain the contents of the first and second paragraphs of the result.
It is not efficient to extract information from the text alone.
• The results of single-factor analysis and multiple factor analysis should be integrated and
shown in the same table.
• Although several results were extracted and shown as Kaplan-Meier curve in Figures 2 and 3,
the number of graphs was too many and it doesn't tell the reader what the main result is. Besides,
I don't see the clinical significance of creating multiple graphs by changing the cutoff value. The
cutoff value itself is meaningless because if the patient cohort changes the value will also change.
• You should summarize the results of this study using the first paragraph of the discussion
section.
• If you want to conclude that ACEI is significantly related to the prognosis of pN+ rectal cancer,
the mechanism needs to be discussed more deeply.
Title: Title: Risk factors for long-term survival in patients with ypN+M0 rectal cancer after
radical anterior resection
Version: 1 Date: 15 Oct 2021
Reviewer's report:
Thank you for the opportunity to review your manuscript. I understood this is the single-center
retrospective analysis to identify the risk factor for OS, DFS, and DSS in pN+M0 rectal cancer
patients. You concluded that ACEI had a negative and NLN had a positive effect on the long-
term outcome in the above-mentioned cohort. Several comments are listed below.
• I understood that reports on the risk factor of long-term survival in the group ypN+ are not
consistent; however, what are the real question and unsolved problems in clinical practice?
Clinically, what is troubling you that it is not evident and what would be helpful if it were
evident? You should clarify more about the motivation and purpose of this study in the
background section.
• The main concept of this study is unclear. Do you want to clarify the relationship between
ACEI and long-term results? Or do you want to prove the superiority of the proposed lymph
node-related index (e.g., LNR, LODDS, NLN, etc.) compared to the existing N staging of TNM
classification? What subject do you want to clarify, OS, DFS, or DSS? The sample size is too
small if you want to comprehensively analyze everything including the above. The main theme
of this study should be narrowed down, simplified, and focused on more. Besides, the sub-theme
should be transferred to supplementary tables and figures. Otherwise, your message through this
study will be difficult to convey to readers.
• The tables are needed to explain the contents of the first and second paragraphs of the result.
It is not efficient to extract information from the text alone.
• The results of single-factor analysis and multiple factor analysis should be integrated and
shown in the same table.
• Although several results were extracted and shown as Kaplan-Meier curve in Figures 2 and 3,
the number of graphs was too many and it doesn't tell the reader what the main result is. Besides,
I don't see the clinical significance of creating multiple graphs by changing the cutoff value. The
cutoff value itself is meaningless because if the patient cohort changes the value will also change.
• You should summarize the results of this study using the first paragraph of the discussion
section.
• If you want to conclude that ACEI is significantly related to the prognosis of pN+ rectal cancer,
the mechanism needs to be discussed more deeply.
Please review this paper.
user
Title: Title: Risk factors for long-term survival in patients with ypN+M0 rectal cancer after
radical anterior resection
Version: 1 Date: 15 Oct 2021
Reviewer's report:
Thank you for the opportunity to review your manuscript. I understood this is the single-center
retrospective analysis to identify the risk factor for OS, DFS, and DSS in pN+M0 rectal cancer
patients. You concluded that ACEI had a negative and NLN had a positive effect on the long-
term outcome in the above-mentioned cohort. Several comments are listed below.
• I understood that reports on the risk factor of long-term survival in the group ypN+ are not
consistent; however, what are the real question and unsolved problems in clinical practice?
Clinically, what is troubling you that it is not evident and what would be helpful if it were
evident? You should clarify more about the motivation and purpose of this study in the
background section.
• The main concept of this study is unclear. Do you want to clarify the relationship between
ACEI and long-term results? Or do you want to prove the superiority of the proposed lymph
node-related index (e.g., LNR, LODDS, NLN, etc.) compared to the existing N staging of TNM
classification? What subject do you want to clarify, OS, DFS, or DSS? The sample size is too
small if you want to comprehensively analyze everything including the above. The main theme
of this study should be narrowed down, simplified, and focused on more. Besides, the sub-theme
should be transferred to supplementary tables and figures. Otherwise, your message through this
study will be difficult to convey to readers.
• The tables are needed to explain the contents of the first and second paragraphs of the result.
It is not efficient to extract information from the text alone.
• The results of single-factor analysis and multiple factor analysis should be integrated and
shown in the same table.
• Although several results were extracted and shown as Kaplan-Meier curve in Figures 2 and 3,
the number of graphs was too many and it doesn't tell the reader what the main result is. Besides,
I don't see the clinical significance of creating multiple graphs by changing the cutoff value. The
cutoff value itself is meaningless because if the patient cohort changes the value will also change.
• You should summarize the results of this study using the first paragraph of the discussion
section.
• If you want to conclude that ACEI is significantly related to the prognosis of pN+ rectal cancer,
the mechanism needs to be discussed more deeply.
assistant