Title: Evaluation of preoperative diagnostic methods for resectable pancreatic cancer: A
diagnostic capability and impact on the prognosis of endoscopic ultrasound-guided fine needle
aspiration
Version: 3 Date: 28 Jun 2021
Reviewer's report:
The authors describe an interesting study looking at outcomes for patients with pancreatic cancer
who are considered suitable for resection. This is an interesting study but there are some issues
that need to be addressed:
1. More information is needed concerning the selection for EUS or not. It is the absolute crux
of this paper and is the single most important variable that may have caused bias. Explicit
description of selection criteria for EUS or not EUS needs to be given.
2. The accuracy of EUS-FNA here is very high. This usually occurs when centres combine
categories of results and exclude inadequate samples. The usual 5 categories are inadeqaute,
benign, atypia, suspicious but not definite for cancer and definite for cancer on cytology.
Could the authors please breakdown the results in this way to allow understanding of their
cytopathological results.
3. For the survival curves were these adjusted for other important variables such as chemo
therapy, R1/R0 etc as being in the FNA group or not would not be the only influencer of
outcomes.
4. Table 1 would be better to show the characteristics of both the EUS and non-EUS groups
with any statistical differences or not.
5. The discussion is very long and would benefit from being trimmed down significantly.
6. There are several spelling and grammatical errors throughout the manuscript e.g. "centers"
should be "centres", "tertial" should be "tertiary" and "viridity" should be "validity"
Title: Evaluation of preoperative diagnostic methods for resectable pancreatic cancer: A
diagnostic capability and impact on the prognosis of endoscopic ultrasound-guided fine needle
aspiration
Version: 3 Date: 28 Jun 2021
Reviewer's report:
The authors describe an interesting study looking at outcomes for patients with pancreatic cancer
who are considered suitable for resection. This is an interesting study but there are some issues
that need to be addressed:
1. More information is needed concerning the selection for EUS or not. It is the absolute crux
of this paper and is the single most important variable that may have caused bias. Explicit
description of selection criteria for EUS or not EUS needs to be given.
2. The accuracy of EUS-FNA here is very high. This usually occurs when centres combine
categories of results and exclude inadequate samples. The usual 5 categories are inadeqaute,
benign, atypia, suspicious but not definite for cancer and definite for cancer on cytology.
Could the authors please breakdown the results in this way to allow understanding of their
cytopathological results.
3. For the survival curves were these adjusted for other important variables such as chemo
therapy, R1/R0 etc as being in the FNA group or not would not be the only influencer of
outcomes.
4. Table 1 would be better to show the characteristics of both the EUS and non-EUS groups
with any statistical differences or not.
5. The discussion is very long and would benefit from being trimmed down significantly.
6. There are several spelling and grammatical errors throughout the manuscript e.g. "centers"
should be "centres", "tertial" should be "tertiary" and "viridity" should be "validity"
Please review this paper.
user
Title: Evaluation of preoperative diagnostic methods for resectable pancreatic cancer: A
diagnostic capability and impact on the prognosis of endoscopic ultrasound-guided fine needle
aspiration
Version: 3 Date: 28 Jun 2021
Reviewer's report:
The authors describe an interesting study looking at outcomes for patients with pancreatic cancer
who are considered suitable for resection. This is an interesting study but there are some issues
that need to be addressed:
1. More information is needed concerning the selection for EUS or not. It is the absolute crux
of this paper and is the single most important variable that may have caused bias. Explicit
description of selection criteria for EUS or not EUS needs to be given.
2. The accuracy of EUS-FNA here is very high. This usually occurs when centres combine
categories of results and exclude inadequate samples. The usual 5 categories are inadeqaute,
benign, atypia, suspicious but not definite for cancer and definite for cancer on cytology.
Could the authors please breakdown the results in this way to allow understanding of their
cytopathological results.
3. For the survival curves were these adjusted for other important variables such as chemo
therapy, R1/R0 etc as being in the FNA group or not would not be the only influencer of
outcomes.
4. Table 1 would be better to show the characteristics of both the EUS and non-EUS groups
with any statistical differences or not.
5. The discussion is very long and would benefit from being trimmed down significantly.
6. There are several spelling and grammatical errors throughout the manuscript e.g. "centers"
should be "centres", "tertial" should be "tertiary" and "viridity" should be "validity"
assistant