Reviewer’s report
Title: 
Clinical outcomes of early gastric cardiac cancer treated with endoscopic
submucosal dissection in patients with different indications
Version: 
1 
Date: 
17 Jun 2020
Reviewer's report:
Please include all comments for the authors in this box rather than uploading
your report as an attachment. Please only upload as attachments annotated
versions of manuscripts, graphs, supporting materials or other aspects of your
report which cannot be included in a text format.
Please overwrite this text when adding your comments to the authors.
I have read this manuscript with interest. The author studied the short-term and
long-term outcomes of ESD for EGCC in many patients. However, there are
many results in the whole, and it is difficult to understand because it is long.
Please focus on the points and describe the results and discussion. For example,
regarding the short-term outcomes of EGCC's ESD, many researchers have
already reported in the past, so it is not so important. On the other hand, there are
few reports on long-term outcomes, so I think it is valuable data.
In this study, there were 4 disease-related deaths in long-term outcomes, 1 in the
AI group and 3 in the BEI group. The 4 patients are listed in Table 5, but there
are some uncertainties in their clinical course.
The AI group patient died of metastatic recurrence, but the tumor size was 9mm,
the depth was M3 and the lateral margin was positive. Was the pathological
result of the lesion after ESD for this patient correctly diagnosed? In such cases,
the depth of invasion and the lymph-vascular invasion might sometimes change
due to reexamination, so it is necessary to review the pathological results. Also,
the pathological result of the patient is positive of lateral margin, but did you
consider re-ESD? The patient refuses surgery, but when did the patient refuse to
do it? 
One patient of three BEI groups died from postoperative bleeding. Is this a
related death due to surgical procedures? In this study, 42 people in the BEI
group have undergone surgery, Surgery-related death is 2.4% (1/42). Is this
frequency higher than past reports? If 2.4% is common, I think it is not necessary
to recommend the additional surgery to the elderly patient.
What about this point?
In another BEI group death, a woman in her 40's died of metastasis without
surgery for 5mm SM2 cancer. Why didn't she receive surgery? In this study, the
BEI group had significantly lower survival rates than the other groups. We have
to actively recommend surgery for such cases. The author should mention the
point in the discussion part.

Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
No
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the
authors.
No
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
No
Are you able to assess any statistics in the manuscript or would you
recommend an additional statistical review?
If an additional statistical review is recommended, please specify what aspects
require further assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
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)
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
Reviewer’s report
Title: 
Clinical outcomes of early gastric cardiac cancer treated with endoscopic
submucosal dissection in patients with different indications
Version: 
1 
Date: 
17 Jun 2020
Reviewer's report:
Please include all comments for the authors in this box rather than uploading
your report as an attachment. Please only upload as attachments annotated
versions of manuscripts, graphs, supporting materials or other aspects of your
report which cannot be included in a text format.
Please overwrite this text when adding your comments to the authors.
I have read this manuscript with interest. The author studied the short-term and
long-term outcomes of ESD for EGCC in many patients. However, there are
many results in the whole, and it is difficult to understand because it is long.
Please focus on the points and describe the results and discussion. For example,
regarding the short-term outcomes of EGCC's ESD, many researchers have
already reported in the past, so it is not so important. On the other hand, there are
few reports on long-term outcomes, so I think it is valuable data.
In this study, there were 4 disease-related deaths in long-term outcomes, 1 in the
AI group and 3 in the BEI group. The 4 patients are listed in Table 5, but there
are some uncertainties in their clinical course.
The AI group patient died of metastatic recurrence, but the tumor size was 9mm,
the depth was M3 and the lateral margin was positive. Was the pathological
result of the lesion after ESD for this patient correctly diagnosed? In such cases,
the depth of invasion and the lymph-vascular invasion might sometimes change
due to reexamination, so it is necessary to review the pathological results. Also,
the pathological result of the patient is positive of lateral margin, but did you
consider re-ESD? The patient refuses surgery, but when did the patient refuse to
do it? 
One patient of three BEI groups died from postoperative bleeding. Is this a
related death due to surgical procedures? In this study, 42 people in the BEI
group have undergone surgery, Surgery-related death is 2.4% (1/42). Is this
frequency higher than past reports? If 2.4% is common, I think it is not necessary
to recommend the additional surgery to the elderly patient.
What about this point?
In another BEI group death, a woman in her 40's died of metastasis without
surgery for 5mm SM2 cancer. Why didn't she receive surgery? In this study, the
BEI group had significantly lower survival rates than the other groups. We have
to actively recommend surgery for such cases. The author should mention the
point in the discussion part.

Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
No
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the
authors.
No
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
No
Are you able to assess any statistics in the manuscript or would you
recommend an additional statistical review?
If an additional statistical review is recommended, please specify what aspects
require further assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
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)
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
Please review this paper.
user
Reviewer’s report
Title: 
Clinical outcomes of early gastric cardiac cancer treated with endoscopic
submucosal dissection in patients with different indications
Version: 
1 
Date: 
17 Jun 2020
Reviewer's report:
Please include all comments for the authors in this box rather than uploading
your report as an attachment. Please only upload as attachments annotated
versions of manuscripts, graphs, supporting materials or other aspects of your
report which cannot be included in a text format.
Please overwrite this text when adding your comments to the authors.
I have read this manuscript with interest. The author studied the short-term and
long-term outcomes of ESD for EGCC in many patients. However, there are
many results in the whole, and it is difficult to understand because it is long.
Please focus on the points and describe the results and discussion. For example,
regarding the short-term outcomes of EGCC's ESD, many researchers have
already reported in the past, so it is not so important. On the other hand, there are
few reports on long-term outcomes, so I think it is valuable data.
In this study, there were 4 disease-related deaths in long-term outcomes, 1 in the
AI group and 3 in the BEI group. The 4 patients are listed in Table 5, but there
are some uncertainties in their clinical course.
The AI group patient died of metastatic recurrence, but the tumor size was 9mm,
the depth was M3 and the lateral margin was positive. Was the pathological
result of the lesion after ESD for this patient correctly diagnosed? In such cases,
the depth of invasion and the lymph-vascular invasion might sometimes change
due to reexamination, so it is necessary to review the pathological results. Also,
the pathological result of the patient is positive of lateral margin, but did you
consider re-ESD? The patient refuses surgery, but when did the patient refuse to
do it? 
One patient of three BEI groups died from postoperative bleeding. Is this a
related death due to surgical procedures? In this study, 42 people in the BEI
group have undergone surgery, Surgery-related death is 2.4% (1/42). Is this
frequency higher than past reports? If 2.4% is common, I think it is not necessary
to recommend the additional surgery to the elderly patient.
What about this point?
In another BEI group death, a woman in her 40's died of metastasis without
surgery for 5mm SM2 cancer. Why didn't she receive surgery? In this study, the
BEI group had significantly lower survival rates than the other groups. We have
to actively recommend surgery for such cases. The author should mention the
point in the discussion part.

Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
No
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the
authors.
No
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
No
Are you able to assess any statistics in the manuscript or would you
recommend an additional statistical review?
If an additional statistical review is recommended, please specify what aspects
require further assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
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)
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
assistant