Title: Reduced muscle mass is an important part of Global Leadership Initiative on Malnutrition
criteria in nutritional diagnosis of hepatocellular carcinoma
Version: 3 Date: 09 Aug 2024
Reviewer's report:
Thanks to the authors for their response and clarifying the aim of the present study.
According to the authors, the main aim was to assess the clinical application of the GLIM criteria
with or without CT-determined reduced muscle mass in patients with HCC. I totally agree that
skeletal muscle mass has an indispensable role as a GLIM criterion and the importance of CT-
derived data for malnutrition diagnosis is immense, as this method represents the gold standard
and provides reliable results (also in patients with ascites). However, it makes little sense to
assess malnutrition without taking muscle mass into account. In my opinion, another method
(such as BIA or muscle performance which is also discussed) would have been an appropriate
control if the importance of CT scans was to be the focus. The results achieved in the present
manuscript are therefore kind of self-fulfilling.
I acknowledge that an additional paragraph on ascites was made. However, my concerns were
not taken into consideration in the revised version of the manuscript, not even as a limitation.
For this reason, unfortunately, I cannot see any improvement of the revised manuscript.
Title: Reduced muscle mass is an important part of Global Leadership Initiative on Malnutrition
criteria in nutritional diagnosis of hepatocellular carcinoma
Version: 3 Date: 09 Aug 2024
Reviewer's report:
Thanks to the authors for their response and clarifying the aim of the present study.
According to the authors, the main aim was to assess the clinical application of the GLIM criteria
with or without CT-determined reduced muscle mass in patients with HCC. I totally agree that
skeletal muscle mass has an indispensable role as a GLIM criterion and the importance of CT-
derived data for malnutrition diagnosis is immense, as this method represents the gold standard
and provides reliable results (also in patients with ascites). However, it makes little sense to
assess malnutrition without taking muscle mass into account. In my opinion, another method
(such as BIA or muscle performance which is also discussed) would have been an appropriate
control if the importance of CT scans was to be the focus. The results achieved in the present
manuscript are therefore kind of self-fulfilling.
I acknowledge that an additional paragraph on ascites was made. However, my concerns were
not taken into consideration in the revised version of the manuscript, not even as a limitation.
For this reason, unfortunately, I cannot see any improvement of the revised manuscript.
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: 3 Date: 09 Aug 2024
Reviewer's report:
Thanks to the authors for their response and clarifying the aim of the present study.
According to the authors, the main aim was to assess the clinical application of the GLIM criteria
with or without CT-determined reduced muscle mass in patients with HCC. I totally agree that
skeletal muscle mass has an indispensable role as a GLIM criterion and the importance of CT-
derived data for malnutrition diagnosis is immense, as this method represents the gold standard
and provides reliable results (also in patients with ascites). However, it makes little sense to
assess malnutrition without taking muscle mass into account. In my opinion, another method
(such as BIA or muscle performance which is also discussed) would have been an appropriate
control if the importance of CT scans was to be the focus. The results achieved in the present
manuscript are therefore kind of self-fulfilling.
I acknowledge that an additional paragraph on ascites was made. However, my concerns were
not taken into consideration in the revised version of the manuscript, not even as a limitation.
For this reason, unfortunately, I cannot see any improvement of the revised manuscript.
assistant