Title: Poorly Differentiated Cluster Grade-A Vital Predictor for Lymph Node Metastasis and
Oncological Outcomes in Patients with T1 Colorectal Cancer: A Retrospective Study
Version: 2 Date: 13 Jun 2022
Reviewer's report:
Xiaolin Ji et al. investigated the PDC as a predictor for LNM and prognosis in T1 CRCs. They
concluded the PDC was an independent risk factors for LNM and indicated shorter OS and DFS.
Although this paper needs some revisions, it is well-structured. To improve the quality of this
paper, my comments were as follows.
Major comments:
1. Please provide a breakdown of the number of cases of primary surgical resection and
secondary surgical resection followed by initial endoscopic resection in the methods section.
This is because the role of PDC as a risk factor for lymph node metastasis is essentially fulfilled
for cases treated with initial endoscopic resection.
2. How about the interobserver agreement for PDC grading among pathologists in this study?
Interobserver agreement in other predictors for LNM such as LVI or tumor grade were reported
to be low. The authors had better present the concordance for PDC grading even for 20-30 T1
cases between two pathologists participating in this study to validate the effectiveness of PDC
as a predictor.
3. A sufficient lymph node yield is important for a robust ground truth of lymph node status.
Please provide the mean number of LNs per patient in this dataset.
4. In a first paragraph in the results, please re-check the number in the following sentences. One
patient was missing. “The percentages of patients with different PDC grades were G1, 71.2%
(131/184); G2, 19.6% (36/184); and G3, 8.7% (16/184).”
5. This study included only surgical resection cases, which was one of the limitations the authors
should mention in the discussion section. This is because the endoscopic resection alone cohort
was essentially part of the true target.
6. Please provide clinical information such as patients age and sex, and tumor size, etc. in Table 1.
Minor comments:
1. Please add the reference of PMID 34942683, which is closely related to the issue of treatment
strategy of T1 CRC, in the same place as ref 18 in the introduction.
Title: Poorly Differentiated Cluster Grade-A Vital Predictor for Lymph Node Metastasis and
Oncological Outcomes in Patients with T1 Colorectal Cancer: A Retrospective Study
Version: 2 Date: 13 Jun 2022
Reviewer's report:
Xiaolin Ji et al. investigated the PDC as a predictor for LNM and prognosis in T1 CRCs. They
concluded the PDC was an independent risk factors for LNM and indicated shorter OS and DFS.
Although this paper needs some revisions, it is well-structured. To improve the quality of this
paper, my comments were as follows.
Major comments:
1. Please provide a breakdown of the number of cases of primary surgical resection and
secondary surgical resection followed by initial endoscopic resection in the methods section.
This is because the role of PDC as a risk factor for lymph node metastasis is essentially fulfilled
for cases treated with initial endoscopic resection.
2. How about the interobserver agreement for PDC grading among pathologists in this study?
Interobserver agreement in other predictors for LNM such as LVI or tumor grade were reported
to be low. The authors had better present the concordance for PDC grading even for 20-30 T1
cases between two pathologists participating in this study to validate the effectiveness of PDC
as a predictor.
3. A sufficient lymph node yield is important for a robust ground truth of lymph node status.
Please provide the mean number of LNs per patient in this dataset.
4. In a first paragraph in the results, please re-check the number in the following sentences. One
patient was missing. “The percentages of patients with different PDC grades were G1, 71.2%
(131/184); G2, 19.6% (36/184); and G3, 8.7% (16/184).”
5. This study included only surgical resection cases, which was one of the limitations the authors
should mention in the discussion section. This is because the endoscopic resection alone cohort
was essentially part of the true target.
6. Please provide clinical information such as patients age and sex, and tumor size, etc. in Table 1.
Minor comments:
1. Please add the reference of PMID 34942683, which is closely related to the issue of treatment
strategy of T1 CRC, in the same place as ref 18 in the introduction.
Please review this paper.
user
Title: Poorly Differentiated Cluster Grade-A Vital Predictor for Lymph Node Metastasis and
Oncological Outcomes in Patients with T1 Colorectal Cancer: A Retrospective Study
Version: 2 Date: 13 Jun 2022
Reviewer's report:
Xiaolin Ji et al. investigated the PDC as a predictor for LNM and prognosis in T1 CRCs. They
concluded the PDC was an independent risk factors for LNM and indicated shorter OS and DFS.
Although this paper needs some revisions, it is well-structured. To improve the quality of this
paper, my comments were as follows.
Major comments:
1. Please provide a breakdown of the number of cases of primary surgical resection and
secondary surgical resection followed by initial endoscopic resection in the methods section.
This is because the role of PDC as a risk factor for lymph node metastasis is essentially fulfilled
for cases treated with initial endoscopic resection.
2. How about the interobserver agreement for PDC grading among pathologists in this study?
Interobserver agreement in other predictors for LNM such as LVI or tumor grade were reported
to be low. The authors had better present the concordance for PDC grading even for 20-30 T1
cases between two pathologists participating in this study to validate the effectiveness of PDC
as a predictor.
3. A sufficient lymph node yield is important for a robust ground truth of lymph node status.
Please provide the mean number of LNs per patient in this dataset.
4. In a first paragraph in the results, please re-check the number in the following sentences. One
patient was missing. “The percentages of patients with different PDC grades were G1, 71.2%
(131/184); G2, 19.6% (36/184); and G3, 8.7% (16/184).”
5. This study included only surgical resection cases, which was one of the limitations the authors
should mention in the discussion section. This is because the endoscopic resection alone cohort
was essentially part of the true target.
6. Please provide clinical information such as patients age and sex, and tumor size, etc. in Table 1.
Minor comments:
1. Please add the reference of PMID 34942683, which is closely related to the issue of treatment
strategy of T1 CRC, in the same place as ref 18 in the introduction.
assistant