Reviewer's report
Title:Comparison of percutaneous radiofrequency thermal ablation and surgical
resection for small hepatocellular carcinoma
Version: 2Date:5 October 2011
Reviewer: Alfredo Guglielmi
Reviewer's report:
This is a retrospective analysis of 231 patients with small HCC treated by either
liver resection (SR) or percutaneous radiofrequency thermal ablation therapy
(PRFA).
The study addresses an important topic that is particularly relevant in the context
of the increasing incidence of viral hepatitis, cirrhosis and HCC. Several
retrospective study had been already published in this field and importantly three
RCT had been recently published.
Several criticism must be underline:
1. In the methods the two groups of patients have significant differences in
sample size.
The Authors had to specify the criteria to assign patients to the two different
treatments.
and why they excluded to PRFA 35 patients with chronic hepatitis and without
cirrhosis and included in the analysis three patients with Child Pugh C cirrhosis.
The Authors should revise the selection criteria for this study selecting more
precisely the two groups of patients .
2. In the methods the diagnosis of HCC should be done according to the
international guidelines.
Why they use the angiography, that is not recommended in all recent guidelines?
3. In the methods the assessment of complete necrosis after PRFA is made after
1 week. Several clinical and experimental studies demonstrated that this
assessment should be done after 4 weeks to avoid inflammatory perilesional
alterations that can alter the accuracy of CT evaluation. Why they do not apply
this recommendations ?
5. In the results survival and DFS should be reported also as median values. We
suggest performing, if possible, subgroup analysis according to the different
Child Pugh classes or the presence of LC.
6. In the DFS analysis the Authors should specify the local recurrence rate in the
two different groups
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Reviewer's report
Title:Comparison of percutaneous radiofrequency thermal ablation and surgical
resection for small hepatocellular carcinoma
Version: 2Date:5 October 2011
Reviewer: Alfredo Guglielmi
Reviewer's report:
This is a retrospective analysis of 231 patients with small HCC treated by either
liver resection (SR) or percutaneous radiofrequency thermal ablation therapy
(PRFA).
The study addresses an important topic that is particularly relevant in the context
of the increasing incidence of viral hepatitis, cirrhosis and HCC. Several
retrospective study had been already published in this field and importantly three
RCT had been recently published.
Several criticism must be underline:
1. In the methods the two groups of patients have significant differences in
sample size.
The Authors had to specify the criteria to assign patients to the two different
treatments.
and why they excluded to PRFA 35 patients with chronic hepatitis and without
cirrhosis and included in the analysis three patients with Child Pugh C cirrhosis.
The Authors should revise the selection criteria for this study selecting more
precisely the two groups of patients .
2. In the methods the diagnosis of HCC should be done according to the
international guidelines.
Why they use the angiography, that is not recommended in all recent guidelines?
3. In the methods the assessment of complete necrosis after PRFA is made after
1 week. Several clinical and experimental studies demonstrated that this
assessment should be done after 4 weeks to avoid inflammatory perilesional
alterations that can alter the accuracy of CT evaluation. Why they do not apply
this recommendations ?
5. In the results survival and DFS should be reported also as median values. We
suggest performing, if possible, subgroup analysis according to the different
Child Pugh classes or the presence of LC.
6. In the DFS analysis the Authors should specify the local recurrence rate in the
two different groups
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Please review this paper.
user
Reviewer's report
Title:Comparison of percutaneous radiofrequency thermal ablation and surgical
resection for small hepatocellular carcinoma
Version: 2Date:5 October 2011
Reviewer: Alfredo Guglielmi
Reviewer's report:
This is a retrospective analysis of 231 patients with small HCC treated by either
liver resection (SR) or percutaneous radiofrequency thermal ablation therapy
(PRFA).
The study addresses an important topic that is particularly relevant in the context
of the increasing incidence of viral hepatitis, cirrhosis and HCC. Several
retrospective study had been already published in this field and importantly three
RCT had been recently published.
Several criticism must be underline:
1. In the methods the two groups of patients have significant differences in
sample size.
The Authors had to specify the criteria to assign patients to the two different
treatments.
and why they excluded to PRFA 35 patients with chronic hepatitis and without
cirrhosis and included in the analysis three patients with Child Pugh C cirrhosis.
The Authors should revise the selection criteria for this study selecting more
precisely the two groups of patients .
2. In the methods the diagnosis of HCC should be done according to the
international guidelines.
Why they use the angiography, that is not recommended in all recent guidelines?
3. In the methods the assessment of complete necrosis after PRFA is made after
1 week. Several clinical and experimental studies demonstrated that this
assessment should be done after 4 weeks to avoid inflammatory perilesional
alterations that can alter the accuracy of CT evaluation. Why they do not apply
this recommendations ?
5. In the results survival and DFS should be reported also as median values. We
suggest performing, if possible, subgroup analysis according to the different
Child Pugh classes or the presence of LC.
6. In the DFS analysis the Authors should specify the local recurrence rate in the
two different groups
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
assistant