Reviewer’s report
Title: 
Impacts of neoadjuvant therapy on the number of dissected lymph nodes
in esophagogastric junction cancer patients
Version: 
0 
Date: 
06 Nov 2022
Reviewer's report:
The manuscript entitled "Preoperative radiotherapy decreased the number of
resected lymph nodes in patients with esophagogastric junction cancer"
submitted by the authors demonstrated that preoperative radiotherapy decreased
the number of resected LNs and recommended a minimum number of 10 nodes
resected in EGC patients through the analysis of the SEER Database. This study
included patients who received preoperative radiotherapy, however, it should be
taken into account that whether preoperative chemotherapy was allowed because
preoperative chemoradiation was the standard treatment for patients with stage
of cT2N0 (high-risk lesions: Lymphovascular invasion, ≥3 cm, poorly
differentiated), cT1b-cT2N+ or cT3-cT4a with Any N. In esophageal cancer,
reports showed that preoperative chemoradiation therapy decreases the number
of lymph nodes resected during esophagectomy [Issaka A, etal. World J Surg.
2015;39(3):721-6.], but the optimum number of nodes after preoperative
chemoradiation is unknown. Therefore, it will be more meaningful to study the
number of resected lymph nodes in patients receiving preoperative
chemoradiation than patients receiving preoperative radiotherapy. 
The manuscript also has many limitations. During process of the univariable and
multivariable analyses, patients were divided into 3 groups based on the number
of LNs resected (1-8, 9-13, and >19), while the optimal cutoff value for the
number of resected LNs was determined to be 10 according to the X-tile
software in this manuscript. Authors should pay more attention to studying the
role of the cut-off value of 10 LNs in patients receiving preoperative therapy.
The discussion is poorly organized, and authors should say more about the
limitations of this study in the discussion section, such as the radiotherapy
techniques, radiation dose and etc. Regarding the readability, the language of
this manuscript is distracting and the authors should improve the writing of paper
and restructure the paper.
Publons Reviewer Recognition
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registered for such service or help editors to identify candidate reviewers. Please
find the details of processing in Publons’ privacy policy
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No
Declaration of competing interests
Please complete a declaration of competing
interests, considering the following questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
I declare that I have no competing interests
Reviewer Publication Consent.
 I agree for my report to be made available
under an Open Access Creative Commons CC-BY License (
http://creativecommons.org/licenses/by/4.0
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the
editorial office before completing the review.
If you wish, you can include your
name in your published report. Please note you must decide whether to include
your name at the start of the process and confirm this decision whenever
prompted. If you change your decision later, we will not be able to publish your
name.
I agree to the terms of the CC-BY 4.0 license; please 
do not
 publish my name
with my report. (default)
Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
No
Are the methods sufficiently described to allow the study to be repeated?
No
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
No
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes
Reviewer’s report
Title: 
Impacts of neoadjuvant therapy on the number of dissected lymph nodes
in esophagogastric junction cancer patients
Version: 
0 
Date: 
06 Nov 2022
Reviewer's report:
The manuscript entitled "Preoperative radiotherapy decreased the number of
resected lymph nodes in patients with esophagogastric junction cancer"
submitted by the authors demonstrated that preoperative radiotherapy decreased
the number of resected LNs and recommended a minimum number of 10 nodes
resected in EGC patients through the analysis of the SEER Database. This study
included patients who received preoperative radiotherapy, however, it should be
taken into account that whether preoperative chemotherapy was allowed because
preoperative chemoradiation was the standard treatment for patients with stage
of cT2N0 (high-risk lesions: Lymphovascular invasion, ≥3 cm, poorly
differentiated), cT1b-cT2N+ or cT3-cT4a with Any N. In esophageal cancer,
reports showed that preoperative chemoradiation therapy decreases the number
of lymph nodes resected during esophagectomy [Issaka A, etal. World J Surg.
2015;39(3):721-6.], but the optimum number of nodes after preoperative
chemoradiation is unknown. Therefore, it will be more meaningful to study the
number of resected lymph nodes in patients receiving preoperative
chemoradiation than patients receiving preoperative radiotherapy. 
The manuscript also has many limitations. During process of the univariable and
multivariable analyses, patients were divided into 3 groups based on the number
of LNs resected (1-8, 9-13, and >19), while the optimal cutoff value for the
number of resected LNs was determined to be 10 according to the X-tile
software in this manuscript. Authors should pay more attention to studying the
role of the cut-off value of 10 LNs in patients receiving preoperative therapy.
The discussion is poorly organized, and authors should say more about the
limitations of this study in the discussion section, such as the radiotherapy
techniques, radiation dose and etc. Regarding the readability, the language of
this manuscript is distracting and the authors should improve the writing of paper
and restructure the paper.
Publons Reviewer Recognition
. Springer Nature can send verification of this
review directly to Publons (a subsidiary of Clarivate Analytics). If you would
like to take advantage of this service, please click on the “Yes” option below.
Your name, email address, title of the reviewed manuscript, name of the journal,
and date of your review submission (the “Review Data”) will then be transmitted
to Publons after the final decision on the manuscript has been made. If you have
already registered at Publons, they will notify you of the receipt of this review
and update your profile 
as per your settings and their policy. If you are not
registered with Publons, you will receive an email from them asking you to
register in order for them to be able to recognize your review on your new
profile page. Publons may use the Review Data to generate derivative metadata
for the benefit of Publons and you as a reviewer, carefully considering the
sensitivity of such information. For example, Publons may verify your record as
a reviewer by updating your profile published on its webservice if you have
registered for such service or help editors to identify candidate reviewers. Please
find the details of processing in Publons’ privacy policy
https://publons.com/about/terms
No
Declaration of competing interests
Please complete a declaration of competing
interests, considering the following questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
I declare that I have no competing interests
Reviewer Publication Consent.
 I agree for my report to be made available
under an Open Access Creative Commons CC-BY License (
http://creativecommons.org/licenses/by/4.0
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the
editorial office before completing the review.
If you wish, you can include your
name in your published report. Please note you must decide whether to include
your name at the start of the process and confirm this decision whenever
prompted. If you change your decision later, we will not be able to publish your
name.
I agree to the terms of the CC-BY 4.0 license; please 
do not
 publish my name
with my report. (default)
Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
No
Are the methods sufficiently described to allow the study to be repeated?
No
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
No
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes
Please review this paper.
user
Reviewer’s report
Title: 
Impacts of neoadjuvant therapy on the number of dissected lymph nodes
in esophagogastric junction cancer patients
Version: 
0 
Date: 
06 Nov 2022
Reviewer's report:
The manuscript entitled "Preoperative radiotherapy decreased the number of
resected lymph nodes in patients with esophagogastric junction cancer"
submitted by the authors demonstrated that preoperative radiotherapy decreased
the number of resected LNs and recommended a minimum number of 10 nodes
resected in EGC patients through the analysis of the SEER Database. This study
included patients who received preoperative radiotherapy, however, it should be
taken into account that whether preoperative chemotherapy was allowed because
preoperative chemoradiation was the standard treatment for patients with stage
of cT2N0 (high-risk lesions: Lymphovascular invasion, ≥3 cm, poorly
differentiated), cT1b-cT2N+ or cT3-cT4a with Any N. In esophageal cancer,
reports showed that preoperative chemoradiation therapy decreases the number
of lymph nodes resected during esophagectomy [Issaka A, etal. World J Surg.
2015;39(3):721-6.], but the optimum number of nodes after preoperative
chemoradiation is unknown. Therefore, it will be more meaningful to study the
number of resected lymph nodes in patients receiving preoperative
chemoradiation than patients receiving preoperative radiotherapy. 
The manuscript also has many limitations. During process of the univariable and
multivariable analyses, patients were divided into 3 groups based on the number
of LNs resected (1-8, 9-13, and >19), while the optimal cutoff value for the
number of resected LNs was determined to be 10 according to the X-tile
software in this manuscript. Authors should pay more attention to studying the
role of the cut-off value of 10 LNs in patients receiving preoperative therapy.
The discussion is poorly organized, and authors should say more about the
limitations of this study in the discussion section, such as the radiotherapy
techniques, radiation dose and etc. Regarding the readability, the language of
this manuscript is distracting and the authors should improve the writing of paper
and restructure the paper.
Publons Reviewer Recognition
. Springer Nature can send verification of this
review directly to Publons (a subsidiary of Clarivate Analytics). If you would
like to take advantage of this service, please click on the “Yes” option below.
Your name, email address, title of the reviewed manuscript, name of the journal,
and date of your review submission (the “Review Data”) will then be transmitted
to Publons after the final decision on the manuscript has been made. If you have
already registered at Publons, they will notify you of the receipt of this review
and update your profile 
as per your settings and their policy. If you are not
registered with Publons, you will receive an email from them asking you to
register in order for them to be able to recognize your review on your new
profile page. Publons may use the Review Data to generate derivative metadata
for the benefit of Publons and you as a reviewer, carefully considering the
sensitivity of such information. For example, Publons may verify your record as
a reviewer by updating your profile published on its webservice if you have
registered for such service or help editors to identify candidate reviewers. Please
find the details of processing in Publons’ privacy policy
https://publons.com/about/terms
No
Declaration of competing interests
Please complete a declaration of competing
interests, considering the following questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
I declare that I have no competing interests
Reviewer Publication Consent.
 I agree for my report to be made available
under an Open Access Creative Commons CC-BY License (
http://creativecommons.org/licenses/by/4.0
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the
editorial office before completing the review.
If you wish, you can include your
name in your published report. Please note you must decide whether to include
your name at the start of the process and confirm this decision whenever
prompted. If you change your decision later, we will not be able to publish your
name.
I agree to the terms of the CC-BY 4.0 license; please 
do not
 publish my name
with my report. (default)
Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
No
Are the methods sufficiently described to allow the study to be repeated?
No
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
No
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes
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