Reviewer ’s report  
 
Title: Small Bowel Adenocarcinoma As a Complication of Celiac Disease: Clinical and 
Diagnostic Features  
 
Version: 0 Date: 29 Dec 2018  
 
Reviewer: Thomas Aparicio  
 
Reviewer's report:  
 
It is an interesting cases reports of 5 SBA occuring in coeliac disease.  
 
Despite the small number new findings are reported with these well describe cases  
 
Other comments  
 
Title: title is to emphatic. 5 cases could not resume research of millennium  
 
Abstract: conclusion should be nuanced as there is only 5 cases  
 
Discussion:  
 
1) It is very interesting that even poor prognostic patient (N2) according to the literature 
have a good prognosis in this study.  That should be pointed out  
 
 
2) The author recommand investigation for patient with CD to detect SBA. According to the 
low rate of SBA in CD (despite an elevated relative risk), the doubtfull about the 
adenoma to carcinoma sequence, the fact that in this st udy the majority of the cases had 
concomittent diagnosis of CD and SBA, and the lack of standardized repeated screening 
procedure it is difficult to made any recommandation about screening.  
 
 
3) SBA associate with Crohn disease are not located in duodenum (P alascak -Juif V, 
Inflamm Bowel Dis. 2005 ; Aparicio T, ESMO 2018, Ann Oncol (2018) 29 (suppl_8): 
viii150 -viii204)  
 
 
4) It is unclear that the new diagnostic tools allowed early diagnosis and better prognosis. A 
recent european study did not find a significant improvment of diagnosis and prognosis 
of SBA (Legue L, Acta Oncol 2016)  
 
 
5) Overall conclusion should be nuanced as it is difficult to draw robust findings from 5 
cases  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary c ontrols?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
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 asse ss any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
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, f ees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publi cation of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat 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 curr ently 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  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named repor t 
including any attachments I upload will be posted on the website along with the authors' 
responses. 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/ ). I understand  that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editor s, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Small Bowel Adenocarcinoma As a Complication of Celiac Disease: Clinical and 
Diagnostic Features  
 
Version: 0 Date: 29 Dec 2018  
 
Reviewer: Thomas Aparicio  
 
Reviewer's report:  
 
It is an interesting cases reports of 5 SBA occuring in coeliac disease.  
 
Despite the small number new findings are reported with these well describe cases  
 
Other comments  
 
Title: title is to emphatic. 5 cases could not resume research of millennium  
 
Abstract: conclusion should be nuanced as there is only 5 cases  
 
Discussion:  
 
1) It is very interesting that even poor prognostic patient (N2) according to the literature 
have a good prognosis in this study.  That should be pointed out  
 
 
2) The author recommand investigation for patient with CD to detect SBA. According to the 
low rate of SBA in CD (despite an elevated relative risk), the doubtfull about the 
adenoma to carcinoma sequence, the fact that in this st udy the majority of the cases had 
concomittent diagnosis of CD and SBA, and the lack of standardized repeated screening 
procedure it is difficult to made any recommandation about screening.  
 
 
3) SBA associate with Crohn disease are not located in duodenum (P alascak -Juif V, 
Inflamm Bowel Dis. 2005 ; Aparicio T, ESMO 2018, Ann Oncol (2018) 29 (suppl_8): 
viii150 -viii204)  
 
 
4) It is unclear that the new diagnostic tools allowed early diagnosis and better prognosis. A 
recent european study did not find a significant improvment of diagnosis and prognosis 
of SBA (Legue L, Acta Oncol 2016)  
 
 
5) Overall conclusion should be nuanced as it is difficult to draw robust findings from 5 
cases  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary c ontrols?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
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 asse ss any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
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, f ees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publi cation of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat 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 curr ently 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  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named repor t 
including any attachments I upload will be posted on the website along with the authors' 
responses. 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/ ). I understand  that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editor s, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Small Bowel Adenocarcinoma As a Complication of Celiac Disease: Clinical and 
Diagnostic Features  
 
Version: 0 Date: 29 Dec 2018  
 
Reviewer: Thomas Aparicio  
 
Reviewer's report:  
 
It is an interesting cases reports of 5 SBA occuring in coeliac disease.  
 
Despite the small number new findings are reported with these well describe cases  
 
Other comments  
 
Title: title is to emphatic. 5 cases could not resume research of millennium  
 
Abstract: conclusion should be nuanced as there is only 5 cases  
 
Discussion:  
 
1) It is very interesting that even poor prognostic patient (N2) according to the literature 
have a good prognosis in this study.  That should be pointed out  
 
 
2) The author recommand investigation for patient with CD to detect SBA. According to the 
low rate of SBA in CD (despite an elevated relative risk), the doubtfull about the 
adenoma to carcinoma sequence, the fact that in this st udy the majority of the cases had 
concomittent diagnosis of CD and SBA, and the lack of standardized repeated screening 
procedure it is difficult to made any recommandation about screening.  
 
 
3) SBA associate with Crohn disease are not located in duodenum (P alascak -Juif V, 
Inflamm Bowel Dis. 2005 ; Aparicio T, ESMO 2018, Ann Oncol (2018) 29 (suppl_8): 
viii150 -viii204)  
 
 
4) It is unclear that the new diagnostic tools allowed early diagnosis and better prognosis. A 
recent european study did not find a significant improvment of diagnosis and prognosis 
of SBA (Legue L, Acta Oncol 2016)  
 
 
5) Overall conclusion should be nuanced as it is difficult to draw robust findings from 5 
cases  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary c ontrols?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
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 asse ss any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
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, f ees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publi cation of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat 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 curr ently 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  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named repor t 
including any attachments I upload will be posted on the website along with the authors' 
responses. 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/ ). I understand  that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editor s, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant