Title: Examination of the characteristics of long-term survivors among patients with gallbladder
cancer with liver metastasis who underwent surgical treatment: A retrospective multicenter study
(ACRoS1406)
Version: 3 Date: 05 Mar 2022
Reviewer:  Marta Krawczyk
Reviewer's report:
The paper entitled “Examination of the characteristics of long-term survivors among patients
with gallbladder cancer with liver metastasis who underwent surgical treatment: A retrospective
multicenter study” is a retrospective analysis of the treatment of 503 patients with gallbladder
cancer with liver oligometastasis collected from several surgical departments in Japan.
The problem analyzed by the authors is important because in the Far East countries, gallbladder
cancer is quite a common disease, and the results of treatment are still unsatisfactory, especially
in the group of patients with metastases to the liver and other organs.
While analyzing the manuscript, I noticed two problems which, in my opinion, require
clarification or correction.
The first one concerns the inclusion of patients with gallbladder cancer of various
histopathological types. In my opinion, this part needs to be improved. The results of treatment
of patients with gallbladder adenocarcinoma and carcinosarcoma tumors, neuroendocrine
carcinomas or undifferentiated carcinomas should not be analyzed jointly. The biology and
malignancy of each of these histopathological types are different. Therefore, in my opinion, the
analysis should include only adenocarcinoma type gallbladder cancer, and other cases should
be excluded from the study.
The second point that is unclear to me is the scope of the operation. The authors write that they
analyzed patients with oligometastasis, while some patients had to undergo hemihepatectomy
or even duodenopancreatectomy. How it is possible to assume in advance that the patient with
oligometastasis requires such huge surgical procedure. This, in my opinion, needs an explanation
or a separate analysis.
Title: Examination of the characteristics of long-term survivors among patients with gallbladder
cancer with liver metastasis who underwent surgical treatment: A retrospective multicenter study
(ACRoS1406)
Version: 3 Date: 05 Mar 2022
Reviewer:  Marta Krawczyk
Reviewer's report:
The paper entitled “Examination of the characteristics of long-term survivors among patients
with gallbladder cancer with liver metastasis who underwent surgical treatment: A retrospective
multicenter study” is a retrospective analysis of the treatment of 503 patients with gallbladder
cancer with liver oligometastasis collected from several surgical departments in Japan.
The problem analyzed by the authors is important because in the Far East countries, gallbladder
cancer is quite a common disease, and the results of treatment are still unsatisfactory, especially
in the group of patients with metastases to the liver and other organs.
While analyzing the manuscript, I noticed two problems which, in my opinion, require
clarification or correction.
The first one concerns the inclusion of patients with gallbladder cancer of various
histopathological types. In my opinion, this part needs to be improved. The results of treatment
of patients with gallbladder adenocarcinoma and carcinosarcoma tumors, neuroendocrine
carcinomas or undifferentiated carcinomas should not be analyzed jointly. The biology and
malignancy of each of these histopathological types are different. Therefore, in my opinion, the
analysis should include only adenocarcinoma type gallbladder cancer, and other cases should
be excluded from the study.
The second point that is unclear to me is the scope of the operation. The authors write that they
analyzed patients with oligometastasis, while some patients had to undergo hemihepatectomy
or even duodenopancreatectomy. How it is possible to assume in advance that the patient with
oligometastasis requires such huge surgical procedure. This, in my opinion, needs an explanation
or a separate analysis.
Please review this paper.
user
Title: Examination of the characteristics of long-term survivors among patients with gallbladder
cancer with liver metastasis who underwent surgical treatment: A retrospective multicenter study
(ACRoS1406)
Version: 3 Date: 05 Mar 2022
Reviewer:  Marta Krawczyk
Reviewer's report:
The paper entitled “Examination of the characteristics of long-term survivors among patients
with gallbladder cancer with liver metastasis who underwent surgical treatment: A retrospective
multicenter study” is a retrospective analysis of the treatment of 503 patients with gallbladder
cancer with liver oligometastasis collected from several surgical departments in Japan.
The problem analyzed by the authors is important because in the Far East countries, gallbladder
cancer is quite a common disease, and the results of treatment are still unsatisfactory, especially
in the group of patients with metastases to the liver and other organs.
While analyzing the manuscript, I noticed two problems which, in my opinion, require
clarification or correction.
The first one concerns the inclusion of patients with gallbladder cancer of various
histopathological types. In my opinion, this part needs to be improved. The results of treatment
of patients with gallbladder adenocarcinoma and carcinosarcoma tumors, neuroendocrine
carcinomas or undifferentiated carcinomas should not be analyzed jointly. The biology and
malignancy of each of these histopathological types are different. Therefore, in my opinion, the
analysis should include only adenocarcinoma type gallbladder cancer, and other cases should
be excluded from the study.
The second point that is unclear to me is the scope of the operation. The authors write that they
analyzed patients with oligometastasis, while some patients had to undergo hemihepatectomy
or even duodenopancreatectomy. How it is possible to assume in advance that the patient with
oligometastasis requires such huge surgical procedure. This, in my opinion, needs an explanation
or a separate analysis.
assistant