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: 5 Date: 07 Jun 2022
Reviewer's report:
I still have significant concerns regarding the appropriate methodology and language structure
of the manuscript. I believed that authors can write manuscripts more succinctly. The sentences
are a little too lengthy. The paper was padded out with many descriptions from statistical
methodology, causing the reader not to follow the main story.
Abstract.
Need to define early death and describe the demographic description of the study cohort.
For example, the author can write like
Of 6,602 study cohorts (mean age xx, xx male, xx white,.. ), xx% and xx% had stage IVA and
IVS, respectively.  On the multivariable analyses, xx, xx, xx, and xx were significantly associated
with early deaths. A nomogram comprising risk factors with the concordance indexes of 0.819
(95% CI: 0.798-0.840) in stage IVA and 0.785 (95% CI:0.764-0.0.806) stage IVB patient for
internal validation.
The author may report c-indexes from one method. Another method can be used as sensitivity
analysis
I do not agree with the author’s approach to using logistic regression. If event time is defined by
time from date to diagnosis to the date of death or to 3 months, whichever came first, the author
can run the cox model. Logistic regression could be acceptable but lost important information
about event time.
The most concern is to use a binary variable of age (aged >40). Aged 40 is not appropriate for
this data where more than 98% are older than 40 years. It means that their findings for risk factors
were not adjusted for the most important confounder, age. Also, the study the author referred
to utilized <40 years as inclusion criteria.
In discussion, the authors need to explain whether their risk factors are consistent with those
from other studies.
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: 5 Date: 07 Jun 2022
Reviewer's report:
I still have significant concerns regarding the appropriate methodology and language structure
of the manuscript. I believed that authors can write manuscripts more succinctly. The sentences
are a little too lengthy. The paper was padded out with many descriptions from statistical
methodology, causing the reader not to follow the main story.
Abstract.
Need to define early death and describe the demographic description of the study cohort.
For example, the author can write like
Of 6,602 study cohorts (mean age xx, xx male, xx white,.. ), xx% and xx% had stage IVA and
IVS, respectively.  On the multivariable analyses, xx, xx, xx, and xx were significantly associated
with early deaths. A nomogram comprising risk factors with the concordance indexes of 0.819
(95% CI: 0.798-0.840) in stage IVA and 0.785 (95% CI:0.764-0.0.806) stage IVB patient for
internal validation.
The author may report c-indexes from one method. Another method can be used as sensitivity
analysis
I do not agree with the author’s approach to using logistic regression. If event time is defined by
time from date to diagnosis to the date of death or to 3 months, whichever came first, the author
can run the cox model. Logistic regression could be acceptable but lost important information
about event time.
The most concern is to use a binary variable of age (aged >40). Aged 40 is not appropriate for
this data where more than 98% are older than 40 years. It means that their findings for risk factors
were not adjusted for the most important confounder, age. Also, the study the author referred
to utilized <40 years as inclusion criteria.
In discussion, the authors need to explain whether their risk factors are consistent with those
from other studies.
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: 5 Date: 07 Jun 2022
Reviewer's report:
I still have significant concerns regarding the appropriate methodology and language structure
of the manuscript. I believed that authors can write manuscripts more succinctly. The sentences
are a little too lengthy. The paper was padded out with many descriptions from statistical
methodology, causing the reader not to follow the main story.
Abstract.
Need to define early death and describe the demographic description of the study cohort.
For example, the author can write like
Of 6,602 study cohorts (mean age xx, xx male, xx white,.. ), xx% and xx% had stage IVA and
IVS, respectively.  On the multivariable analyses, xx, xx, xx, and xx were significantly associated
with early deaths. A nomogram comprising risk factors with the concordance indexes of 0.819
(95% CI: 0.798-0.840) in stage IVA and 0.785 (95% CI:0.764-0.0.806) stage IVB patient for
internal validation.
The author may report c-indexes from one method. Another method can be used as sensitivity
analysis
I do not agree with the author’s approach to using logistic regression. If event time is defined by
time from date to diagnosis to the date of death or to 3 months, whichever came first, the author
can run the cox model. Logistic regression could be acceptable but lost important information
about event time.
The most concern is to use a binary variable of age (aged >40). Aged 40 is not appropriate for
this data where more than 98% are older than 40 years. It means that their findings for risk factors
were not adjusted for the most important confounder, age. Also, the study the author referred
to utilized <40 years as inclusion criteria.
In discussion, the authors need to explain whether their risk factors are consistent with those
from other studies.
assistant