Title: Risk factors and prognostic analysis of microscopic positive margins after radical surgery
for proximal gastric cancer
Version: 1 Date: 09 Jul 2024
Reviewer:  Shunji Endo
Reviewer's report:
Thank you for giving me such a great opportunity to review your paper entitled "Risk factors and
prognostic analysis of microscopic positive margins after radical surgery for proximal gastric
cancer." I read it with great interest.
However, while reading it, I felt a contradiction in the content of the discussion. I think that
readers will be unsure of how to apply this paper to their daily clinical practice after reading it.
1. The conclusion, "Patients with proximal gastric cancer whose tumors are located in the
esophagogastric junction, Borrmann type 3/4, Lauren diffuse/mixed type, margin distance <3
cm, pT4 stage, and vascular invasion are more likely to have positive margins, and intraoperative
frozen pathology is recommended for patients with a combination of these risk factors to ensure
negative margins, especially for patients with early-stage disease," is difficult to understand. It
is contradictory to say that patients with type 3/type 4 and pT4 have early-stage cancer. What
kind of patients should be subjected to intraoperative frozen pathology diagnosis?
2. Please provide a breakdown of the surgical procedure. Please state the indications for proximal
gastrectomy.
3. I think that proximal margin positive and distal margin positive should be discussed
separately. Actually, additional esophageal resection is sometimes difficult in case of positive
proximal margin, but in proximal gastrectomy, intraoperative pathological diagnosis of distal
margin should be performed proactively, and total gastrectomy should not be hesitated if the
margin is positive.
4. What does "constant" mean in Table 2?
5. Please state the classification method and version used for staging of gastric cancer. What
is pPn staging?
6. Was the SPSS version used 22.0 or 24?
Title: Risk factors and prognostic analysis of microscopic positive margins after radical surgery
for proximal gastric cancer
Version: 1 Date: 09 Jul 2024
Reviewer:  Shunji Endo
Reviewer's report:
Thank you for giving me such a great opportunity to review your paper entitled "Risk factors and
prognostic analysis of microscopic positive margins after radical surgery for proximal gastric
cancer." I read it with great interest.
However, while reading it, I felt a contradiction in the content of the discussion. I think that
readers will be unsure of how to apply this paper to their daily clinical practice after reading it.
1. The conclusion, "Patients with proximal gastric cancer whose tumors are located in the
esophagogastric junction, Borrmann type 3/4, Lauren diffuse/mixed type, margin distance <3
cm, pT4 stage, and vascular invasion are more likely to have positive margins, and intraoperative
frozen pathology is recommended for patients with a combination of these risk factors to ensure
negative margins, especially for patients with early-stage disease," is difficult to understand. It
is contradictory to say that patients with type 3/type 4 and pT4 have early-stage cancer. What
kind of patients should be subjected to intraoperative frozen pathology diagnosis?
2. Please provide a breakdown of the surgical procedure. Please state the indications for proximal
gastrectomy.
3. I think that proximal margin positive and distal margin positive should be discussed
separately. Actually, additional esophageal resection is sometimes difficult in case of positive
proximal margin, but in proximal gastrectomy, intraoperative pathological diagnosis of distal
margin should be performed proactively, and total gastrectomy should not be hesitated if the
margin is positive.
4. What does "constant" mean in Table 2?
5. Please state the classification method and version used for staging of gastric cancer. What
is pPn staging?
6. Was the SPSS version used 22.0 or 24?
Please review this paper.
user
Title: Risk factors and prognostic analysis of microscopic positive margins after radical surgery
for proximal gastric cancer
Version: 1 Date: 09 Jul 2024
Reviewer:  Shunji Endo
Reviewer's report:
Thank you for giving me such a great opportunity to review your paper entitled "Risk factors and
prognostic analysis of microscopic positive margins after radical surgery for proximal gastric
cancer." I read it with great interest.
However, while reading it, I felt a contradiction in the content of the discussion. I think that
readers will be unsure of how to apply this paper to their daily clinical practice after reading it.
1. The conclusion, "Patients with proximal gastric cancer whose tumors are located in the
esophagogastric junction, Borrmann type 3/4, Lauren diffuse/mixed type, margin distance <3
cm, pT4 stage, and vascular invasion are more likely to have positive margins, and intraoperative
frozen pathology is recommended for patients with a combination of these risk factors to ensure
negative margins, especially for patients with early-stage disease," is difficult to understand. It
is contradictory to say that patients with type 3/type 4 and pT4 have early-stage cancer. What
kind of patients should be subjected to intraoperative frozen pathology diagnosis?
2. Please provide a breakdown of the surgical procedure. Please state the indications for proximal
gastrectomy.
3. I think that proximal margin positive and distal margin positive should be discussed
separately. Actually, additional esophageal resection is sometimes difficult in case of positive
proximal margin, but in proximal gastrectomy, intraoperative pathological diagnosis of distal
margin should be performed proactively, and total gastrectomy should not be hesitated if the
margin is positive.
4. What does "constant" mean in Table 2?
5. Please state the classification method and version used for staging of gastric cancer. What
is pPn staging?
6. Was the SPSS version used 22.0 or 24?
assistant