Title: Combination of tumor markers predicts progression and pathological response in patients
with locally advanced gastric cancer after neoadjuvant chemotherapy treatment
Version: 3 Date: 06 Jan 2021
Reviewer's report:
The present study examined the clinical value of a new scoring system named post-neoadjuvant
chemotherapy treatment (NACT) combination of serum tumor markers (post-NAC CTM)
involving CEA, CA19-9, and CA 72-4 for predicting pCR and prognosis in patients with locally
advanced gastric cancer. Although this paper included some important data, there were several
concerns as below.
Major comments
1. How can we make use of the findings of this study in actual clinical practice? In the
prediction of pathological response of NACT, pre-treatment parameters including CTM seem
to be clinically more useful compared to post-treatment parameters. Therefore, the authors need
to show the clinical value of post-NAC CTM in comparison with that of pre-NAC CTM. Was it
necessary to include cases with normal pre-NAC CTM value in this study? It may be interesting
to do same analyses by targeting only cases with high pre-NACT CTM value. On the other hand,
in the prediction of postoperative prognosis, ypStage seems to be more reliable compared to post-
NAC CTM. Can post-NAC CTM affect the indication of surgery or post-operative treatment
strategy such as adjuvant chemotherapy? Please give enough discussion of this point.
2. Please give the comments about the reasons why post-NACT CTM predicted pCR and
prognosis. Did post-NACT CTM reflect residual tumor burden?
Minor comments
1. Please add the indication for NAC and postoperative adjuvant chemotherapy to the method
section.
2. How many patients with pCR were there after NACT?
3. There were two Table 4, and no Table 5.
4. There were many mistakes in the grammar that need to be corrected.
Title: Combination of tumor markers predicts progression and pathological response in patients
with locally advanced gastric cancer after neoadjuvant chemotherapy treatment
Version: 3 Date: 06 Jan 2021
Reviewer's report:
The present study examined the clinical value of a new scoring system named post-neoadjuvant
chemotherapy treatment (NACT) combination of serum tumor markers (post-NAC CTM)
involving CEA, CA19-9, and CA 72-4 for predicting pCR and prognosis in patients with locally
advanced gastric cancer. Although this paper included some important data, there were several
concerns as below.
Major comments
1. How can we make use of the findings of this study in actual clinical practice? In the
prediction of pathological response of NACT, pre-treatment parameters including CTM seem
to be clinically more useful compared to post-treatment parameters. Therefore, the authors need
to show the clinical value of post-NAC CTM in comparison with that of pre-NAC CTM. Was it
necessary to include cases with normal pre-NAC CTM value in this study? It may be interesting
to do same analyses by targeting only cases with high pre-NACT CTM value. On the other hand,
in the prediction of postoperative prognosis, ypStage seems to be more reliable compared to post-
NAC CTM. Can post-NAC CTM affect the indication of surgery or post-operative treatment
strategy such as adjuvant chemotherapy? Please give enough discussion of this point.
2. Please give the comments about the reasons why post-NACT CTM predicted pCR and
prognosis. Did post-NACT CTM reflect residual tumor burden?
Minor comments
1. Please add the indication for NAC and postoperative adjuvant chemotherapy to the method
section.
2. How many patients with pCR were there after NACT?
3. There were two Table 4, and no Table 5.
4. There were many mistakes in the grammar that need to be corrected.
Please review this paper.
user
Title: Combination of tumor markers predicts progression and pathological response in patients
with locally advanced gastric cancer after neoadjuvant chemotherapy treatment
Version: 3 Date: 06 Jan 2021
Reviewer's report:
The present study examined the clinical value of a new scoring system named post-neoadjuvant
chemotherapy treatment (NACT) combination of serum tumor markers (post-NAC CTM)
involving CEA, CA19-9, and CA 72-4 for predicting pCR and prognosis in patients with locally
advanced gastric cancer. Although this paper included some important data, there were several
concerns as below.
Major comments
1. How can we make use of the findings of this study in actual clinical practice? In the
prediction of pathological response of NACT, pre-treatment parameters including CTM seem
to be clinically more useful compared to post-treatment parameters. Therefore, the authors need
to show the clinical value of post-NAC CTM in comparison with that of pre-NAC CTM. Was it
necessary to include cases with normal pre-NAC CTM value in this study? It may be interesting
to do same analyses by targeting only cases with high pre-NACT CTM value. On the other hand,
in the prediction of postoperative prognosis, ypStage seems to be more reliable compared to post-
NAC CTM. Can post-NAC CTM affect the indication of surgery or post-operative treatment
strategy such as adjuvant chemotherapy? Please give enough discussion of this point.
2. Please give the comments about the reasons why post-NACT CTM predicted pCR and
prognosis. Did post-NACT CTM reflect residual tumor burden?
Minor comments
1. Please add the indication for NAC and postoperative adjuvant chemotherapy to the method
section.
2. How many patients with pCR were there after NACT?
3. There were two Table 4, and no Table 5.
4. There were many mistakes in the grammar that need to be corrected.
assistant