Title: Inflammatory Biomarker Correlations and Prognosis in High-risk Gastrointestinal
Stromal Tumor Patients: A Multicenter Retrospective Analysis
Version: 5 Date: 10 Jan 2025
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
Yes - the approach is appropriate
EXECUTION - Are the experiments and analyses performed with sufficient technical rigor to
allow confidence in the results?
Yes - experiments and analyses were performed appropriately
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
Yes - the author's interpretation is reasonable
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently
for you to now recommend the work as a technically sound contribution? If not, can further
revisions be made to make the work technically sound?
Probably - with minor revisions
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: HAVE THE AUTHORS RESPONDED ADEQUATELY TO
EACH OF THE QUESTIONS YOU RAISED IN YOUR COMMENTS
Yes thank you authors
HAVE THEY MADE THE APPROPRIATE CHANGES IN THE MANUSCRIPT
These changes will further improve the manuscript’s
WHAT IS YOUR OVERALL IMPRESSION OF THE REVISED MANUSCRIPT
This study shows the importance of the
PNI  in prognosis and may outline an aggressive approach postoperatively to reverse the
malnutrition.
Unfortunately many of the inflammatory parameters did not seem to influence prognosis the
study does reinforce the prognostic benefit of age, mitotic index, PNI, and importantly the very
important doable benefit of adjuvant treatment with IM
ADDITIONAL REQUESTS/SUGGESTIONS:
ARE THERE ANY ADDITIONAL REVISIONS THE AUTHORS SHOULD MAKE
I have re-read the entire manuscript and will make any suggestions that will aid the readers
1.line 44. Why not add the word "increasing” before “age”, “low” before the word “PNI”, and
“high” before the word “mitotic” that really will clarify these parameters
2. Line 53 it might read and sound better if you say “neoplasms arising in the interstitial  space
of the “
3. Line 65. Instead of comprehensive do you really mean complete R0 resection”?
4. Change line 87 to “to poorer outcomes in patients with GISTS(19)  and patients with breast
cancer (20)”. Reference 20  unlike 17,18, and 19  refers to breast cancer
5. Line 102. I would change the word “diagnosis” to “finding  in pathological review”
6. Line 104 as written this makes no sense. I think you mean "no clinical symptoms were
indicative of the lack of any associated infection”. Is that what you mean?
7. Authors were the data on the patients collected “prospectively” with the goal of determining
the importance of these markers? If so then you really need to register this study in a national
or international  database like for instance Clinical Trials.gov or a Chinese national registry
so that other  investigators  know that you have done or are doing this.  If indeed you had so
planned it, ideally. You would have registered it before starting the study.   In contract, if the
idea to study this potential association was made after the patients were operate on and had this
duration of follow up and the data were collected RETROSPECTIVELY, the there is no need
to register it.  And if so then on li e 130 you should say “The data were collected retrospectively
and encompassed•••”
Authors when I look at lines 180-182 and 194-196 . This really sounds like you had planned
on this study and collected the data prospectively.  If so the. Yes you need to register it. Most
current journals will not publish a prospective study in humans unless the study is registered.
You can do this after completing the study but that is not the best way to rather to register the
study before starting so others will. It also do the same study
8. Line 228. If I am not mistaken this is the first time you mention RFS and OS in the text so
you need to define these abbreviations.  Defining them in the abstract is not sufficient for using
them in the text, because many readers may not have read the abstract
9. Line 231 and 307 . Add the word “statistically” before the word “significant”
10. Line 283. Change “significance” to “importance”
11. Line 303  change “prove” to “strongly suggest
12.  “line 329. Do you mean to say that 15-40% of caner patients have  malnutrition at diagnosis”
-I think so
13. Line 33- here you use the word “retrospective” you will really need to point out as described
above #7 whether this was a prospective or retrospective design
24. Line 346-347. Should you add the phrase “ as well as a possible focus of postoperative
treatment” after the word “ prognosis”
Authors. Virtually all my comments are constructive and supportive of this excellent study
and should be easy to incorporate, however you do need to be clear about whether this was a
prospective design or whether it was a retrospective review and I if prospective register it.
Title: Inflammatory Biomarker Correlations and Prognosis in High-risk Gastrointestinal
Stromal Tumor Patients: A Multicenter Retrospective Analysis
Version: 5 Date: 10 Jan 2025
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
Yes - the approach is appropriate
EXECUTION - Are the experiments and analyses performed with sufficient technical rigor to
allow confidence in the results?
Yes - experiments and analyses were performed appropriately
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
Yes - the author's interpretation is reasonable
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently
for you to now recommend the work as a technically sound contribution? If not, can further
revisions be made to make the work technically sound?
Probably - with minor revisions
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: HAVE THE AUTHORS RESPONDED ADEQUATELY TO
EACH OF THE QUESTIONS YOU RAISED IN YOUR COMMENTS
Yes thank you authors
HAVE THEY MADE THE APPROPRIATE CHANGES IN THE MANUSCRIPT
These changes will further improve the manuscript’s
WHAT IS YOUR OVERALL IMPRESSION OF THE REVISED MANUSCRIPT
This study shows the importance of the
PNI  in prognosis and may outline an aggressive approach postoperatively to reverse the
malnutrition.
Unfortunately many of the inflammatory parameters did not seem to influence prognosis the
study does reinforce the prognostic benefit of age, mitotic index, PNI, and importantly the very
important doable benefit of adjuvant treatment with IM
ADDITIONAL REQUESTS/SUGGESTIONS:
ARE THERE ANY ADDITIONAL REVISIONS THE AUTHORS SHOULD MAKE
I have re-read the entire manuscript and will make any suggestions that will aid the readers
1.line 44. Why not add the word "increasing” before “age”, “low” before the word “PNI”, and
“high” before the word “mitotic” that really will clarify these parameters
2. Line 53 it might read and sound better if you say “neoplasms arising in the interstitial  space
of the “
3. Line 65. Instead of comprehensive do you really mean complete R0 resection”?
4. Change line 87 to “to poorer outcomes in patients with GISTS(19)  and patients with breast
cancer (20)”. Reference 20  unlike 17,18, and 19  refers to breast cancer
5. Line 102. I would change the word “diagnosis” to “finding  in pathological review”
6. Line 104 as written this makes no sense. I think you mean "no clinical symptoms were
indicative of the lack of any associated infection”. Is that what you mean?
7. Authors were the data on the patients collected “prospectively” with the goal of determining
the importance of these markers? If so then you really need to register this study in a national
or international  database like for instance Clinical Trials.gov or a Chinese national registry
so that other  investigators  know that you have done or are doing this.  If indeed you had so
planned it, ideally. You would have registered it before starting the study.   In contract, if the
idea to study this potential association was made after the patients were operate on and had this
duration of follow up and the data were collected RETROSPECTIVELY, the there is no need
to register it.  And if so then on li e 130 you should say “The data were collected retrospectively
and encompassed•••”
Authors when I look at lines 180-182 and 194-196 . This really sounds like you had planned
on this study and collected the data prospectively.  If so the. Yes you need to register it. Most
current journals will not publish a prospective study in humans unless the study is registered.
You can do this after completing the study but that is not the best way to rather to register the
study before starting so others will. It also do the same study
8. Line 228. If I am not mistaken this is the first time you mention RFS and OS in the text so
you need to define these abbreviations.  Defining them in the abstract is not sufficient for using
them in the text, because many readers may not have read the abstract
9. Line 231 and 307 . Add the word “statistically” before the word “significant”
10. Line 283. Change “significance” to “importance”
11. Line 303  change “prove” to “strongly suggest
12.  “line 329. Do you mean to say that 15-40% of caner patients have  malnutrition at diagnosis”
-I think so
13. Line 33- here you use the word “retrospective” you will really need to point out as described
above #7 whether this was a prospective or retrospective design
24. Line 346-347. Should you add the phrase “ as well as a possible focus of postoperative
treatment” after the word “ prognosis”
Authors. Virtually all my comments are constructive and supportive of this excellent study
and should be easy to incorporate, however you do need to be clear about whether this was a
prospective design or whether it was a retrospective review and I if prospective register it.
Please review this paper.
user
Title: Inflammatory Biomarker Correlations and Prognosis in High-risk Gastrointestinal
Stromal Tumor Patients: A Multicenter Retrospective Analysis
Version: 5 Date: 10 Jan 2025
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
Yes - the approach is appropriate
EXECUTION - Are the experiments and analyses performed with sufficient technical rigor to
allow confidence in the results?
Yes - experiments and analyses were performed appropriately
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
Yes - the author's interpretation is reasonable
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently
for you to now recommend the work as a technically sound contribution? If not, can further
revisions be made to make the work technically sound?
Probably - with minor revisions
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: HAVE THE AUTHORS RESPONDED ADEQUATELY TO
EACH OF THE QUESTIONS YOU RAISED IN YOUR COMMENTS
Yes thank you authors
HAVE THEY MADE THE APPROPRIATE CHANGES IN THE MANUSCRIPT
These changes will further improve the manuscript’s
WHAT IS YOUR OVERALL IMPRESSION OF THE REVISED MANUSCRIPT
This study shows the importance of the
PNI  in prognosis and may outline an aggressive approach postoperatively to reverse the
malnutrition.
Unfortunately many of the inflammatory parameters did not seem to influence prognosis the
study does reinforce the prognostic benefit of age, mitotic index, PNI, and importantly the very
important doable benefit of adjuvant treatment with IM
ADDITIONAL REQUESTS/SUGGESTIONS:
ARE THERE ANY ADDITIONAL REVISIONS THE AUTHORS SHOULD MAKE
I have re-read the entire manuscript and will make any suggestions that will aid the readers
1.line 44. Why not add the word "increasing” before “age”, “low” before the word “PNI”, and
“high” before the word “mitotic” that really will clarify these parameters
2. Line 53 it might read and sound better if you say “neoplasms arising in the interstitial  space
of the “
3. Line 65. Instead of comprehensive do you really mean complete R0 resection”?
4. Change line 87 to “to poorer outcomes in patients with GISTS(19)  and patients with breast
cancer (20)”. Reference 20  unlike 17,18, and 19  refers to breast cancer
5. Line 102. I would change the word “diagnosis” to “finding  in pathological review”
6. Line 104 as written this makes no sense. I think you mean "no clinical symptoms were
indicative of the lack of any associated infection”. Is that what you mean?
7. Authors were the data on the patients collected “prospectively” with the goal of determining
the importance of these markers? If so then you really need to register this study in a national
or international  database like for instance Clinical Trials.gov or a Chinese national registry
so that other  investigators  know that you have done or are doing this.  If indeed you had so
planned it, ideally. You would have registered it before starting the study.   In contract, if the
idea to study this potential association was made after the patients were operate on and had this
duration of follow up and the data were collected RETROSPECTIVELY, the there is no need
to register it.  And if so then on li e 130 you should say “The data were collected retrospectively
and encompassed•••”
Authors when I look at lines 180-182 and 194-196 . This really sounds like you had planned
on this study and collected the data prospectively.  If so the. Yes you need to register it. Most
current journals will not publish a prospective study in humans unless the study is registered.
You can do this after completing the study but that is not the best way to rather to register the
study before starting so others will. It also do the same study
8. Line 228. If I am not mistaken this is the first time you mention RFS and OS in the text so
you need to define these abbreviations.  Defining them in the abstract is not sufficient for using
them in the text, because many readers may not have read the abstract
9. Line 231 and 307 . Add the word “statistically” before the word “significant”
10. Line 283. Change “significance” to “importance”
11. Line 303  change “prove” to “strongly suggest
12.  “line 329. Do you mean to say that 15-40% of caner patients have  malnutrition at diagnosis”
-I think so
13. Line 33- here you use the word “retrospective” you will really need to point out as described
above #7 whether this was a prospective or retrospective design
24. Line 346-347. Should you add the phrase “ as well as a possible focus of postoperative
treatment” after the word “ prognosis”
Authors. Virtually all my comments are constructive and supportive of this excellent study
and should be easy to incorporate, however you do need to be clear about whether this was a
prospective design or whether it was a retrospective review and I if prospective register it.
assistant