Reviewer's report
Title:Factors affecting post-embolization fever and liver failure after trans-arterial
chemo-embolization in a cohort without background infective hepatitis- a
prospective analysis
Version:1Date:10 June 2015
Reviewer: Oren Shibolet
Reviewer's report:
Dear editor
The manuscript by Dr. Siriwardana entitled: "Factors affecting post embolization
fever and liver failure after TACE in a cohort without a background of infective
hepatitis-a prospective study", describes the outcomes of a small cohort of
patients with NASH and ALD associated cirrhosis that underwent TACE for HCC.
The study adds little to current knowledge, however the methodology is
reasonable and the manuscript is well written and can be accepted pending
corrections
Major comments:
1. The authors repeatedly state that his cohort is of NASH and ALD associated
cirrhosis. It is unclear whether these are consecutive patients or selected
patients. The authors should clarify this point. It would be interesting to compare
complication rates of this cohort and a cohort with viral hepatitis
2. The study adds very little to current knowledge. Multiple larger and more
rigorous studies were already published in the past.
3. In the definition of AHD there are 2 parameters that are subjective. I.e.
encephalopathy and increased ascites. The authors should explain how these
parameters were measured and determined. They should state the exact
increase in encephalopathy New-Haven score and the amount of ascites that
was considered deterioration.
4. Follow-up was done on days 1-3 post embolization; however the authors state
that without early complications patients were discharged after 48 hours. This
would suggest that delayed appearance of symptoms may have been missed.
5. Furthermore-the authors followed patients on day 7 at an out-patient clinic.
The authors should describe whether there were any drop-outs and missed clinic
visits
6. In any case the authors do not discuss the possibility of missing late
complications. Hepatic abscesses can occur further then this short time
follow-up.
7. The discussion is very repetitive with the entire first paragraph, re-stating the
results. Furthermore the authors do not fully discuss the mechanisms that may
be responsible for their results, and their narrative is purely descriptive.
Minor comments
1. There are multiple typos that need to be corrected
2. Page 12 line 259-a ref should be inserted
Level of interest: An article of limited interest
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:Factors affecting post-embolization fever and liver failure after trans-arterial
chemo-embolization in a cohort without background infective hepatitis- a
prospective analysis
Version:1Date:10 June 2015
Reviewer: Oren Shibolet
Reviewer's report:
Dear editor
The manuscript by Dr. Siriwardana entitled: "Factors affecting post embolization
fever and liver failure after TACE in a cohort without a background of infective
hepatitis-a prospective study", describes the outcomes of a small cohort of
patients with NASH and ALD associated cirrhosis that underwent TACE for HCC.
The study adds little to current knowledge, however the methodology is
reasonable and the manuscript is well written and can be accepted pending
corrections
Major comments:
1. The authors repeatedly state that his cohort is of NASH and ALD associated
cirrhosis. It is unclear whether these are consecutive patients or selected
patients. The authors should clarify this point. It would be interesting to compare
complication rates of this cohort and a cohort with viral hepatitis
2. The study adds very little to current knowledge. Multiple larger and more
rigorous studies were already published in the past.
3. In the definition of AHD there are 2 parameters that are subjective. I.e.
encephalopathy and increased ascites. The authors should explain how these
parameters were measured and determined. They should state the exact
increase in encephalopathy New-Haven score and the amount of ascites that
was considered deterioration.
4. Follow-up was done on days 1-3 post embolization; however the authors state
that without early complications patients were discharged after 48 hours. This
would suggest that delayed appearance of symptoms may have been missed.
5. Furthermore-the authors followed patients on day 7 at an out-patient clinic.
The authors should describe whether there were any drop-outs and missed clinic
visits
6. In any case the authors do not discuss the possibility of missing late
complications. Hepatic abscesses can occur further then this short time
follow-up.
7. The discussion is very repetitive with the entire first paragraph, re-stating the
results. Furthermore the authors do not fully discuss the mechanisms that may
be responsible for their results, and their narrative is purely descriptive.
Minor comments
1. There are multiple typos that need to be corrected
2. Page 12 line 259-a ref should be inserted
Level of interest: An article of limited interest
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:Factors affecting post-embolization fever and liver failure after trans-arterial
chemo-embolization in a cohort without background infective hepatitis- a
prospective analysis
Version:1Date:10 June 2015
Reviewer: Oren Shibolet
Reviewer's report:
Dear editor
The manuscript by Dr. Siriwardana entitled: "Factors affecting post embolization
fever and liver failure after TACE in a cohort without a background of infective
hepatitis-a prospective study", describes the outcomes of a small cohort of
patients with NASH and ALD associated cirrhosis that underwent TACE for HCC.
The study adds little to current knowledge, however the methodology is
reasonable and the manuscript is well written and can be accepted pending
corrections
Major comments:
1. The authors repeatedly state that his cohort is of NASH and ALD associated
cirrhosis. It is unclear whether these are consecutive patients or selected
patients. The authors should clarify this point. It would be interesting to compare
complication rates of this cohort and a cohort with viral hepatitis
2. The study adds very little to current knowledge. Multiple larger and more
rigorous studies were already published in the past.
3. In the definition of AHD there are 2 parameters that are subjective. I.e.
encephalopathy and increased ascites. The authors should explain how these
parameters were measured and determined. They should state the exact
increase in encephalopathy New-Haven score and the amount of ascites that
was considered deterioration.
4. Follow-up was done on days 1-3 post embolization; however the authors state
that without early complications patients were discharged after 48 hours. This
would suggest that delayed appearance of symptoms may have been missed.
5. Furthermore-the authors followed patients on day 7 at an out-patient clinic.
The authors should describe whether there were any drop-outs and missed clinic
visits
6. In any case the authors do not discuss the possibility of missing late
complications. Hepatic abscesses can occur further then this short time
follow-up.
7. The discussion is very repetitive with the entire first paragraph, re-stating the
results. Furthermore the authors do not fully discuss the mechanisms that may
be responsible for their results, and their narrative is purely descriptive.
Minor comments
1. There are multiple typos that need to be corrected
2. Page 12 line 259-a ref should be inserted
Level of interest: An article of limited interest
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'
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