Reviewer ’s report  
 
Title: Comparison of five tumor regression grading systems for gastric adenocarcinoma after  
neoadjuvant chemotherapy: a retrospective study of 192 cases from National Cancer Center in  
China  
 
Version: 0 Date: 12 Oct 2016  
 
Reviewer: Zhou Zhi -wei 
 
Reviewer's report:  
 
The authors aimed to compare regression gra ding for patients with gastric  adenocarcinoma 
treated by neoadjuvant chemotherapy and surgery according to four previously described 
regression models, and to analyse the association of tumour regression and other tumour 
characteristics with patients' cha racteristics and overall survival. They found that the Mandard -
TRG system would be more reasonable.  
 
 
 
In general, the manuscript is well done. However, the following problems exists.  
 
1. As I know, the Becker -TRG system was much more commonly used for gastro intestinal 
carcinomas than (JGCA) -TRG system and China -TRG system, and was successfully 
applied in many large -scale clinical studies. Please explain the reason why the study did 
not include the Becker system, which is the current mainstream of TRG systems.  
 
 
 
2. The author mentioned that "All the patients received neoadjuvant chemotherapy 
previously" in the patients section. However, the manuscript did not elaborate the details, 
including the chemotherapy regimen and courses ，whether or not receiving adjuvant 
chemotherapy followed by radical surgery, and so on.  
 
 
 
3. Frankly, I don't quite follow the reason why the Mandard -TRG system was  better than 
JGCA -TRG system. Previous conclusion have not had adequate statistical evidence.  
 
 
 
 
 
 
 
 
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 controls?  
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 assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional s tatistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
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 fut ure? 
 
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.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is acce pted for publication, my named report  
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 included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Comparison of five tumor regression grading systems for gastric adenocarcinoma after  
neoadjuvant chemotherapy: a retrospective study of 192 cases from National Cancer Center in  
China  
 
Version: 0 Date: 12 Oct 2016  
 
Reviewer: Zhou Zhi -wei 
 
Reviewer's report:  
 
The authors aimed to compare regression gra ding for patients with gastric  adenocarcinoma 
treated by neoadjuvant chemotherapy and surgery according to four previously described 
regression models, and to analyse the association of tumour regression and other tumour 
characteristics with patients' cha racteristics and overall survival. They found that the Mandard -
TRG system would be more reasonable.  
 
 
 
In general, the manuscript is well done. However, the following problems exists.  
 
1. As I know, the Becker -TRG system was much more commonly used for gastro intestinal 
carcinomas than (JGCA) -TRG system and China -TRG system, and was successfully 
applied in many large -scale clinical studies. Please explain the reason why the study did 
not include the Becker system, which is the current mainstream of TRG systems.  
 
 
 
2. The author mentioned that "All the patients received neoadjuvant chemotherapy 
previously" in the patients section. However, the manuscript did not elaborate the details, 
including the chemotherapy regimen and courses ，whether or not receiving adjuvant 
chemotherapy followed by radical surgery, and so on.  
 
 
 
3. Frankly, I don't quite follow the reason why the Mandard -TRG system was  better than 
JGCA -TRG system. Previous conclusion have not had adequate statistical evidence.  
 
 
 
 
 
 
 
 
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 controls?  
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 assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional s tatistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
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 fut ure? 
 
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.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is acce pted for publication, my named report  
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 included as confidential comments  
to the editors, 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: Comparison of five tumor regression grading systems for gastric adenocarcinoma after  
neoadjuvant chemotherapy: a retrospective study of 192 cases from National Cancer Center in  
China  
 
Version: 0 Date: 12 Oct 2016  
 
Reviewer: Zhou Zhi -wei 
 
Reviewer's report:  
 
The authors aimed to compare regression gra ding for patients with gastric  adenocarcinoma 
treated by neoadjuvant chemotherapy and surgery according to four previously described 
regression models, and to analyse the association of tumour regression and other tumour 
characteristics with patients' cha racteristics and overall survival. They found that the Mandard -
TRG system would be more reasonable.  
 
 
 
In general, the manuscript is well done. However, the following problems exists.  
 
1. As I know, the Becker -TRG system was much more commonly used for gastro intestinal 
carcinomas than (JGCA) -TRG system and China -TRG system, and was successfully 
applied in many large -scale clinical studies. Please explain the reason why the study did 
not include the Becker system, which is the current mainstream of TRG systems.  
 
 
 
2. The author mentioned that "All the patients received neoadjuvant chemotherapy 
previously" in the patients section. However, the manuscript did not elaborate the details, 
including the chemotherapy regimen and courses ，whether or not receiving adjuvant 
chemotherapy followed by radical surgery, and so on.  
 
 
 
3. Frankly, I don't quite follow the reason why the Mandard -TRG system was  better than 
JGCA -TRG system. Previous conclusion have not had adequate statistical evidence.  
 
 
 
 
 
 
 
 
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 controls?  
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 assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional s tatistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
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 fut ure? 
 
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.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is acce pted for publication, my named report  
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 included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant