Title: Short- and long-term outcomes of neoadjuvant chemotherapy compared with neoadjuvant
chemoradiotherapy for locally advanced rectal cancer: An updated meta-analysis
Version: 1 Date: 01 Dec 2024
Reviewer:  Junyang Lu
Reviewer's report:
The optimization of neoadjuvant therapy for rectal cancer has been a hot research topic in recent
years. This meta-analysis compared NAC with standard NACRT in the neoadjuvant treatment
of rectal cancer, providing evidence for the application of NAC in rectal cancer neoadjuvant
therapy. I have the following comments on this article:
1.The inclusion criteria should clearly specify the stage of rectal cancer. TNM staging is the
most important factor influencing long-term efficacy, followed by the neoadjuvant treatment
regimen. In the conclusion, the authors recommend NAC for stage II/III patients and NACRT for
stage IV patients. The research conclusions need to be supported by the study's results, meaning
that the conclusions should apply only to the patients included in the study.
2.The majority of the studies included in the meta-analysis are non-randomized controlled
studies, which have a higher risk of bias. Low-risk patients may be more likely to choose NAC,
while high-risk patients may opt for NACRT. This potential bias should be discussed in the
discussion section of the article.
3.Tumor response in the NACRT group was better than in the NAC group, including a higher
pCR rate and better TRG grading. Theoretically, better tumor shrinkage is more favorable
for sphincter-preserving surgery. However, the higher rate of sphincter-preserving surgery in
the NAC group may be due to differences in tumor location between the two groups before
treatment. As mentioned, tumors located higher in the rectum generally have a lower risk,
and these patients may be more likely to choose NAC. Given these potential biases, the
corresponding statements in the conclusion should be removed.
Title: Short- and long-term outcomes of neoadjuvant chemotherapy compared with neoadjuvant
chemoradiotherapy for locally advanced rectal cancer: An updated meta-analysis
Version: 1 Date: 01 Dec 2024
Reviewer:  Junyang Lu
Reviewer's report:
The optimization of neoadjuvant therapy for rectal cancer has been a hot research topic in recent
years. This meta-analysis compared NAC with standard NACRT in the neoadjuvant treatment
of rectal cancer, providing evidence for the application of NAC in rectal cancer neoadjuvant
therapy. I have the following comments on this article:
1.The inclusion criteria should clearly specify the stage of rectal cancer. TNM staging is the
most important factor influencing long-term efficacy, followed by the neoadjuvant treatment
regimen. In the conclusion, the authors recommend NAC for stage II/III patients and NACRT for
stage IV patients. The research conclusions need to be supported by the study's results, meaning
that the conclusions should apply only to the patients included in the study.
2.The majority of the studies included in the meta-analysis are non-randomized controlled
studies, which have a higher risk of bias. Low-risk patients may be more likely to choose NAC,
while high-risk patients may opt for NACRT. This potential bias should be discussed in the
discussion section of the article.
3.Tumor response in the NACRT group was better than in the NAC group, including a higher
pCR rate and better TRG grading. Theoretically, better tumor shrinkage is more favorable
for sphincter-preserving surgery. However, the higher rate of sphincter-preserving surgery in
the NAC group may be due to differences in tumor location between the two groups before
treatment. As mentioned, tumors located higher in the rectum generally have a lower risk,
and these patients may be more likely to choose NAC. Given these potential biases, the
corresponding statements in the conclusion should be removed.
Please review this paper.
user
Title: Short- and long-term outcomes of neoadjuvant chemotherapy compared with neoadjuvant
chemoradiotherapy for locally advanced rectal cancer: An updated meta-analysis
Version: 1 Date: 01 Dec 2024
Reviewer:  Junyang Lu
Reviewer's report:
The optimization of neoadjuvant therapy for rectal cancer has been a hot research topic in recent
years. This meta-analysis compared NAC with standard NACRT in the neoadjuvant treatment
of rectal cancer, providing evidence for the application of NAC in rectal cancer neoadjuvant
therapy. I have the following comments on this article:
1.The inclusion criteria should clearly specify the stage of rectal cancer. TNM staging is the
most important factor influencing long-term efficacy, followed by the neoadjuvant treatment
regimen. In the conclusion, the authors recommend NAC for stage II/III patients and NACRT for
stage IV patients. The research conclusions need to be supported by the study's results, meaning
that the conclusions should apply only to the patients included in the study.
2.The majority of the studies included in the meta-analysis are non-randomized controlled
studies, which have a higher risk of bias. Low-risk patients may be more likely to choose NAC,
while high-risk patients may opt for NACRT. This potential bias should be discussed in the
discussion section of the article.
3.Tumor response in the NACRT group was better than in the NAC group, including a higher
pCR rate and better TRG grading. Theoretically, better tumor shrinkage is more favorable
for sphincter-preserving surgery. However, the higher rate of sphincter-preserving surgery in
the NAC group may be due to differences in tumor location between the two groups before
treatment. As mentioned, tumors located higher in the rectum generally have a lower risk,
and these patients may be more likely to choose NAC. Given these potential biases, the
corresponding statements in the conclusion should be removed.
assistant