Title: Lymph node ratio is a prognostic indicator for locally advanced gastric cancer after
neoadjuvant immunochemotherapy
Version: 3 Date: 26 Aug 2024
Reviewer:  Chikara Kunisaki
Reviewer's report:
Major comments
The topic of this study is interesting and informative.
However, the number of patients is unfortunately small to conclude something.
Based on the results of this study, the prognostic value of LNR was as equal to Nstage.
What can we clinically do based on the results of this study?
Minor comments
1. In Results of Abstract section, non-PCR should be fully spelled out at the first appearance.
2. This study is approved by the Ethics Committee of the institution. Please clearly show us the
approved number for this study.
3. It is better to obtain the informed consent from each patient by the opt-out recruitment in the
home page of the institution.
4. How did authors select the regimen of the NICT?
5. Please show us the information of adjuvant chemotherapy.
6. Did all patients undergo R0 gastrectomy? Please clarify this issue.
7. Continuous variables should be expressed if the normal distribution is not observed.
8. It is mandatory to precisely describe the method of multivariate analysis. For example, how
did authors select the factors inserted into multivariate analysis?
9. The duration of follow-up is short to lead appropriate outcomes.
10. In Table 1, please add the explanations for abbreviations.
11. Please unify pCR and PCR. Moreover, was this pathological estimation performed for lymph
node alone or whole resected specimen?
12. In Figure 2, LNR may serve as an alternative to ypN stage for prognostication in LAGC
following NICT.
This is correct. However, the value of AUC between 0.6 to 0.7 is regarded as poor. Therefore,
impact of LNR as prognostic factor is not strong.
13. It is possible to combine Table 2 and Table 3 into new Table 2.
14. Conclusion of Discussion section is too long. I wonder that the following sentence can be
conclusion. Consequently, the LNR may be employed as an ------ diagnosed with LAGC and
treated with NICT.
15. There are many grammatical errors. Please check these.
Title: Lymph node ratio is a prognostic indicator for locally advanced gastric cancer after
neoadjuvant immunochemotherapy
Version: 3 Date: 26 Aug 2024
Reviewer:  Chikara Kunisaki
Reviewer's report:
Major comments
The topic of this study is interesting and informative.
However, the number of patients is unfortunately small to conclude something.
Based on the results of this study, the prognostic value of LNR was as equal to Nstage.
What can we clinically do based on the results of this study?
Minor comments
1. In Results of Abstract section, non-PCR should be fully spelled out at the first appearance.
2. This study is approved by the Ethics Committee of the institution. Please clearly show us the
approved number for this study.
3. It is better to obtain the informed consent from each patient by the opt-out recruitment in the
home page of the institution.
4. How did authors select the regimen of the NICT?
5. Please show us the information of adjuvant chemotherapy.
6. Did all patients undergo R0 gastrectomy? Please clarify this issue.
7. Continuous variables should be expressed if the normal distribution is not observed.
8. It is mandatory to precisely describe the method of multivariate analysis. For example, how
did authors select the factors inserted into multivariate analysis?
9. The duration of follow-up is short to lead appropriate outcomes.
10. In Table 1, please add the explanations for abbreviations.
11. Please unify pCR and PCR. Moreover, was this pathological estimation performed for lymph
node alone or whole resected specimen?
12. In Figure 2, LNR may serve as an alternative to ypN stage for prognostication in LAGC
following NICT.
This is correct. However, the value of AUC between 0.6 to 0.7 is regarded as poor. Therefore,
impact of LNR as prognostic factor is not strong.
13. It is possible to combine Table 2 and Table 3 into new Table 2.
14. Conclusion of Discussion section is too long. I wonder that the following sentence can be
conclusion. Consequently, the LNR may be employed as an ------ diagnosed with LAGC and
treated with NICT.
15. There are many grammatical errors. Please check these.
Please review this paper.
user
Title: Lymph node ratio is a prognostic indicator for locally advanced gastric cancer after
neoadjuvant immunochemotherapy
Version: 3 Date: 26 Aug 2024
Reviewer:  Chikara Kunisaki
Reviewer's report:
Major comments
The topic of this study is interesting and informative.
However, the number of patients is unfortunately small to conclude something.
Based on the results of this study, the prognostic value of LNR was as equal to Nstage.
What can we clinically do based on the results of this study?
Minor comments
1. In Results of Abstract section, non-PCR should be fully spelled out at the first appearance.
2. This study is approved by the Ethics Committee of the institution. Please clearly show us the
approved number for this study.
3. It is better to obtain the informed consent from each patient by the opt-out recruitment in the
home page of the institution.
4. How did authors select the regimen of the NICT?
5. Please show us the information of adjuvant chemotherapy.
6. Did all patients undergo R0 gastrectomy? Please clarify this issue.
7. Continuous variables should be expressed if the normal distribution is not observed.
8. It is mandatory to precisely describe the method of multivariate analysis. For example, how
did authors select the factors inserted into multivariate analysis?
9. The duration of follow-up is short to lead appropriate outcomes.
10. In Table 1, please add the explanations for abbreviations.
11. Please unify pCR and PCR. Moreover, was this pathological estimation performed for lymph
node alone or whole resected specimen?
12. In Figure 2, LNR may serve as an alternative to ypN stage for prognostication in LAGC
following NICT.
This is correct. However, the value of AUC between 0.6 to 0.7 is regarded as poor. Therefore,
impact of LNR as prognostic factor is not strong.
13. It is possible to combine Table 2 and Table 3 into new Table 2.
14. Conclusion of Discussion section is too long. I wonder that the following sentence can be
conclusion. Consequently, the LNR may be employed as an ------ diagnosed with LAGC and
treated with NICT.
15. There are many grammatical errors. Please check these.
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