Title: Clinical value of systemic immunoinflammatory index in predicting recurrence and
metastasis in patients with primary liver cancer
Version: 2 Date: 10 Dec 2024
Reviewer's report:
The clinical value of SII in predicting recurrence and metastasis in 186 patients with primary
liver cancer treated by TACE was discussed. Several aspects require further clarification and
discussion to enhance the manuscript’s scientific rigor.
1. In the part of inclusion criteria, the author selected 186 patients with primary liver cancer,
and focused on the clinical significance of the AFP level of patients. However, we know that
the significance of AFP for hepatocellular carcinoma and intrahepatic cholangiocarcinoma is
different. Therefore, whether it is appropriate to analyze the relationship between AFP level and
recurrence and metastasis of patients with primary liver cancer.
2. Why did the selected 186 patients not choose surgical treatment, and why did not they use
immunotherapy and targeted therapy? Surgical treatment, immune therapy and targeted therapy
will have a great impact on SII, which needs to be accurately analyzed and compared.
3. In (1) and (4) of the exclusion criteria, posterior pathology and surgical margins are mentioned,
but the study does not mention that the selected patients underwent surgery.
4.According to the guidelines, patients with primary liver cancer may have multiple SII index
and AFP levels reviewed during the 2-year follow-up period. In Table 4 and Table 5, how did
the author statistically analyze SII index and AFP levels.
5.The article repeatedly mentioned tumor recurrence after TACE, but did not accurately evaluate
the effect of TACE in patients.
6.When analyzing the results of Table 4, the article mentioned that "AFP levels were independent
risk factors affecting the recurrence and metabolism of patients with primary liver cancer
(p<0.05)" However, we all know that elevated AFP may be the result of tumor recurrence and
metastasis, not necessarily independent risk factors affecting the recurrence and metastasis. Is
this conclusion appropriate.
7.The discussion part should focus on the analysis of the feasibility and limitations of SII as a
predictor.
Title: Clinical value of systemic immunoinflammatory index in predicting recurrence and
metastasis in patients with primary liver cancer
Version: 2 Date: 10 Dec 2024
Reviewer's report:
The clinical value of SII in predicting recurrence and metastasis in 186 patients with primary
liver cancer treated by TACE was discussed. Several aspects require further clarification and
discussion to enhance the manuscript’s scientific rigor.
1. In the part of inclusion criteria, the author selected 186 patients with primary liver cancer,
and focused on the clinical significance of the AFP level of patients. However, we know that
the significance of AFP for hepatocellular carcinoma and intrahepatic cholangiocarcinoma is
different. Therefore, whether it is appropriate to analyze the relationship between AFP level and
recurrence and metastasis of patients with primary liver cancer.
2. Why did the selected 186 patients not choose surgical treatment, and why did not they use
immunotherapy and targeted therapy? Surgical treatment, immune therapy and targeted therapy
will have a great impact on SII, which needs to be accurately analyzed and compared.
3. In (1) and (4) of the exclusion criteria, posterior pathology and surgical margins are mentioned,
but the study does not mention that the selected patients underwent surgery.
4.According to the guidelines, patients with primary liver cancer may have multiple SII index
and AFP levels reviewed during the 2-year follow-up period. In Table 4 and Table 5, how did
the author statistically analyze SII index and AFP levels.
5.The article repeatedly mentioned tumor recurrence after TACE, but did not accurately evaluate
the effect of TACE in patients.
6.When analyzing the results of Table 4, the article mentioned that "AFP levels were independent
risk factors affecting the recurrence and metabolism of patients with primary liver cancer
(p<0.05)" However, we all know that elevated AFP may be the result of tumor recurrence and
metastasis, not necessarily independent risk factors affecting the recurrence and metastasis. Is
this conclusion appropriate.
7.The discussion part should focus on the analysis of the feasibility and limitations of SII as a
predictor.
Please review this paper.
user
Title: Clinical value of systemic immunoinflammatory index in predicting recurrence and
metastasis in patients with primary liver cancer
Version: 2 Date: 10 Dec 2024
Reviewer's report:
The clinical value of SII in predicting recurrence and metastasis in 186 patients with primary
liver cancer treated by TACE was discussed. Several aspects require further clarification and
discussion to enhance the manuscript’s scientific rigor.
1. In the part of inclusion criteria, the author selected 186 patients with primary liver cancer,
and focused on the clinical significance of the AFP level of patients. However, we know that
the significance of AFP for hepatocellular carcinoma and intrahepatic cholangiocarcinoma is
different. Therefore, whether it is appropriate to analyze the relationship between AFP level and
recurrence and metastasis of patients with primary liver cancer.
2. Why did the selected 186 patients not choose surgical treatment, and why did not they use
immunotherapy and targeted therapy? Surgical treatment, immune therapy and targeted therapy
will have a great impact on SII, which needs to be accurately analyzed and compared.
3. In (1) and (4) of the exclusion criteria, posterior pathology and surgical margins are mentioned,
but the study does not mention that the selected patients underwent surgery.
4.According to the guidelines, patients with primary liver cancer may have multiple SII index
and AFP levels reviewed during the 2-year follow-up period. In Table 4 and Table 5, how did
the author statistically analyze SII index and AFP levels.
5.The article repeatedly mentioned tumor recurrence after TACE, but did not accurately evaluate
the effect of TACE in patients.
6.When analyzing the results of Table 4, the article mentioned that "AFP levels were independent
risk factors affecting the recurrence and metabolism of patients with primary liver cancer
(p<0.05)" However, we all know that elevated AFP may be the result of tumor recurrence and
metastasis, not necessarily independent risk factors affecting the recurrence and metastasis. Is
this conclusion appropriate.
7.The discussion part should focus on the analysis of the feasibility and limitations of SII as a
predictor.
assistant