Title: Resection of the Primary Tumor Improves the Prognosis of Gastrointestinal
Neuroendocrine Neoplasms with liver metastases: Mutual Validation based on SEER Database
and Institutional Data
Version: 1 Date: 10 Oct 2023
Reviewer's report:
Yifang, et al. compared clinical outcomes between PTR and non-PTR groups using propensity
score-matching. They concluded that PTR plays a positive role in the treatment of GINET and
expands the potential applicability of PRT.
This manuscript is generally easy to follow, and the data shown could be potentially interesting.
However, the study suffers from major study design flaws. For acceptance, the authors should
improve the following points:
Major comments:
# It is common to set the standardized difference at #0.1 in PSM. However, the authors set the
standard at #0.3. I think the authors' setting is too optimistic, and the authors should not state
that balance is achieved in PSM. I believe that the authors should reanalyze with a standardized
difference of #0.1.
# The study periods of both cohorts should be matched. The authors retrieved patient data from
SEER between 2000 and 2019, while they retrieved patient data from their institution between
2011 and 2022. Evidence such as everolimus, lanreotide, PRRT, and surufatinib have led to
significant advances in the treatment of metastatic NETs since 2011, and they have improved
the outcomes of GINET patients. Kaplan-Meier curves of FAH cohort (Figure 2) showed better
prognosis compared with SEER cohort. These facts suggested that treatment outcomes after
resection of primary tumor were different between FAH and SEER cohort.
# The authors emphasized that this study focused on Asian population. However, the clinical
behavior of NET does not depend on ethnic difference, it depends on tumor origin, especially
for colorectal NET. Authors should mention this point
Minor comments:
# In the columns of Table 1, the description of N is out of place.
# I wonder why the authors defined the cutoff of age as 55 years, which is generally a young age
for metastatic NETs, and the SEER cohort shows it. Also, the authors state that the prognosis is
better in older patients, but 55 years is not old to begin with.
# Yoshida, Tsukasa => Yoshida (Page 23)
# Duplicate periods. (Page 3)
Title: Resection of the Primary Tumor Improves the Prognosis of Gastrointestinal
Neuroendocrine Neoplasms with liver metastases: Mutual Validation based on SEER Database
and Institutional Data
Version: 1 Date: 10 Oct 2023
Reviewer's report:
Yifang, et al. compared clinical outcomes between PTR and non-PTR groups using propensity
score-matching. They concluded that PTR plays a positive role in the treatment of GINET and
expands the potential applicability of PRT.
This manuscript is generally easy to follow, and the data shown could be potentially interesting.
However, the study suffers from major study design flaws. For acceptance, the authors should
improve the following points:
Major comments:
# It is common to set the standardized difference at #0.1 in PSM. However, the authors set the
standard at #0.3. I think the authors' setting is too optimistic, and the authors should not state
that balance is achieved in PSM. I believe that the authors should reanalyze with a standardized
difference of #0.1.
# The study periods of both cohorts should be matched. The authors retrieved patient data from
SEER between 2000 and 2019, while they retrieved patient data from their institution between
2011 and 2022. Evidence such as everolimus, lanreotide, PRRT, and surufatinib have led to
significant advances in the treatment of metastatic NETs since 2011, and they have improved
the outcomes of GINET patients. Kaplan-Meier curves of FAH cohort (Figure 2) showed better
prognosis compared with SEER cohort. These facts suggested that treatment outcomes after
resection of primary tumor were different between FAH and SEER cohort.
# The authors emphasized that this study focused on Asian population. However, the clinical
behavior of NET does not depend on ethnic difference, it depends on tumor origin, especially
for colorectal NET. Authors should mention this point
Minor comments:
# In the columns of Table 1, the description of N is out of place.
# I wonder why the authors defined the cutoff of age as 55 years, which is generally a young age
for metastatic NETs, and the SEER cohort shows it. Also, the authors state that the prognosis is
better in older patients, but 55 years is not old to begin with.
# Yoshida, Tsukasa => Yoshida (Page 23)
# Duplicate periods. (Page 3)
Please review this paper.
user
Title: Resection of the Primary Tumor Improves the Prognosis of Gastrointestinal
Neuroendocrine Neoplasms with liver metastases: Mutual Validation based on SEER Database
and Institutional Data
Version: 1 Date: 10 Oct 2023
Reviewer's report:
Yifang, et al. compared clinical outcomes between PTR and non-PTR groups using propensity
score-matching. They concluded that PTR plays a positive role in the treatment of GINET and
expands the potential applicability of PRT.
This manuscript is generally easy to follow, and the data shown could be potentially interesting.
However, the study suffers from major study design flaws. For acceptance, the authors should
improve the following points:
Major comments:
# It is common to set the standardized difference at #0.1 in PSM. However, the authors set the
standard at #0.3. I think the authors' setting is too optimistic, and the authors should not state
that balance is achieved in PSM. I believe that the authors should reanalyze with a standardized
difference of #0.1.
# The study periods of both cohorts should be matched. The authors retrieved patient data from
SEER between 2000 and 2019, while they retrieved patient data from their institution between
2011 and 2022. Evidence such as everolimus, lanreotide, PRRT, and surufatinib have led to
significant advances in the treatment of metastatic NETs since 2011, and they have improved
the outcomes of GINET patients. Kaplan-Meier curves of FAH cohort (Figure 2) showed better
prognosis compared with SEER cohort. These facts suggested that treatment outcomes after
resection of primary tumor were different between FAH and SEER cohort.
# The authors emphasized that this study focused on Asian population. However, the clinical
behavior of NET does not depend on ethnic difference, it depends on tumor origin, especially
for colorectal NET. Authors should mention this point
Minor comments:
# In the columns of Table 1, the description of N is out of place.
# I wonder why the authors defined the cutoff of age as 55 years, which is generally a young age
for metastatic NETs, and the SEER cohort shows it. Also, the authors state that the prognosis is
better in older patients, but 55 years is not old to begin with.
# Yoshida, Tsukasa => Yoshida (Page 23)
# Duplicate periods. (Page 3)
assistant