Title: Predicting the risk of lymph node metastasis in colon cancer: development and validation
of an online dynamic nomogram based on multiple preoperative data
Version: 0 Date: 15 Nov 2024
Reviewer's report:
Title “Predicting the risk of lymph node metastasis in colon cancer: development and validation
of an online dynamic nomogram based on multiple preoperative data”
Thank you for the opportunity to review this article. I have the following comments.
This study presented a novel nomogram to predict the risk of lymph node metastasis in colon
cancer patients.
This study will make certain contributions to the field of research on the prediction model of
lymph node metastasis in colorectal cancer patients. However, some points should be addressed.
“Major issues”
1) Generally, the derivation cohort and validation cohort are required to build a nomogram; in
the absence of a cohort for external validation, it is common practice to split the total cohort.
2) Although lymph node status on CT is a crucial factor in this nomogram (nearly 90 points),
there is no description of what findings resulted in a positive lymph node diagnosis by CT.
3) Intestinal obstruction is also not defined. This is also a crucial factor in this nomogram (100
points) and should be defined.
4) The clinical significance of this nomogram needs to be more specifically described. If
this nomogram indicated that a patient is likely to be positive for lymph node metastases
preoperatively, what difference in decision-making would be made in clinical practice?
“Minor issues”
1) The “CIC” in the abstract should not be abbreviated.
2) Regarding lines 18-21 of the Introduction section, the authors mentioned that accurate
preoperative prediction of regional lymph node metastasis facilitates postoperative adjuvant
chemotherapy, but postoperative chemotherapy is based on postoperative pathology results. The
authors should correct this description to be accurate.
3) One unique aspect of this nomogram is that it includes blood type as a factor. However, the
percentage of blood types is known to vary considerably around the world. It is unclear whether
it has external validity for cohorts in other countries.
4) In table 2, it should be clarified what is the reference value of age.
5) RAS, BRAF, and MSI status may be also an important predictive factor, and this information
should be provided.
Title: Predicting the risk of lymph node metastasis in colon cancer: development and validation
of an online dynamic nomogram based on multiple preoperative data
Version: 0 Date: 15 Nov 2024
Reviewer's report:
Title “Predicting the risk of lymph node metastasis in colon cancer: development and validation
of an online dynamic nomogram based on multiple preoperative data”
Thank you for the opportunity to review this article. I have the following comments.
This study presented a novel nomogram to predict the risk of lymph node metastasis in colon
cancer patients.
This study will make certain contributions to the field of research on the prediction model of
lymph node metastasis in colorectal cancer patients. However, some points should be addressed.
“Major issues”
1) Generally, the derivation cohort and validation cohort are required to build a nomogram; in
the absence of a cohort for external validation, it is common practice to split the total cohort.
2) Although lymph node status on CT is a crucial factor in this nomogram (nearly 90 points),
there is no description of what findings resulted in a positive lymph node diagnosis by CT.
3) Intestinal obstruction is also not defined. This is also a crucial factor in this nomogram (100
points) and should be defined.
4) The clinical significance of this nomogram needs to be more specifically described. If
this nomogram indicated that a patient is likely to be positive for lymph node metastases
preoperatively, what difference in decision-making would be made in clinical practice?
“Minor issues”
1) The “CIC” in the abstract should not be abbreviated.
2) Regarding lines 18-21 of the Introduction section, the authors mentioned that accurate
preoperative prediction of regional lymph node metastasis facilitates postoperative adjuvant
chemotherapy, but postoperative chemotherapy is based on postoperative pathology results. The
authors should correct this description to be accurate.
3) One unique aspect of this nomogram is that it includes blood type as a factor. However, the
percentage of blood types is known to vary considerably around the world. It is unclear whether
it has external validity for cohorts in other countries.
4) In table 2, it should be clarified what is the reference value of age.
5) RAS, BRAF, and MSI status may be also an important predictive factor, and this information
should be provided.
Please review this paper.
user
Title: Predicting the risk of lymph node metastasis in colon cancer: development and validation
of an online dynamic nomogram based on multiple preoperative data
Version: 0 Date: 15 Nov 2024
Reviewer's report:
Title “Predicting the risk of lymph node metastasis in colon cancer: development and validation
of an online dynamic nomogram based on multiple preoperative data”
Thank you for the opportunity to review this article. I have the following comments.
This study presented a novel nomogram to predict the risk of lymph node metastasis in colon
cancer patients.
This study will make certain contributions to the field of research on the prediction model of
lymph node metastasis in colorectal cancer patients. However, some points should be addressed.
“Major issues”
1) Generally, the derivation cohort and validation cohort are required to build a nomogram; in
the absence of a cohort for external validation, it is common practice to split the total cohort.
2) Although lymph node status on CT is a crucial factor in this nomogram (nearly 90 points),
there is no description of what findings resulted in a positive lymph node diagnosis by CT.
3) Intestinal obstruction is also not defined. This is also a crucial factor in this nomogram (100
points) and should be defined.
4) The clinical significance of this nomogram needs to be more specifically described. If
this nomogram indicated that a patient is likely to be positive for lymph node metastases
preoperatively, what difference in decision-making would be made in clinical practice?
“Minor issues”
1) The “CIC” in the abstract should not be abbreviated.
2) Regarding lines 18-21 of the Introduction section, the authors mentioned that accurate
preoperative prediction of regional lymph node metastasis facilitates postoperative adjuvant
chemotherapy, but postoperative chemotherapy is based on postoperative pathology results. The
authors should correct this description to be accurate.
3) One unique aspect of this nomogram is that it includes blood type as a factor. However, the
percentage of blood types is known to vary considerably around the world. It is unclear whether
it has external validity for cohorts in other countries.
4) In table 2, it should be clarified what is the reference value of age.
5) RAS, BRAF, and MSI status may be also an important predictive factor, and this information
should be provided.
assistant