Title: Reduced muscle mass is an important part of Global Leadership Initiative on Malnutrition
criteria in nutritional diagnosis of hepatocellular carcinoma
Version: 2 Date: 03 Jul 2024
Reviewer:  Ramona S. S. B. Boulhosa
Reviewer's report:
This is a clinically relevant paper, with a clear objective, a well-described methodology, and
results that contribute to the understanding of the best nutritional indicators in the prediction
of clinical outcomes.  When reading the manuscript, I did not observe a discussion about the
fragility of the BMI and % of weight loss variables in this population, since 79% of those
evaluated had ascites. It is important to emphasize that, as this is a retrospective study, the
assessment of the degree of ascites is highly subjective and may be a bias in the estimation of
dry weight.
Finally, there is no information on how many of these patients had a previous diagnosis of
cirrhosis and its respective causes. The presence of a chronic liver alteration associated to HCC
may explain malnutrition and early mortality in these patients.
Title: Reduced muscle mass is an important part of Global Leadership Initiative on Malnutrition
criteria in nutritional diagnosis of hepatocellular carcinoma
Version: 2 Date: 03 Jul 2024
Reviewer:  Ramona S. S. B. Boulhosa
Reviewer's report:
This is a clinically relevant paper, with a clear objective, a well-described methodology, and
results that contribute to the understanding of the best nutritional indicators in the prediction
of clinical outcomes.  When reading the manuscript, I did not observe a discussion about the
fragility of the BMI and % of weight loss variables in this population, since 79% of those
evaluated had ascites. It is important to emphasize that, as this is a retrospective study, the
assessment of the degree of ascites is highly subjective and may be a bias in the estimation of
dry weight.
Finally, there is no information on how many of these patients had a previous diagnosis of
cirrhosis and its respective causes. The presence of a chronic liver alteration associated to HCC
may explain malnutrition and early mortality in these patients.
Please review this paper.
user
Title: Reduced muscle mass is an important part of Global Leadership Initiative on Malnutrition
criteria in nutritional diagnosis of hepatocellular carcinoma
Version: 2 Date: 03 Jul 2024
Reviewer:  Ramona S. S. B. Boulhosa
Reviewer's report:
This is a clinically relevant paper, with a clear objective, a well-described methodology, and
results that contribute to the understanding of the best nutritional indicators in the prediction
of clinical outcomes.  When reading the manuscript, I did not observe a discussion about the
fragility of the BMI and % of weight loss variables in this population, since 79% of those
evaluated had ascites. It is important to emphasize that, as this is a retrospective study, the
assessment of the degree of ascites is highly subjective and may be a bias in the estimation of
dry weight.
Finally, there is no information on how many of these patients had a previous diagnosis of
cirrhosis and its respective causes. The presence of a chronic liver alteration associated to HCC
may explain malnutrition and early mortality in these patients.
assistant