Title: A Study on Prevention of Bleeding Complications Using Lusutrombopag for Safe RFA in
Patients with Hepatocellular Carcinoma with Low Platelet Counts: Prospective Observational
Study.
Version: 4 Date: 07 Jun 2023
Reviewer's report:
1. Can lusutrombopag be used in decompensated cirrhosis with Child Pugh Score C?
2. Each percentage of patient number who were lower than 50,000 and higher than 50,000 at
baseline, is recommended to be described in table 1 & 2.
3. Regarding exclusion criteria, what were the criteria for patients who could not receive
lusutrombopag?
4. What authors are required to describe is about safety profile in this study’s results not previous
other study results. Because this study has prospective design, detailed description of adverse
events in separate table are necessary. (Grade of A/E also is required
5. Regarding previous question #7, how could TNM stage III, and IV patients and BLCC stage
B, C, D undergo RFA? For example, RFA is often considered as treatment methods only in
BCLC 0 and A.
6. Authors described that the predictors of effective outcome were verified in Methods
section. What’s the predictor for effective outcome and risk factor for non-effectiveness with
lusutrombopag?
7. What was the criteria for PLT transfusion? Regarding table 2, did patients group with initial
PLT count > 50,000 did not undergo PLT transfusion if PLT at last exam was higher than 50,000?
There would be severe bias if criteria for PLT transfusion is based on the level of PLT level
because baseline PLT differs in the beginning. This is important because the authors regarded
the PLT transfusion as primary outcome of this study.
Title: A Study on Prevention of Bleeding Complications Using Lusutrombopag for Safe RFA in
Patients with Hepatocellular Carcinoma with Low Platelet Counts: Prospective Observational
Study.
Version: 4 Date: 07 Jun 2023
Reviewer's report:
1. Can lusutrombopag be used in decompensated cirrhosis with Child Pugh Score C?
2. Each percentage of patient number who were lower than 50,000 and higher than 50,000 at
baseline, is recommended to be described in table 1 & 2.
3. Regarding exclusion criteria, what were the criteria for patients who could not receive
lusutrombopag?
4. What authors are required to describe is about safety profile in this study’s results not previous
other study results. Because this study has prospective design, detailed description of adverse
events in separate table are necessary. (Grade of A/E also is required
5. Regarding previous question #7, how could TNM stage III, and IV patients and BLCC stage
B, C, D undergo RFA? For example, RFA is often considered as treatment methods only in
BCLC 0 and A.
6. Authors described that the predictors of effective outcome were verified in Methods
section. What’s the predictor for effective outcome and risk factor for non-effectiveness with
lusutrombopag?
7. What was the criteria for PLT transfusion? Regarding table 2, did patients group with initial
PLT count > 50,000 did not undergo PLT transfusion if PLT at last exam was higher than 50,000?
There would be severe bias if criteria for PLT transfusion is based on the level of PLT level
because baseline PLT differs in the beginning. This is important because the authors regarded
the PLT transfusion as primary outcome of this study.
Please review this paper.
user
Title: A Study on Prevention of Bleeding Complications Using Lusutrombopag for Safe RFA in
Patients with Hepatocellular Carcinoma with Low Platelet Counts: Prospective Observational
Study.
Version: 4 Date: 07 Jun 2023
Reviewer's report:
1. Can lusutrombopag be used in decompensated cirrhosis with Child Pugh Score C?
2. Each percentage of patient number who were lower than 50,000 and higher than 50,000 at
baseline, is recommended to be described in table 1 & 2.
3. Regarding exclusion criteria, what were the criteria for patients who could not receive
lusutrombopag?
4. What authors are required to describe is about safety profile in this study’s results not previous
other study results. Because this study has prospective design, detailed description of adverse
events in separate table are necessary. (Grade of A/E also is required
5. Regarding previous question #7, how could TNM stage III, and IV patients and BLCC stage
B, C, D undergo RFA? For example, RFA is often considered as treatment methods only in
BCLC 0 and A.
6. Authors described that the predictors of effective outcome were verified in Methods
section. What’s the predictor for effective outcome and risk factor for non-effectiveness with
lusutrombopag?
7. What was the criteria for PLT transfusion? Regarding table 2, did patients group with initial
PLT count > 50,000 did not undergo PLT transfusion if PLT at last exam was higher than 50,000?
There would be severe bias if criteria for PLT transfusion is based on the level of PLT level
because baseline PLT differs in the beginning. This is important because the authors regarded
the PLT transfusion as primary outcome of this study.
assistant