Reviewer's report
Title:Transarterial chemoembolization for hepatocellular carcinoma with portal
vein tumor thrombus: A meta-analysis
Version: 1Date:10 January 2013
Reviewer: Yoon Jun Kim
Reviewer's report:
The authors conducted this meta-analysis using nonrandomized trials having
different study design including 3 prospective controlled studies and 5
retrospective studies. In this case, bias of each group was not fully balanced in
this study and the comparability of prognosis could not be ensured. However, as
the authors stated, the real “randomized” trials are difficult to be designed and
performed. The authors performed a meta-analysis based on thorough
systematic review. They found that TACE significantly improved the overall
6-month (HR, 0.41; 95% CI: 0.32, 0.53; z, 6.28; p=.000) and 1-year (HR, 0.44;
95% CI: 0.34, 0.57; z, 6.22; p=.000) survival of patients with PVTT compared
with conservative treatment. In addition, they demonstrated that the severe
deadly complications were very low, even if in patients with MPV obstruction.
Based on these findings, the authors concluded that TACE has potential to incur
a survival benefit and is safe for advanced HCC with PVTT. This is a
well-conducted study but the following comment is to be addressed before its
publication.
<Discretionary Revisions>
1. Because of no full text, four trials from Europe, and another trial from Asia
were not included in this study. Although the authors performed sensitivity
analysis to rule out publication bias, the possibility of publication bias still may
exist. The authors may need to provide additional funnel plot and describe the
results of these excluded five studies.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Reviewer's report
Title:Transarterial chemoembolization for hepatocellular carcinoma with portal
vein tumor thrombus: A meta-analysis
Version: 1Date:10 January 2013
Reviewer: Yoon Jun Kim
Reviewer's report:
The authors conducted this meta-analysis using nonrandomized trials having
different study design including 3 prospective controlled studies and 5
retrospective studies. In this case, bias of each group was not fully balanced in
this study and the comparability of prognosis could not be ensured. However, as
the authors stated, the real “randomized” trials are difficult to be designed and
performed. The authors performed a meta-analysis based on thorough
systematic review. They found that TACE significantly improved the overall
6-month (HR, 0.41; 95% CI: 0.32, 0.53; z, 6.28; p=.000) and 1-year (HR, 0.44;
95% CI: 0.34, 0.57; z, 6.22; p=.000) survival of patients with PVTT compared
with conservative treatment. In addition, they demonstrated that the severe
deadly complications were very low, even if in patients with MPV obstruction.
Based on these findings, the authors concluded that TACE has potential to incur
a survival benefit and is safe for advanced HCC with PVTT. This is a
well-conducted study but the following comment is to be addressed before its
publication.
<Discretionary Revisions>
1. Because of no full text, four trials from Europe, and another trial from Asia
were not included in this study. Although the authors performed sensitivity
analysis to rule out publication bias, the possibility of publication bias still may
exist. The authors may need to provide additional funnel plot and describe the
results of these excluded five studies.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Please review this paper.
user
Reviewer's report
Title:Transarterial chemoembolization for hepatocellular carcinoma with portal
vein tumor thrombus: A meta-analysis
Version: 1Date:10 January 2013
Reviewer: Yoon Jun Kim
Reviewer's report:
The authors conducted this meta-analysis using nonrandomized trials having
different study design including 3 prospective controlled studies and 5
retrospective studies. In this case, bias of each group was not fully balanced in
this study and the comparability of prognosis could not be ensured. However, as
the authors stated, the real “randomized” trials are difficult to be designed and
performed. The authors performed a meta-analysis based on thorough
systematic review. They found that TACE significantly improved the overall
6-month (HR, 0.41; 95% CI: 0.32, 0.53; z, 6.28; p=.000) and 1-year (HR, 0.44;
95% CI: 0.34, 0.57; z, 6.22; p=.000) survival of patients with PVTT compared
with conservative treatment. In addition, they demonstrated that the severe
deadly complications were very low, even if in patients with MPV obstruction.
Based on these findings, the authors concluded that TACE has potential to incur
a survival benefit and is safe for advanced HCC with PVTT. This is a
well-conducted study but the following comment is to be addressed before its
publication.
<Discretionary Revisions>
1. Because of no full text, four trials from Europe, and another trial from Asia
were not included in this study. Although the authors performed sensitivity
analysis to rule out publication bias, the possibility of publication bias still may
exist. The authors may need to provide additional funnel plot and describe the
results of these excluded five studies.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
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