Title: Risk factors and predictive nomograms for early death of patients with advanced
hepatocellular carcinoma: a large retrospective study based on the SEER database
Version: 3 Date: 08 Apr 2022
Reviewer's report:
In this paper, Zhang and colleagues established a nomogram to predict the survival probability of
early death in patients with advanced HCC using SEER database. The authors concluded that the
nomograms are helpful to identify risk factors for the early death of patients with advanced HCC.
The topic is very interesting. However, while most of the statistical analyses were performed
nicely, the logistic regression model is not appropriate to construct a nomogram compared to
Cox model.  Also, the abstract, method and result section needs more attention to detail. The
method section is not sufficiently addressed to follow.
I would further like to address the following concerns regarding the manuscript:
Abstract:
• I think it would be better to write concisely and report more information with statistics in the
result section (e.g. risk factors with OR, 95% CI) and ROC with 95 CI
Method:
• Lack of information to follow
• How were IVA and IVB defined? Add brief descriptions of definitions.
• What is the follow-up for vital status? When is the study cutoff date?
• How were AFP, fibrosis scores, and stage,…. defined?
• Survival time should be defined clearly.
• Sensitivity analysis. Are the author’s findings robust when survivors were excluded (early
death versus deaths)?
• Nomogram construction would be better in the method section.
Statistical analysis:
• Need to write more clearly. E.g., lines 127-128
• Survival time is available. Why did the author a logistic regression model instead of Cox
proportional hazard multivariable regression?
• The sample size is large enough to run external validation. Why did the authors only internal
validation?
• A thought: survival patterns would give a lot of information about early deaths.
• It would be better to explain how the calibration curves were created and how to interpret them.
• Univariate and multivariate need to be replaced by univariable and multivariable.
Result:
• The result section is confusing and lacks information to follow. Needs more attention to detail.
• Report ORs of risk factor
• Report the significant variables with specific scores in the nomogram. Figures would not be
enough.
Discussion:
• I think the discussion should focus on early deaths of HCC patients since this is the novelty
here. Also, describe the differences between the author’s nomograms of early deaths and the
published nomograms of survival probability of patients with HCC.
Title: Risk factors and predictive nomograms for early death of patients with advanced
hepatocellular carcinoma: a large retrospective study based on the SEER database
Version: 3 Date: 08 Apr 2022
Reviewer's report:
In this paper, Zhang and colleagues established a nomogram to predict the survival probability of
early death in patients with advanced HCC using SEER database. The authors concluded that the
nomograms are helpful to identify risk factors for the early death of patients with advanced HCC.
The topic is very interesting. However, while most of the statistical analyses were performed
nicely, the logistic regression model is not appropriate to construct a nomogram compared to
Cox model.  Also, the abstract, method and result section needs more attention to detail. The
method section is not sufficiently addressed to follow.
I would further like to address the following concerns regarding the manuscript:
Abstract:
• I think it would be better to write concisely and report more information with statistics in the
result section (e.g. risk factors with OR, 95% CI) and ROC with 95 CI
Method:
• Lack of information to follow
• How were IVA and IVB defined? Add brief descriptions of definitions.
• What is the follow-up for vital status? When is the study cutoff date?
• How were AFP, fibrosis scores, and stage,…. defined?
• Survival time should be defined clearly.
• Sensitivity analysis. Are the author’s findings robust when survivors were excluded (early
death versus deaths)?
• Nomogram construction would be better in the method section.
Statistical analysis:
• Need to write more clearly. E.g., lines 127-128
• Survival time is available. Why did the author a logistic regression model instead of Cox
proportional hazard multivariable regression?
• The sample size is large enough to run external validation. Why did the authors only internal
validation?
• A thought: survival patterns would give a lot of information about early deaths.
• It would be better to explain how the calibration curves were created and how to interpret them.
• Univariate and multivariate need to be replaced by univariable and multivariable.
Result:
• The result section is confusing and lacks information to follow. Needs more attention to detail.
• Report ORs of risk factor
• Report the significant variables with specific scores in the nomogram. Figures would not be
enough.
Discussion:
• I think the discussion should focus on early deaths of HCC patients since this is the novelty
here. Also, describe the differences between the author’s nomograms of early deaths and the
published nomograms of survival probability of patients with HCC.
Please review this paper.
user
Title: Risk factors and predictive nomograms for early death of patients with advanced
hepatocellular carcinoma: a large retrospective study based on the SEER database
Version: 3 Date: 08 Apr 2022
Reviewer's report:
In this paper, Zhang and colleagues established a nomogram to predict the survival probability of
early death in patients with advanced HCC using SEER database. The authors concluded that the
nomograms are helpful to identify risk factors for the early death of patients with advanced HCC.
The topic is very interesting. However, while most of the statistical analyses were performed
nicely, the logistic regression model is not appropriate to construct a nomogram compared to
Cox model.  Also, the abstract, method and result section needs more attention to detail. The
method section is not sufficiently addressed to follow.
I would further like to address the following concerns regarding the manuscript:
Abstract:
• I think it would be better to write concisely and report more information with statistics in the
result section (e.g. risk factors with OR, 95% CI) and ROC with 95 CI
Method:
• Lack of information to follow
• How were IVA and IVB defined? Add brief descriptions of definitions.
• What is the follow-up for vital status? When is the study cutoff date?
• How were AFP, fibrosis scores, and stage,…. defined?
• Survival time should be defined clearly.
• Sensitivity analysis. Are the author’s findings robust when survivors were excluded (early
death versus deaths)?
• Nomogram construction would be better in the method section.
Statistical analysis:
• Need to write more clearly. E.g., lines 127-128
• Survival time is available. Why did the author a logistic regression model instead of Cox
proportional hazard multivariable regression?
• The sample size is large enough to run external validation. Why did the authors only internal
validation?
• A thought: survival patterns would give a lot of information about early deaths.
• It would be better to explain how the calibration curves were created and how to interpret them.
• Univariate and multivariate need to be replaced by univariable and multivariable.
Result:
• The result section is confusing and lacks information to follow. Needs more attention to detail.
• Report ORs of risk factor
• Report the significant variables with specific scores in the nomogram. Figures would not be
enough.
Discussion:
• I think the discussion should focus on early deaths of HCC patients since this is the novelty
here. Also, describe the differences between the author’s nomograms of early deaths and the
published nomograms of survival probability of patients with HCC.
assistant