Reviewer ’s report  
 
Title: Elevated preoperative platelet -to-lymphocyte ratio predicts poor prognosis of patients with  
primary gastrointestinal stromal tumor  
 
Version: 2 Date: 24 Mar 2020  
 
Reviewer: Research Square Reviewer 1  
 
Reviewer's report:  
 
PEER REVIEWER ASSESSMENTS:  
 
OBJECTIVE - Full research articles: is there a clear objective that add resses one or several 
testable research questions? (Brief or other article types: is there a clear objective?)  
Yes - there is a clear objective  
 
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for the 
objective?  
Yes - the approach is appropriate  
 
EXECUTION - Are the experiments and analyses performed with sufficient technical rigor to 
allow confidence in the results?  
Yes - experiments and analyses were performed appropriately  
 
STATISTICS - Is the use of statistics in  the manuscript appropriate?  
Yes - appropriate statistical analyses have been used in the study  
 
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not 
overstated?  
Yes - the author's interpretation is reasonable  
 
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently 
for you to now recommend the work as a technically sound contribution? If not, can further 
revisions be made to make the work technically sound?  
Yes - current version is tec hnically sound  
 
 
PEER REVIEWER COMMENTS:  
 
GENERAL COMMENTS: This is an interesting manuscript that deals with a clinically relevant 
issue namely the identification of reliable prognostic biomarkers for recurrence (i.e. PFS and OS) 
in GIST.  The retrospecti ve study included a large number of GIST patients (n=646) who had 
their tumor resected but refused further adjuvant therapy. This manuscript and its conclusions are 
of interest to clinicians, pathologists and researchers studying and/or treating GIST.  
 
The authors have appropriately addressed the concerns of the reviewer and thereby improved the 
manuscript.  
 
 
REQUESTED REVISIONS:  
 
Only a few minor issues remain:  
1. Methods section - Please add a reference to the "modified National Institutes of Health 
(NIH ) consensus"  
2. Methods section - It is stated that all enrolled patients were diagnosed with GIST using 
immunohistochemical stainings. I assume immunostainings for CD117/KIT and DOG1 were 
used. Please specify in the text.  
3. Table 1 - The 6th column is mislabeled, it now states "High NLR" but it should be 
"High PLR". Please correct.  
4. Table 3 - The 2nd column, bottom line; there should be a comma between 4.364 and 
9.184. Please correct.  
5. Figure 1, top panel - Include the abbreviation GIST, and do not abbreviate June so the 
top panel should read: "Patients diagnosed with primary GIST from Jan. 2005 to June 2018 
(n=1082)" Please correct.  
 
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.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the  manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of w ritten 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 r eimbursements, 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 future?  
 
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.  
 
This reviewer has been recruited by a partner organization, Research Square. Reviewe rs with  
declared or apparent competing interests are not utilized for these reviews. This reviewer has  
agreed to publication of their comments online under a Creative Commons Attribution License  
attributed to Research Square and was paid a small honorarium  for completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer  
recommendation.  
 
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 accepted 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: Elevated preoperative platelet -to-lymphocyte ratio predicts poor prognosis of patients with  
primary gastrointestinal stromal tumor  
 
Version: 2 Date: 24 Mar 2020  
 
Reviewer: Research Square Reviewer 1  
 
Reviewer's report:  
 
PEER REVIEWER ASSESSMENTS:  
 
OBJECTIVE - Full research articles: is there a clear objective that add resses one or several 
testable research questions? (Brief or other article types: is there a clear objective?)  
Yes - there is a clear objective  
 
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for the 
objective?  
Yes - the approach is appropriate  
 
EXECUTION - Are the experiments and analyses performed with sufficient technical rigor to 
allow confidence in the results?  
Yes - experiments and analyses were performed appropriately  
 
STATISTICS - Is the use of statistics in  the manuscript appropriate?  
Yes - appropriate statistical analyses have been used in the study  
 
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not 
overstated?  
Yes - the author's interpretation is reasonable  
 
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently 
for you to now recommend the work as a technically sound contribution? If not, can further 
revisions be made to make the work technically sound?  
Yes - current version is tec hnically sound  
 
 
PEER REVIEWER COMMENTS:  
 
GENERAL COMMENTS: This is an interesting manuscript that deals with a clinically relevant 
issue namely the identification of reliable prognostic biomarkers for recurrence (i.e. PFS and OS) 
in GIST.  The retrospecti ve study included a large number of GIST patients (n=646) who had 
their tumor resected but refused further adjuvant therapy. This manuscript and its conclusions are 
of interest to clinicians, pathologists and researchers studying and/or treating GIST.  
 
The authors have appropriately addressed the concerns of the reviewer and thereby improved the 
manuscript.  
 
 
REQUESTED REVISIONS:  
 
Only a few minor issues remain:  
1. Methods section - Please add a reference to the "modified National Institutes of Health 
(NIH ) consensus"  
2. Methods section - It is stated that all enrolled patients were diagnosed with GIST using 
immunohistochemical stainings. I assume immunostainings for CD117/KIT and DOG1 were 
used. Please specify in the text.  
3. Table 1 - The 6th column is mislabeled, it now states "High NLR" but it should be 
"High PLR". Please correct.  
4. Table 3 - The 2nd column, bottom line; there should be a comma between 4.364 and 
9.184. Please correct.  
5. Figure 1, top panel - Include the abbreviation GIST, and do not abbreviate June so the 
top panel should read: "Patients diagnosed with primary GIST from Jan. 2005 to June 2018 
(n=1082)" Please correct.  
 
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.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the  manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of w ritten 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 r eimbursements, 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 future?  
 
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.  
 
This reviewer has been recruited by a partner organization, Research Square. Reviewe rs with  
declared or apparent competing interests are not utilized for these reviews. This reviewer has  
agreed to publication of their comments online under a Creative Commons Attribution License  
attributed to Research Square and was paid a small honorarium  for completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer  
recommendation.  
 
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 accepted 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: Elevated preoperative platelet -to-lymphocyte ratio predicts poor prognosis of patients with  
primary gastrointestinal stromal tumor  
 
Version: 2 Date: 24 Mar 2020  
 
Reviewer: Research Square Reviewer 1  
 
Reviewer's report:  
 
PEER REVIEWER ASSESSMENTS:  
 
OBJECTIVE - Full research articles: is there a clear objective that add resses one or several 
testable research questions? (Brief or other article types: is there a clear objective?)  
Yes - there is a clear objective  
 
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for the 
objective?  
Yes - the approach is appropriate  
 
EXECUTION - Are the experiments and analyses performed with sufficient technical rigor to 
allow confidence in the results?  
Yes - experiments and analyses were performed appropriately  
 
STATISTICS - Is the use of statistics in  the manuscript appropriate?  
Yes - appropriate statistical analyses have been used in the study  
 
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not 
overstated?  
Yes - the author's interpretation is reasonable  
 
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently 
for you to now recommend the work as a technically sound contribution? If not, can further 
revisions be made to make the work technically sound?  
Yes - current version is tec hnically sound  
 
 
PEER REVIEWER COMMENTS:  
 
GENERAL COMMENTS: This is an interesting manuscript that deals with a clinically relevant 
issue namely the identification of reliable prognostic biomarkers for recurrence (i.e. PFS and OS) 
in GIST.  The retrospecti ve study included a large number of GIST patients (n=646) who had 
their tumor resected but refused further adjuvant therapy. This manuscript and its conclusions are 
of interest to clinicians, pathologists and researchers studying and/or treating GIST.  
 
The authors have appropriately addressed the concerns of the reviewer and thereby improved the 
manuscript.  
 
 
REQUESTED REVISIONS:  
 
Only a few minor issues remain:  
1. Methods section - Please add a reference to the "modified National Institutes of Health 
(NIH ) consensus"  
2. Methods section - It is stated that all enrolled patients were diagnosed with GIST using 
immunohistochemical stainings. I assume immunostainings for CD117/KIT and DOG1 were 
used. Please specify in the text.  
3. Table 1 - The 6th column is mislabeled, it now states "High NLR" but it should be 
"High PLR". Please correct.  
4. Table 3 - The 2nd column, bottom line; there should be a comma between 4.364 and 
9.184. Please correct.  
5. Figure 1, top panel - Include the abbreviation GIST, and do not abbreviate June so the 
top panel should read: "Patients diagnosed with primary GIST from Jan. 2005 to June 2018 
(n=1082)" Please correct.  
 
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.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the  manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of w ritten 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 r eimbursements, 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 future?  
 
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.  
 
This reviewer has been recruited by a partner organization, Research Square. Reviewe rs with  
declared or apparent competing interests are not utilized for these reviews. This reviewer has  
agreed to publication of their comments online under a Creative Commons Attribution License  
attributed to Research Square and was paid a small honorarium  for completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer  
recommendation.  
 
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 accepted 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