Title: Reduced muscle mass is an important part of Global Leadership Initiative on Malnutrition
criteria in nutritional diagnosis of hepatocellular carcinoma
Version: 3 Date: 12 Aug 2024
Reviewer's report:
This is a nice study evaluating the added value of incorporating muscle mass by CT scan in the
GLIM criteria in patients with HCC. The study successfully points out that reduced muscle mass
is an integral part of malnutrition assessment and should be used when possible.
Major remarks:
1. Contrary to the manuscript's statements, another study assessed GLIM criteria using CT
scan evaluation of L3-SMI  in patients with HCC. (Tan, S., Jiang, J., Qiu, L., Liang,
Y., Meng, J., Tan, N., & Xiang, B. (2024). Prevalence of Malnutrition in Patients with
Hepatocellular Carcinoma: A Comparative Study of GLIM Criteria, NRS2002, and PG-SGA,
and Identification of Independent Risk Factors. Nutrition and Cancer, 76(4), 335–344. https://
doi.org/10.1080/01635581.2024.2314317).
Please revise the statement and proceed to compare the results of these studies.
2. A practical comment regarding incorporating such measurements in clinical practice would
be most helpful. Can L3-SMI be evaluated retroactively in a CT scan used for the diagnosis
of HCC? Are there any special steps to be taken? Can this methodology be easily incorporated
into clinical practice?
Minor remarks:
Page 2, Introduction Line 7, can(c)er
Page 4, Lines 1 and 2: patients who were long-term bedridden, exclude diagnosed with
Title: Reduced muscle mass is an important part of Global Leadership Initiative on Malnutrition
criteria in nutritional diagnosis of hepatocellular carcinoma
Version: 3 Date: 12 Aug 2024
Reviewer's report:
This is a nice study evaluating the added value of incorporating muscle mass by CT scan in the
GLIM criteria in patients with HCC. The study successfully points out that reduced muscle mass
is an integral part of malnutrition assessment and should be used when possible.
Major remarks:
1. Contrary to the manuscript's statements, another study assessed GLIM criteria using CT
scan evaluation of L3-SMI  in patients with HCC. (Tan, S., Jiang, J., Qiu, L., Liang,
Y., Meng, J., Tan, N., & Xiang, B. (2024). Prevalence of Malnutrition in Patients with
Hepatocellular Carcinoma: A Comparative Study of GLIM Criteria, NRS2002, and PG-SGA,
and Identification of Independent Risk Factors. Nutrition and Cancer, 76(4), 335–344. https://
doi.org/10.1080/01635581.2024.2314317).
Please revise the statement and proceed to compare the results of these studies.
2. A practical comment regarding incorporating such measurements in clinical practice would
be most helpful. Can L3-SMI be evaluated retroactively in a CT scan used for the diagnosis
of HCC? Are there any special steps to be taken? Can this methodology be easily incorporated
into clinical practice?
Minor remarks:
Page 2, Introduction Line 7, can(c)er
Page 4, Lines 1 and 2: patients who were long-term bedridden, exclude diagnosed with
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: 12 Aug 2024
Reviewer's report:
This is a nice study evaluating the added value of incorporating muscle mass by CT scan in the
GLIM criteria in patients with HCC. The study successfully points out that reduced muscle mass
is an integral part of malnutrition assessment and should be used when possible.
Major remarks:
1. Contrary to the manuscript's statements, another study assessed GLIM criteria using CT
scan evaluation of L3-SMI  in patients with HCC. (Tan, S., Jiang, J., Qiu, L., Liang,
Y., Meng, J., Tan, N., & Xiang, B. (2024). Prevalence of Malnutrition in Patients with
Hepatocellular Carcinoma: A Comparative Study of GLIM Criteria, NRS2002, and PG-SGA,
and Identification of Independent Risk Factors. Nutrition and Cancer, 76(4), 335–344. https://
doi.org/10.1080/01635581.2024.2314317).
Please revise the statement and proceed to compare the results of these studies.
2. A practical comment regarding incorporating such measurements in clinical practice would
be most helpful. Can L3-SMI be evaluated retroactively in a CT scan used for the diagnosis
of HCC? Are there any special steps to be taken? Can this methodology be easily incorporated
into clinical practice?
Minor remarks:
Page 2, Introduction Line 7, can(c)er
Page 4, Lines 1 and 2: patients who were long-term bedridden, exclude diagnosed with
assistant