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: 2 Date: 17 May 2023
Reviewer's report:
Yoshida et al submitted the manuscript entitled ‘Safe radiofrequency ablation for low
platelet count patients with a novel platelet count raising drug (lusutrombopag): Prospective
Observational Study.’ There are some concerns to be addressed.
Major
1. Please clarify the study design. In the title, the authors mentioned a "prospective observational
study." However, in the trial registration, the authors mentioned "retrospective." Additionally,
the authors mentioned written informed consent in the Patients and Methods section. Please
clarify these inconsistencies.
2. The authors should provide a paragraph on "statistical analyses." They should describe
categorical variables as number (percentage) and numerical variables as median (IQR) in the
main text, Table 1, Table 2, and so on. Moreover, the authors should clarify the statistical method
used when comparing the two groups. Please provide specific p-values instead of using "n.s"
in Table 2.
3. There were only 91 patients included in this study. This sample size may be too small to
confidently state that the intervention is "safe" in the main text and title. It is difficult to draw a
conclusive "safe" conclusion based on the present results. The authors should consider revising
the wording.
4. Please add detailed patient characteristics, including ALBI score, mALBI grade, serum level
of albumin, serum total bilirubin, platelet count, presence of ascites, hepatic encephalopathy,
performance status, BCLC stage, and MELD score.
5. The study included 7 patients who did not respond to treatment, as their platelet counts did
not increase above 50,000 after administration of lusutrombopag. Did the authors administer
lusutrombopag again for these patients?
6. What are the authors' thoughts on the non-effective cases? How should non-effective cases
be managed when physicians need to perform invasive procedures? The authors should discuss
this aspect.
Minor points
1. Please provide a higher resolution figure
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: 2 Date: 17 May 2023
Reviewer's report:
Yoshida et al submitted the manuscript entitled ‘Safe radiofrequency ablation for low
platelet count patients with a novel platelet count raising drug (lusutrombopag): Prospective
Observational Study.’ There are some concerns to be addressed.
Major
1. Please clarify the study design. In the title, the authors mentioned a "prospective observational
study." However, in the trial registration, the authors mentioned "retrospective." Additionally,
the authors mentioned written informed consent in the Patients and Methods section. Please
clarify these inconsistencies.
2. The authors should provide a paragraph on "statistical analyses." They should describe
categorical variables as number (percentage) and numerical variables as median (IQR) in the
main text, Table 1, Table 2, and so on. Moreover, the authors should clarify the statistical method
used when comparing the two groups. Please provide specific p-values instead of using "n.s"
in Table 2.
3. There were only 91 patients included in this study. This sample size may be too small to
confidently state that the intervention is "safe" in the main text and title. It is difficult to draw a
conclusive "safe" conclusion based on the present results. The authors should consider revising
the wording.
4. Please add detailed patient characteristics, including ALBI score, mALBI grade, serum level
of albumin, serum total bilirubin, platelet count, presence of ascites, hepatic encephalopathy,
performance status, BCLC stage, and MELD score.
5. The study included 7 patients who did not respond to treatment, as their platelet counts did
not increase above 50,000 after administration of lusutrombopag. Did the authors administer
lusutrombopag again for these patients?
6. What are the authors' thoughts on the non-effective cases? How should non-effective cases
be managed when physicians need to perform invasive procedures? The authors should discuss
this aspect.
Minor points
1. Please provide a higher resolution figure
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: 2 Date: 17 May 2023
Reviewer's report:
Yoshida et al submitted the manuscript entitled ‘Safe radiofrequency ablation for low
platelet count patients with a novel platelet count raising drug (lusutrombopag): Prospective
Observational Study.’ There are some concerns to be addressed.
Major
1. Please clarify the study design. In the title, the authors mentioned a "prospective observational
study." However, in the trial registration, the authors mentioned "retrospective." Additionally,
the authors mentioned written informed consent in the Patients and Methods section. Please
clarify these inconsistencies.
2. The authors should provide a paragraph on "statistical analyses." They should describe
categorical variables as number (percentage) and numerical variables as median (IQR) in the
main text, Table 1, Table 2, and so on. Moreover, the authors should clarify the statistical method
used when comparing the two groups. Please provide specific p-values instead of using "n.s"
in Table 2.
3. There were only 91 patients included in this study. This sample size may be too small to
confidently state that the intervention is "safe" in the main text and title. It is difficult to draw a
conclusive "safe" conclusion based on the present results. The authors should consider revising
the wording.
4. Please add detailed patient characteristics, including ALBI score, mALBI grade, serum level
of albumin, serum total bilirubin, platelet count, presence of ascites, hepatic encephalopathy,
performance status, BCLC stage, and MELD score.
5. The study included 7 patients who did not respond to treatment, as their platelet counts did
not increase above 50,000 after administration of lusutrombopag. Did the authors administer
lusutrombopag again for these patients?
6. What are the authors' thoughts on the non-effective cases? How should non-effective cases
be managed when physicians need to perform invasive procedures? The authors should discuss
this aspect.
Minor points
1. Please provide a higher resolution figure
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