Title: The prognostic role of albumin-bilirubin grade in the mortality of extrahepatic
cholangiocarcinoma patients
Version: 0 Date: 09 Feb 2025
Reviewer's report:
Comments to the Author
The article titled " The prognostic role of albumin-bilirubin grade in the mortality of extrahepatic
cholangiocarcinoma patients"
This article is commendable and showcases strong writing skills. The authors merit
recognition for their contributions. Nevertheless, it is suggested that the subsequent notices/
recommendations enhance the caliber of this endeavor.
1. In the Abstract and the main text, the grade of ALBI score in grade 2 should be scaled from
lower to upper limit.  grade 2: #1.39 to #2.60 should change to > #2.60 to # #1.39.
2. In Abstract, the unit of laboratory results should be added to standardized reports (AST, WBC)
and recheck all abbreviated terms are defined the first time in abstract and main text: ERCP,
AST, WBC, INR.
3. Introduction, suggest adding incidence, survival rate of cholangiocarcinoma in Iran, are
different or the same as the global basis.
4. The author should specify whether the bilirubin and other liver function test are evaluated after
drainage, after chemotherapy or before surgery, history infection that affect the WBC, TBIL
level and which methods of drainage after tissue/cytology were received. Only internal drainage
by stent?
5. In the Method, the author should correct the format of ALBI score calculation:
from 0.66 × log10 TBIL (µmol/l)-0.085 × ALB (g/l) to
(0.66 × log10 TBIL [µmol/L]) + (#0.0852 × albumin [g/L])
6. In the Statistical Analysis, please check the symbol. P>0.05 was considered significant in all
tests should be < (less than).
7. Explain the definition of the types of eCCA, in the table the author divided into distal,
proximal, hilar type. How about the surgical procedure, in all types have done by Whipple
operation (Pancreaticoduodenectomy)? No liver resection?
8. In the table, the unit of laboratory results should be added to standardized reports. For example:
ALT (U/l), ALB (g/l), TBIL (µmol/l).
9. The author should mention other main factors that affect survival rates. What was the
pathological stage (size, nodal status, metastasis status) of these patients?  postoperative in-
hospital mortality? Viral hepatitis? Effect on type chemotherapy was used in patients, induced
transaminitis? the chemotherapy in the table was pre or postoperative chemotherapy?
10. Please check spelling: grade in the figure 2
: 2nd paragraph of discussion: Differences in characteristics of patient population (such as sex,
age, economic status, stage of cancer…).
Title: The prognostic role of albumin-bilirubin grade in the mortality of extrahepatic
cholangiocarcinoma patients
Version: 0 Date: 09 Feb 2025
Reviewer's report:
Comments to the Author
The article titled " The prognostic role of albumin-bilirubin grade in the mortality of extrahepatic
cholangiocarcinoma patients"
This article is commendable and showcases strong writing skills. The authors merit
recognition for their contributions. Nevertheless, it is suggested that the subsequent notices/
recommendations enhance the caliber of this endeavor.
1. In the Abstract and the main text, the grade of ALBI score in grade 2 should be scaled from
lower to upper limit.  grade 2: #1.39 to #2.60 should change to > #2.60 to # #1.39.
2. In Abstract, the unit of laboratory results should be added to standardized reports (AST, WBC)
and recheck all abbreviated terms are defined the first time in abstract and main text: ERCP,
AST, WBC, INR.
3. Introduction, suggest adding incidence, survival rate of cholangiocarcinoma in Iran, are
different or the same as the global basis.
4. The author should specify whether the bilirubin and other liver function test are evaluated after
drainage, after chemotherapy or before surgery, history infection that affect the WBC, TBIL
level and which methods of drainage after tissue/cytology were received. Only internal drainage
by stent?
5. In the Method, the author should correct the format of ALBI score calculation:
from 0.66 × log10 TBIL (µmol/l)-0.085 × ALB (g/l) to
(0.66 × log10 TBIL [µmol/L]) + (#0.0852 × albumin [g/L])
6. In the Statistical Analysis, please check the symbol. P>0.05 was considered significant in all
tests should be < (less than).
7. Explain the definition of the types of eCCA, in the table the author divided into distal,
proximal, hilar type. How about the surgical procedure, in all types have done by Whipple
operation (Pancreaticoduodenectomy)? No liver resection?
8. In the table, the unit of laboratory results should be added to standardized reports. For example:
ALT (U/l), ALB (g/l), TBIL (µmol/l).
9. The author should mention other main factors that affect survival rates. What was the
pathological stage (size, nodal status, metastasis status) of these patients?  postoperative in-
hospital mortality? Viral hepatitis? Effect on type chemotherapy was used in patients, induced
transaminitis? the chemotherapy in the table was pre or postoperative chemotherapy?
10. Please check spelling: grade in the figure 2
: 2nd paragraph of discussion: Differences in characteristics of patient population (such as sex,
age, economic status, stage of cancer…).
Please review this paper.
user
Title: The prognostic role of albumin-bilirubin grade in the mortality of extrahepatic
cholangiocarcinoma patients
Version: 0 Date: 09 Feb 2025
Reviewer's report:
Comments to the Author
The article titled " The prognostic role of albumin-bilirubin grade in the mortality of extrahepatic
cholangiocarcinoma patients"
This article is commendable and showcases strong writing skills. The authors merit
recognition for their contributions. Nevertheless, it is suggested that the subsequent notices/
recommendations enhance the caliber of this endeavor.
1. In the Abstract and the main text, the grade of ALBI score in grade 2 should be scaled from
lower to upper limit.  grade 2: #1.39 to #2.60 should change to > #2.60 to # #1.39.
2. In Abstract, the unit of laboratory results should be added to standardized reports (AST, WBC)
and recheck all abbreviated terms are defined the first time in abstract and main text: ERCP,
AST, WBC, INR.
3. Introduction, suggest adding incidence, survival rate of cholangiocarcinoma in Iran, are
different or the same as the global basis.
4. The author should specify whether the bilirubin and other liver function test are evaluated after
drainage, after chemotherapy or before surgery, history infection that affect the WBC, TBIL
level and which methods of drainage after tissue/cytology were received. Only internal drainage
by stent?
5. In the Method, the author should correct the format of ALBI score calculation:
from 0.66 × log10 TBIL (µmol/l)-0.085 × ALB (g/l) to
(0.66 × log10 TBIL [µmol/L]) + (#0.0852 × albumin [g/L])
6. In the Statistical Analysis, please check the symbol. P>0.05 was considered significant in all
tests should be < (less than).
7. Explain the definition of the types of eCCA, in the table the author divided into distal,
proximal, hilar type. How about the surgical procedure, in all types have done by Whipple
operation (Pancreaticoduodenectomy)? No liver resection?
8. In the table, the unit of laboratory results should be added to standardized reports. For example:
ALT (U/l), ALB (g/l), TBIL (µmol/l).
9. The author should mention other main factors that affect survival rates. What was the
pathological stage (size, nodal status, metastasis status) of these patients?  postoperative in-
hospital mortality? Viral hepatitis? Effect on type chemotherapy was used in patients, induced
transaminitis? the chemotherapy in the table was pre or postoperative chemotherapy?
10. Please check spelling: grade in the figure 2
: 2nd paragraph of discussion: Differences in characteristics of patient population (such as sex,
age, economic status, stage of cancer…).
assistant