Title: Features on Contrast-Enhanced Computed Tomography for Predicting Recurrent
Esophageal Variceal Bleeding in Patients with Hepatocellular Carcinoma
Version: 3 Date: 20 Apr 2025
Reviewer's report:
This study is about the prediction of rebleeding of esophageal varices by Contrast-enhanced
computed tomography.
Although the results from the present study are interested me very much, I would like to make
the following comments because there are some concerns which should be reconsidered and
revised.
Major Revisions
1. The presence or absence of additional treatment (elective treatment) is extremely important in
analyzing long-term outcomes, especially variceal rebleeding. following endoscopic hemostasis
of esophageal variceal bleeding. In actual clinical practice, there are few cases that end with
emergency hemostasis alone, and in many cases, the indication and necessity of additional
treatment might be determined based on the prognosis predicted by each scoring system at the
time of esophageal variceal bleeding or after the hemostatic treatment. Detailed information on
additional treatment and additional analysis using this information should be presented.
2. The bleeding risk of esophageal varices is the red color (RC) sign on endoscopy.
However, RC sign during endoscopic treatment was not evaluated in this study.
3. The presence of gastric varices and para-esophageal veins should be considered.
4. Consider the staging of hepatocellular carcinoma between the two groups.
5. The effect of antiplatelet and anticoagulant drugs on rebleeding should be examined in portal
vein thrombosis.
Minor Revisions
none
Title: Features on Contrast-Enhanced Computed Tomography for Predicting Recurrent
Esophageal Variceal Bleeding in Patients with Hepatocellular Carcinoma
Version: 3 Date: 20 Apr 2025
Reviewer's report:
This study is about the prediction of rebleeding of esophageal varices by Contrast-enhanced
computed tomography.
Although the results from the present study are interested me very much, I would like to make
the following comments because there are some concerns which should be reconsidered and
revised.
Major Revisions
1. The presence or absence of additional treatment (elective treatment) is extremely important in
analyzing long-term outcomes, especially variceal rebleeding. following endoscopic hemostasis
of esophageal variceal bleeding. In actual clinical practice, there are few cases that end with
emergency hemostasis alone, and in many cases, the indication and necessity of additional
treatment might be determined based on the prognosis predicted by each scoring system at the
time of esophageal variceal bleeding or after the hemostatic treatment. Detailed information on
additional treatment and additional analysis using this information should be presented.
2. The bleeding risk of esophageal varices is the red color (RC) sign on endoscopy.
However, RC sign during endoscopic treatment was not evaluated in this study.
3. The presence of gastric varices and para-esophageal veins should be considered.
4. Consider the staging of hepatocellular carcinoma between the two groups.
5. The effect of antiplatelet and anticoagulant drugs on rebleeding should be examined in portal
vein thrombosis.
Minor Revisions
none
Please review this paper.
user
Title: Features on Contrast-Enhanced Computed Tomography for Predicting Recurrent
Esophageal Variceal Bleeding in Patients with Hepatocellular Carcinoma
Version: 3 Date: 20 Apr 2025
Reviewer's report:
This study is about the prediction of rebleeding of esophageal varices by Contrast-enhanced
computed tomography.
Although the results from the present study are interested me very much, I would like to make
the following comments because there are some concerns which should be reconsidered and
revised.
Major Revisions
1. The presence or absence of additional treatment (elective treatment) is extremely important in
analyzing long-term outcomes, especially variceal rebleeding. following endoscopic hemostasis
of esophageal variceal bleeding. In actual clinical practice, there are few cases that end with
emergency hemostasis alone, and in many cases, the indication and necessity of additional
treatment might be determined based on the prognosis predicted by each scoring system at the
time of esophageal variceal bleeding or after the hemostatic treatment. Detailed information on
additional treatment and additional analysis using this information should be presented.
2. The bleeding risk of esophageal varices is the red color (RC) sign on endoscopy.
However, RC sign during endoscopic treatment was not evaluated in this study.
3. The presence of gastric varices and para-esophageal veins should be considered.
4. Consider the staging of hepatocellular carcinoma between the two groups.
5. The effect of antiplatelet and anticoagulant drugs on rebleeding should be examined in portal
vein thrombosis.
Minor Revisions
none
assistant