Reviewer's report
Title:Synchronous carcinoid and gastrointestinal stromal tumour of the stomach:
a case report.
Version: 1Date:2 December 2010
Reviewer: Marek Wronski
Reviewer's report:
The manuscript, which I reviewed with interest, reports a case of coexisting
carcinoid and gastrointestinal stromal tumor within the stomach. Concomitant
tumors are quite rare and present particular diagnostic and treatment challenges.
There is growing evidence confirming that the coexistence of gastrointestinal
stromal tumors and adenocarcinomas is not coincidental. In contrast, the
synchronous occurrence of a carcinoid and GIST seems to be just a coincidence,
and as such has little clinical or scientific significance.
Major compulsory revisions
1. The authors conclude that the patients with synchronous GIST and carcinoid
should have a meticulous follow-up because of a high risk and important
consequences of possible metastases. This statement, however, applies to all
the patients with cancer diseases, but the conclusions should reflect the lessons
learned from the discussed case.
Minor essential revisions
1. According to the recent WHO classification, “neuroendocrine tumor” is the
preferred term for the neoplasms originating from the diffuse neuroendocrine
system, irrespective of their location. The term “carcinoid” is currently
discouraged, although still commmon in everyday clinical practice. I would advise
to follow the recommended terminology throughout the manuscript.
2. The first carcinoid tumor should be classified as well differentiated
neuroendocrine tumor with uncertain behavior rather than “a carcinoid with
aggressive clinical behaviour”.
3. “...tumour size and mitotic activity are the most significant parameters (for
GISTs)” – The authors should be more specific and explain what this significance
refers to (tumor malignant potential, prognosis).
4. The authors noted that the co-occurrence of GISTs with other neoplasms is
high and ranges from 4,5% to 33%. Similarily, neuroendocrine tumors coexist
with other neoplasms at a comparable rate. I would recommend to include this
information in the text. In view of so high tumor co-occurrence in both GIST and
carcinoid patients, the fact that the synchronous occurrence of these two
neoplasms have been reported so rarely, contradicts the hypothesis about their
common pathogenesis.
5. The resected specimen is quite small for a partial gastrectomy. Was a wedge
gastric resection performed rather than a partial resection?
6. There are too many figures in the manuscript. I would advise to limit the
images to Figures 1, 3A and B, 4A and B.
Level of interest: An article of insufficient interest to warrant publication in a
scientific/medical journal
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Reviewer's report
Title:Synchronous carcinoid and gastrointestinal stromal tumour of the stomach:
a case report.
Version: 1Date:2 December 2010
Reviewer: Marek Wronski
Reviewer's report:
The manuscript, which I reviewed with interest, reports a case of coexisting
carcinoid and gastrointestinal stromal tumor within the stomach. Concomitant
tumors are quite rare and present particular diagnostic and treatment challenges.
There is growing evidence confirming that the coexistence of gastrointestinal
stromal tumors and adenocarcinomas is not coincidental. In contrast, the
synchronous occurrence of a carcinoid and GIST seems to be just a coincidence,
and as such has little clinical or scientific significance.
Major compulsory revisions
1. The authors conclude that the patients with synchronous GIST and carcinoid
should have a meticulous follow-up because of a high risk and important
consequences of possible metastases. This statement, however, applies to all
the patients with cancer diseases, but the conclusions should reflect the lessons
learned from the discussed case.
Minor essential revisions
1. According to the recent WHO classification, “neuroendocrine tumor” is the
preferred term for the neoplasms originating from the diffuse neuroendocrine
system, irrespective of their location. The term “carcinoid” is currently
discouraged, although still commmon in everyday clinical practice. I would advise
to follow the recommended terminology throughout the manuscript.
2. The first carcinoid tumor should be classified as well differentiated
neuroendocrine tumor with uncertain behavior rather than “a carcinoid with
aggressive clinical behaviour”.
3. “...tumour size and mitotic activity are the most significant parameters (for
GISTs)” – The authors should be more specific and explain what this significance
refers to (tumor malignant potential, prognosis).
4. The authors noted that the co-occurrence of GISTs with other neoplasms is
high and ranges from 4,5% to 33%. Similarily, neuroendocrine tumors coexist
with other neoplasms at a comparable rate. I would recommend to include this
information in the text. In view of so high tumor co-occurrence in both GIST and
carcinoid patients, the fact that the synchronous occurrence of these two
neoplasms have been reported so rarely, contradicts the hypothesis about their
common pathogenesis.
5. The resected specimen is quite small for a partial gastrectomy. Was a wedge
gastric resection performed rather than a partial resection?
6. There are too many figures in the manuscript. I would advise to limit the
images to Figures 1, 3A and B, 4A and B.
Level of interest: An article of insufficient interest to warrant publication in a
scientific/medical journal
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Please review this paper.
user
Reviewer's report
Title:Synchronous carcinoid and gastrointestinal stromal tumour of the stomach:
a case report.
Version: 1Date:2 December 2010
Reviewer: Marek Wronski
Reviewer's report:
The manuscript, which I reviewed with interest, reports a case of coexisting
carcinoid and gastrointestinal stromal tumor within the stomach. Concomitant
tumors are quite rare and present particular diagnostic and treatment challenges.
There is growing evidence confirming that the coexistence of gastrointestinal
stromal tumors and adenocarcinomas is not coincidental. In contrast, the
synchronous occurrence of a carcinoid and GIST seems to be just a coincidence,
and as such has little clinical or scientific significance.
Major compulsory revisions
1. The authors conclude that the patients with synchronous GIST and carcinoid
should have a meticulous follow-up because of a high risk and important
consequences of possible metastases. This statement, however, applies to all
the patients with cancer diseases, but the conclusions should reflect the lessons
learned from the discussed case.
Minor essential revisions
1. According to the recent WHO classification, “neuroendocrine tumor” is the
preferred term for the neoplasms originating from the diffuse neuroendocrine
system, irrespective of their location. The term “carcinoid” is currently
discouraged, although still commmon in everyday clinical practice. I would advise
to follow the recommended terminology throughout the manuscript.
2. The first carcinoid tumor should be classified as well differentiated
neuroendocrine tumor with uncertain behavior rather than “a carcinoid with
aggressive clinical behaviour”.
3. “...tumour size and mitotic activity are the most significant parameters (for
GISTs)” – The authors should be more specific and explain what this significance
refers to (tumor malignant potential, prognosis).
4. The authors noted that the co-occurrence of GISTs with other neoplasms is
high and ranges from 4,5% to 33%. Similarily, neuroendocrine tumors coexist
with other neoplasms at a comparable rate. I would recommend to include this
information in the text. In view of so high tumor co-occurrence in both GIST and
carcinoid patients, the fact that the synchronous occurrence of these two
neoplasms have been reported so rarely, contradicts the hypothesis about their
common pathogenesis.
5. The resected specimen is quite small for a partial gastrectomy. Was a wedge
gastric resection performed rather than a partial resection?
6. There are too many figures in the manuscript. I would advise to limit the
images to Figures 1, 3A and B, 4A and B.
Level of interest: An article of insufficient interest to warrant publication in a
scientific/medical journal
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
assistant