Title: Long-term outcomes of endoscopic submucosal dissection for superficial esophageal
squamous cell carcinoma in Taiwan
Version: 3 Date: 24 May 2021
Reviewer:  Noboru Hanaoka
Reviewer's report:
Thank you for giving me an opportunity to review this article. This is a retrospective analysis of
the outcome of the patients who underwent esophageal ESD in Taiwan. This manuscripts was
well written and would help the readers to manage esophageal cancer.
I have some comments as below.
##There is a consensus on the course of tumors with shallow depths, and many cases have
been proven to be curable with ESD resection. However, tumors deeper than SM1 require
some additional treatment, and no consensus has been reached. In this case, you mentioned that
additional surgical treatment or CRT was chosen for cases deeper than SM1, and you should
present and detail the clinical course of these cases.
2#It details the use of endoscopy for follow-up to detect local recurrence and metachronous
lesions. However, specific methods and examination intervals for detecting lymph node
metastases and distant metastases are not described. I don't think there is a uniform method for
all eligible patients because this is a retrospective analysis, but this can be a limitation.
3#I don't think there is much difference from the reports from Japan, what do you think is the
reason for that?
4.The authors should clarify the definition of adverse events. Mediastinal emphysema was
defined as the presence of air in the mediastinal space.  How did the authors confirm the air in
the mediastinal space? Computed tomography?
5. Esophageal stricture was defined as narrowing with dysphagia that required endoscopic
treatment. How did the authors confirm the stricture? Esophagogastroduodenoscopy?
Title: Long-term outcomes of endoscopic submucosal dissection for superficial esophageal
squamous cell carcinoma in Taiwan
Version: 3 Date: 24 May 2021
Reviewer:  Noboru Hanaoka
Reviewer's report:
Thank you for giving me an opportunity to review this article. This is a retrospective analysis of
the outcome of the patients who underwent esophageal ESD in Taiwan. This manuscripts was
well written and would help the readers to manage esophageal cancer.
I have some comments as below.
##There is a consensus on the course of tumors with shallow depths, and many cases have
been proven to be curable with ESD resection. However, tumors deeper than SM1 require
some additional treatment, and no consensus has been reached. In this case, you mentioned that
additional surgical treatment or CRT was chosen for cases deeper than SM1, and you should
present and detail the clinical course of these cases.
2#It details the use of endoscopy for follow-up to detect local recurrence and metachronous
lesions. However, specific methods and examination intervals for detecting lymph node
metastases and distant metastases are not described. I don't think there is a uniform method for
all eligible patients because this is a retrospective analysis, but this can be a limitation.
3#I don't think there is much difference from the reports from Japan, what do you think is the
reason for that?
4.The authors should clarify the definition of adverse events. Mediastinal emphysema was
defined as the presence of air in the mediastinal space.  How did the authors confirm the air in
the mediastinal space? Computed tomography?
5. Esophageal stricture was defined as narrowing with dysphagia that required endoscopic
treatment. How did the authors confirm the stricture? Esophagogastroduodenoscopy?
Please review this paper.
user
Title: Long-term outcomes of endoscopic submucosal dissection for superficial esophageal
squamous cell carcinoma in Taiwan
Version: 3 Date: 24 May 2021
Reviewer:  Noboru Hanaoka
Reviewer's report:
Thank you for giving me an opportunity to review this article. This is a retrospective analysis of
the outcome of the patients who underwent esophageal ESD in Taiwan. This manuscripts was
well written and would help the readers to manage esophageal cancer.
I have some comments as below.
##There is a consensus on the course of tumors with shallow depths, and many cases have
been proven to be curable with ESD resection. However, tumors deeper than SM1 require
some additional treatment, and no consensus has been reached. In this case, you mentioned that
additional surgical treatment or CRT was chosen for cases deeper than SM1, and you should
present and detail the clinical course of these cases.
2#It details the use of endoscopy for follow-up to detect local recurrence and metachronous
lesions. However, specific methods and examination intervals for detecting lymph node
metastases and distant metastases are not described. I don't think there is a uniform method for
all eligible patients because this is a retrospective analysis, but this can be a limitation.
3#I don't think there is much difference from the reports from Japan, what do you think is the
reason for that?
4.The authors should clarify the definition of adverse events. Mediastinal emphysema was
defined as the presence of air in the mediastinal space.  How did the authors confirm the air in
the mediastinal space? Computed tomography?
5. Esophageal stricture was defined as narrowing with dysphagia that required endoscopic
treatment. How did the authors confirm the stricture? Esophagogastroduodenoscopy?
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