Reviewer’s report
Title: Indications for adjuvant chemotherapy in patients with AJCC stage IIa T3N0M0 and T1N2M0
gastric cancer—an east and west multicenter study
Version: 0 Date: 17 Aug 2019
Reviewer: Emanuele Lo Menzo
Reviewer's report:
I  congratulate  the  authors  for  the  manuscript  entitled:"  Indications  for  adjuvant  chemotherapy in
patients with AJCC (7th ed.) stage IIa T3N0M0 and T1N2M0 gastric cancer - an east and west,
multicenter study"
In  the  manuscript  the  authors  compare  patients  from  the  Surveillance,  Epidemiology,and  End
Results(SEER) database and the databases from Fujian Medical University Union Hospital(FJUUH)
and the Italian IMIGASTRIC center to determine the ideal role of adjuvant chemotherapy. 
Major Compulsory Revisions
1-Your objective was to determine the ideal indications of adjuvant chemotherapy(AC) in patients
with stage IIa gastric cancer (T3N0M0 and T1N2M0). However, I have concerns that this objective can
be accomplished using epidemiological databases with several missing data points.
2-There is a big disparity between the AC group (Group C) (n = 287) and the non-AC group
(Group N) (n = 1306). Can you please comment on the potential impact on you results?
3-Since in the Eastern countries AC is not recommended in T3N0M0 and T1N2M0, these patients
treated with AC in the FJUUH database (198) might have had other reasons for having AC. Can you
offer some potential explanations? 
4-I believe it is necessary to mention as a limitation the fact that the variables not mentioned in
the SEER database were not included in the analysis.
5-Do you have any information on the type of resection these patients had? That is a major
variable missing in your study. Without this data, your conclusions might be skewed.
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.
No
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  statistical  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 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.
I declare that I have no competing interest
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: Indications for adjuvant chemotherapy in patients with AJCC stage IIa T3N0M0 and T1N2M0
gastric cancer—an east and west multicenter study
Version: 0 Date: 17 Aug 2019
Reviewer: Emanuele Lo Menzo
Reviewer's report:
I  congratulate  the  authors  for  the  manuscript  entitled:"  Indications  for  adjuvant  chemotherapy in
patients with AJCC (7th ed.) stage IIa T3N0M0 and T1N2M0 gastric cancer - an east and west,
multicenter study"
In  the  manuscript  the  authors  compare  patients  from  the  Surveillance,  Epidemiology,and  End
Results(SEER) database and the databases from Fujian Medical University Union Hospital(FJUUH)
and the Italian IMIGASTRIC center to determine the ideal role of adjuvant chemotherapy. 
Major Compulsory Revisions
1-Your objective was to determine the ideal indications of adjuvant chemotherapy(AC) in patients
with stage IIa gastric cancer (T3N0M0 and T1N2M0). However, I have concerns that this objective can
be accomplished using epidemiological databases with several missing data points.
2-There is a big disparity between the AC group (Group C) (n = 287) and the non-AC group
(Group N) (n = 1306). Can you please comment on the potential impact on you results?
3-Since in the Eastern countries AC is not recommended in T3N0M0 and T1N2M0, these patients
treated with AC in the FJUUH database (198) might have had other reasons for having AC. Can you
offer some potential explanations? 
4-I believe it is necessary to mention as a limitation the fact that the variables not mentioned in
the SEER database were not included in the analysis.
5-Do you have any information on the type of resection these patients had? That is a major
variable missing in your study. Without this data, your conclusions might be skewed.
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.
No
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  statistical  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 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.
I declare that I have no competing interest
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: Indications for adjuvant chemotherapy in patients with AJCC stage IIa T3N0M0 and T1N2M0
gastric cancer—an east and west multicenter study
Version: 0 Date: 17 Aug 2019
Reviewer: Emanuele Lo Menzo
Reviewer's report:
I  congratulate  the  authors  for  the  manuscript  entitled:"  Indications  for  adjuvant  chemotherapy in
patients with AJCC (7th ed.) stage IIa T3N0M0 and T1N2M0 gastric cancer - an east and west,
multicenter study"
In  the  manuscript  the  authors  compare  patients  from  the  Surveillance,  Epidemiology,and  End
Results(SEER) database and the databases from Fujian Medical University Union Hospital(FJUUH)
and the Italian IMIGASTRIC center to determine the ideal role of adjuvant chemotherapy. 
Major Compulsory Revisions
1-Your objective was to determine the ideal indications of adjuvant chemotherapy(AC) in patients
with stage IIa gastric cancer (T3N0M0 and T1N2M0). However, I have concerns that this objective can
be accomplished using epidemiological databases with several missing data points.
2-There is a big disparity between the AC group (Group C) (n = 287) and the non-AC group
(Group N) (n = 1306). Can you please comment on the potential impact on you results?
3-Since in the Eastern countries AC is not recommended in T3N0M0 and T1N2M0, these patients
treated with AC in the FJUUH database (198) might have had other reasons for having AC. Can you
offer some potential explanations? 
4-I believe it is necessary to mention as a limitation the fact that the variables not mentioned in
the SEER database were not included in the analysis.
5-Do you have any information on the type of resection these patients had? That is a major
variable missing in your study. Without this data, your conclusions might be skewed.
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.
No
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  statistical  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 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.
I declare that I have no competing interest
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