Title: Risk of Lymph Node Metastasis and Feasibility of Endoscopic Submucosal Dissection
in Undifferentiated-type Early Gastric Cancer
Version: 2 Date: 01 Mar 2023
Reviewer's report:
Thank you for revising the manuscript. Unfortunately, some of responses are not satisfactory.
1. I understand the limitations in the retrospective design, but, if the authors use “preoperatively
assessable factors,” it is not appropriate to evaluate SM or ulceration by using histological data.
Especially, it is strange to evaluate preoperative and postoperative SM as the same factor in
Table 2, and the same can be said about ulceration. At least, clear description about this limitation
is mandatory.
2. Some data of 95% CI in Table 3 are wrong. For example, the lower limit of 95% CI of 20.0%
is described as 0.36 (maybe it means 36%). It is strange.
3. Outcome measure subsection was not added in the revised manuscript and the reasons for
selecting candidate variables were not also added, despite the reviewer’s recommendation. The
reasons shown by the authors are not reasonable for the scientific journal. Please add them.
4. Distinction of SM1 and SM2 is important. SM2 can be differentiated from SM1 even in the
surgical specimen, according to the Japanese guidelines. At least, clear description about this
limitation is required.
5. The authors suggested that preoperative evaluation should be cautious when the lesion is
depressed, flat or located in the cardia, 94-99% of undifferentiated early gastric cancer are flat
or depressed type, as shown in my previous report. Thus, it means that preoperative evaluation
should be cautious in most of undifferentiated early gastric cancer. This message may be strange,
and it was not improved in the revised version.
Title: Risk of Lymph Node Metastasis and Feasibility of Endoscopic Submucosal Dissection
in Undifferentiated-type Early Gastric Cancer
Version: 2 Date: 01 Mar 2023
Reviewer's report:
Thank you for revising the manuscript. Unfortunately, some of responses are not satisfactory.
1. I understand the limitations in the retrospective design, but, if the authors use “preoperatively
assessable factors,” it is not appropriate to evaluate SM or ulceration by using histological data.
Especially, it is strange to evaluate preoperative and postoperative SM as the same factor in
Table 2, and the same can be said about ulceration. At least, clear description about this limitation
is mandatory.
2. Some data of 95% CI in Table 3 are wrong. For example, the lower limit of 95% CI of 20.0%
is described as 0.36 (maybe it means 36%). It is strange.
3. Outcome measure subsection was not added in the revised manuscript and the reasons for
selecting candidate variables were not also added, despite the reviewer’s recommendation. The
reasons shown by the authors are not reasonable for the scientific journal. Please add them.
4. Distinction of SM1 and SM2 is important. SM2 can be differentiated from SM1 even in the
surgical specimen, according to the Japanese guidelines. At least, clear description about this
limitation is required.
5. The authors suggested that preoperative evaluation should be cautious when the lesion is
depressed, flat or located in the cardia, 94-99% of undifferentiated early gastric cancer are flat
or depressed type, as shown in my previous report. Thus, it means that preoperative evaluation
should be cautious in most of undifferentiated early gastric cancer. This message may be strange,
and it was not improved in the revised version.
Please review this paper.
user
Title: Risk of Lymph Node Metastasis and Feasibility of Endoscopic Submucosal Dissection
in Undifferentiated-type Early Gastric Cancer
Version: 2 Date: 01 Mar 2023
Reviewer's report:
Thank you for revising the manuscript. Unfortunately, some of responses are not satisfactory.
1. I understand the limitations in the retrospective design, but, if the authors use “preoperatively
assessable factors,” it is not appropriate to evaluate SM or ulceration by using histological data.
Especially, it is strange to evaluate preoperative and postoperative SM as the same factor in
Table 2, and the same can be said about ulceration. At least, clear description about this limitation
is mandatory.
2. Some data of 95% CI in Table 3 are wrong. For example, the lower limit of 95% CI of 20.0%
is described as 0.36 (maybe it means 36%). It is strange.
3. Outcome measure subsection was not added in the revised manuscript and the reasons for
selecting candidate variables were not also added, despite the reviewer’s recommendation. The
reasons shown by the authors are not reasonable for the scientific journal. Please add them.
4. Distinction of SM1 and SM2 is important. SM2 can be differentiated from SM1 even in the
surgical specimen, according to the Japanese guidelines. At least, clear description about this
limitation is required.
5. The authors suggested that preoperative evaluation should be cautious when the lesion is
depressed, flat or located in the cardia, 94-99% of undifferentiated early gastric cancer are flat
or depressed type, as shown in my previous report. Thus, it means that preoperative evaluation
should be cautious in most of undifferentiated early gastric cancer. This message may be strange,
and it was not improved in the revised version.
assistant