Title: Clinicopathological characteristics and prognosis of signet ring cell carcinoma of the
gallbladder
Version: 0 Date: 20 Apr 2021
Reviewer:  Feng Wei
Reviewer's report:
The authors described the clinicopathologic features and prognosis of SRC had potential clinical
value in gallbladder adenocarcinoma.
The design of the study is reasonable, however some of the details remain problematic. I have
more comments regarding the study.
1] In figure 1, 2,364 whose diagnosis confirmation # positive histology and 2,549 whose tumor
sequence number were excluded from the study. Why these patients are excluded and it needs
to be explained in the research method or discussion section at least.
2] Overall survival [OS] of SRC of gallbladder was showed in this study. Cancer-specific
survival [CSS] is another prognostic parameter and is a useful complement to OS. Can authors
add CSS data in this study?
3] In study, 22,781 gallbladder adenocarcinomas retrieved, 377 (1.7%) were SRC and the other
22,404 were non-SRC. The baseline of 377 SRC patients (e.g. age, sex, tumor size, etc.),
however, was different from the no-SRC. Selection bias  maybe occur in the study. propensity
score matching (PSM) can reduce the effect of selection bias in studies. Can authors add PSM
data in this study?
4] In tables 2 and 3, what do you mean“Reference ”? Please add its meaning selection bias is
prevalent in retrospective studies.
5] The SEER dataset does not cover many covariates, such as comorbidities, which would greatly
impact survival. This part should be discussed as source of bias in the discussion section.
6] Language needs polishing. Preferably use a professional editing service and provide a
certificate.
Title: Clinicopathological characteristics and prognosis of signet ring cell carcinoma of the
gallbladder
Version: 0 Date: 20 Apr 2021
Reviewer:  Feng Wei
Reviewer's report:
The authors described the clinicopathologic features and prognosis of SRC had potential clinical
value in gallbladder adenocarcinoma.
The design of the study is reasonable, however some of the details remain problematic. I have
more comments regarding the study.
1] In figure 1, 2,364 whose diagnosis confirmation # positive histology and 2,549 whose tumor
sequence number were excluded from the study. Why these patients are excluded and it needs
to be explained in the research method or discussion section at least.
2] Overall survival [OS] of SRC of gallbladder was showed in this study. Cancer-specific
survival [CSS] is another prognostic parameter and is a useful complement to OS. Can authors
add CSS data in this study?
3] In study, 22,781 gallbladder adenocarcinomas retrieved, 377 (1.7%) were SRC and the other
22,404 were non-SRC. The baseline of 377 SRC patients (e.g. age, sex, tumor size, etc.),
however, was different from the no-SRC. Selection bias  maybe occur in the study. propensity
score matching (PSM) can reduce the effect of selection bias in studies. Can authors add PSM
data in this study?
4] In tables 2 and 3, what do you mean“Reference ”? Please add its meaning selection bias is
prevalent in retrospective studies.
5] The SEER dataset does not cover many covariates, such as comorbidities, which would greatly
impact survival. This part should be discussed as source of bias in the discussion section.
6] Language needs polishing. Preferably use a professional editing service and provide a
certificate.
Please review this paper.
user
Title: Clinicopathological characteristics and prognosis of signet ring cell carcinoma of the
gallbladder
Version: 0 Date: 20 Apr 2021
Reviewer:  Feng Wei
Reviewer's report:
The authors described the clinicopathologic features and prognosis of SRC had potential clinical
value in gallbladder adenocarcinoma.
The design of the study is reasonable, however some of the details remain problematic. I have
more comments regarding the study.
1] In figure 1, 2,364 whose diagnosis confirmation # positive histology and 2,549 whose tumor
sequence number were excluded from the study. Why these patients are excluded and it needs
to be explained in the research method or discussion section at least.
2] Overall survival [OS] of SRC of gallbladder was showed in this study. Cancer-specific
survival [CSS] is another prognostic parameter and is a useful complement to OS. Can authors
add CSS data in this study?
3] In study, 22,781 gallbladder adenocarcinomas retrieved, 377 (1.7%) were SRC and the other
22,404 were non-SRC. The baseline of 377 SRC patients (e.g. age, sex, tumor size, etc.),
however, was different from the no-SRC. Selection bias  maybe occur in the study. propensity
score matching (PSM) can reduce the effect of selection bias in studies. Can authors add PSM
data in this study?
4] In tables 2 and 3, what do you mean“Reference ”? Please add its meaning selection bias is
prevalent in retrospective studies.
5] The SEER dataset does not cover many covariates, such as comorbidities, which would greatly
impact survival. This part should be discussed as source of bias in the discussion section.
6] Language needs polishing. Preferably use a professional editing service and provide a
certificate.
assistant