Reviewer’s report
Title: 
A dynamic predictive nomogram of long-term survival in primary gastric
lymphoma: a retrospective study
Version: 
0 
Date: 
26 Mar 2022
Reviewer's report:
This study aims to construct a nomogram in primary gastric lymphomas. In this
regard, the authors take into consideration two databases from which they select
two cohorts, referring to different time frames: SEER from 1975-2018 for a total
of 8898 patients and the Chinese one from 2015 to 2021 for a total of 127
patients. The work is well written, has logical sequence but there are some points
that need clarification:
1) Since the discovery of Helicobacter pylori dates back to 1984 and Isaacson's
first reports of MALT lymphoma date back to 1986, it would be interesting to
know how the data in the SEER database were extrapolated in the time ranging
from 1975 to early 1990.
2) From the text it is not possible to detect the magnitude of the population
studied for both cohorts and consequently the percentage of incidence of PGL.
3) The Ann Arbor staging system, as reported in the AJCC 7th edition of cancer
staging manual, was developed as a staging system to "photograph" the
developmental stage of lymphomas. In this intent, it does not consider other
variables such as marital status, age and race (Lines from 194 to 196 page 9) as
well as other staging systems do for other neoplasms, Lugano classification, for
instance, a more recent modification of Ann Arbor Staging System. However, for
DLBCL several additional factors are recommended for clinical care (page 943,
AJCC Cancer staging manual, 8th edition): International Prognostic Index (IPI)
and Related Indices, Cell of Origin (COO), Double-hit and Double expressor
DLBCL.
4) As correctly noted in the limitations of the study, the selection bias, the
absence of important parameters such as surgical details, HP status and
eventually its molecular status studied with RT-PCR and or FISH regarding
possible antibiotic resistance, family history, but also HIV, EBV status, gastric
microbiota analysis and any associated gastric pathologies that could possibly
interfere with therapeutic strategies were not considered. This is a severe
limitation on the impact of the study on patients' management. Despite this, I
believe that the study brings some clarifications in the therapeutic management
of PGL's patients that could be useful in association with the aforementioned
parameters.
5) Finally, it should be noted that the authors refer to the seventh edition of the
Cancer staging manual of the AJCC even if the eighth edition is currently in use,
with some differences listed above.
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Yes
Declaration of competing interests
Please complete a declaration of competing
interests, considering the following questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
I declare that I have no competing interests
Reviewer Publication Consent.
 I agree for my report to be made available
under an Open Access Creative Commons CC-BY License (
http://creativecommons.org/licenses/by/4.0
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the
editorial office before completing the review.
If you wish, you can include your
name in your published report. Please note you must decide whether to include
your name at the start of the process and confirm this decision whenever
prompted. If you change your decision later, we will not be able to publish your
name.
I agree to the terms of the CC-BY 4.0 license; please 
do not
 publish my name
with my report. (default)
Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes
Reviewer’s report
Title: 
A dynamic predictive nomogram of long-term survival in primary gastric
lymphoma: a retrospective study
Version: 
0 
Date: 
26 Mar 2022
Reviewer's report:
This study aims to construct a nomogram in primary gastric lymphomas. In this
regard, the authors take into consideration two databases from which they select
two cohorts, referring to different time frames: SEER from 1975-2018 for a total
of 8898 patients and the Chinese one from 2015 to 2021 for a total of 127
patients. The work is well written, has logical sequence but there are some points
that need clarification:
1) Since the discovery of Helicobacter pylori dates back to 1984 and Isaacson's
first reports of MALT lymphoma date back to 1986, it would be interesting to
know how the data in the SEER database were extrapolated in the time ranging
from 1975 to early 1990.
2) From the text it is not possible to detect the magnitude of the population
studied for both cohorts and consequently the percentage of incidence of PGL.
3) The Ann Arbor staging system, as reported in the AJCC 7th edition of cancer
staging manual, was developed as a staging system to "photograph" the
developmental stage of lymphomas. In this intent, it does not consider other
variables such as marital status, age and race (Lines from 194 to 196 page 9) as
well as other staging systems do for other neoplasms, Lugano classification, for
instance, a more recent modification of Ann Arbor Staging System. However, for
DLBCL several additional factors are recommended for clinical care (page 943,
AJCC Cancer staging manual, 8th edition): International Prognostic Index (IPI)
and Related Indices, Cell of Origin (COO), Double-hit and Double expressor
DLBCL.
4) As correctly noted in the limitations of the study, the selection bias, the
absence of important parameters such as surgical details, HP status and
eventually its molecular status studied with RT-PCR and or FISH regarding
possible antibiotic resistance, family history, but also HIV, EBV status, gastric
microbiota analysis and any associated gastric pathologies that could possibly
interfere with therapeutic strategies were not considered. This is a severe
limitation on the impact of the study on patients' management. Despite this, I
believe that the study brings some clarifications in the therapeutic management
of PGL's patients that could be useful in association with the aforementioned
parameters.
5) Finally, it should be noted that the authors refer to the seventh edition of the
Cancer staging manual of the AJCC even if the eighth edition is currently in use,
with some differences listed above.
Publons Reviewer Recognition
. Springer Nature can send verification of this
review directly to Publons (a subsidiary of Clarivate Analytics). If you would
like to take advantage of this service, please click on the “Yes” option below.
Your name, email address, title of the reviewed manuscript, name of the journal,
and date of your review submission (the “Review Data”) will then be transmitted
to Publons after the final decision on the manuscript has been made. If you have
already registered at Publons, they will notify you of the receipt of this review
and update your profile 
as per your settings and their policy. If you are not
registered with Publons, you will receive an email from them asking you to
register in order for them to be able to recognize your review on your new
profile page. Publons may use the Review Data to generate derivative metadata
for the benefit of Publons and you as a reviewer, carefully considering the
sensitivity of such information. For example, Publons may verify your record as
a reviewer by updating your profile published on its webservice if you have
registered for such service or help editors to identify candidate reviewers. Please
find the details of processing in Publons’ privacy policy
https://publons.com/about/terms
Yes
Declaration of competing interests
Please complete a declaration of competing
interests, considering the following questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
I declare that I have no competing interests
Reviewer Publication Consent.
 I agree for my report to be made available
under an Open Access Creative Commons CC-BY License (
http://creativecommons.org/licenses/by/4.0
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the
editorial office before completing the review.
If you wish, you can include your
name in your published report. Please note you must decide whether to include
your name at the start of the process and confirm this decision whenever
prompted. If you change your decision later, we will not be able to publish your
name.
I agree to the terms of the CC-BY 4.0 license; please 
do not
 publish my name
with my report. (default)
Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes
Please review this paper.
user
Reviewer’s report
Title: 
A dynamic predictive nomogram of long-term survival in primary gastric
lymphoma: a retrospective study
Version: 
0 
Date: 
26 Mar 2022
Reviewer's report:
This study aims to construct a nomogram in primary gastric lymphomas. In this
regard, the authors take into consideration two databases from which they select
two cohorts, referring to different time frames: SEER from 1975-2018 for a total
of 8898 patients and the Chinese one from 2015 to 2021 for a total of 127
patients. The work is well written, has logical sequence but there are some points
that need clarification:
1) Since the discovery of Helicobacter pylori dates back to 1984 and Isaacson's
first reports of MALT lymphoma date back to 1986, it would be interesting to
know how the data in the SEER database were extrapolated in the time ranging
from 1975 to early 1990.
2) From the text it is not possible to detect the magnitude of the population
studied for both cohorts and consequently the percentage of incidence of PGL.
3) The Ann Arbor staging system, as reported in the AJCC 7th edition of cancer
staging manual, was developed as a staging system to "photograph" the
developmental stage of lymphomas. In this intent, it does not consider other
variables such as marital status, age and race (Lines from 194 to 196 page 9) as
well as other staging systems do for other neoplasms, Lugano classification, for
instance, a more recent modification of Ann Arbor Staging System. However, for
DLBCL several additional factors are recommended for clinical care (page 943,
AJCC Cancer staging manual, 8th edition): International Prognostic Index (IPI)
and Related Indices, Cell of Origin (COO), Double-hit and Double expressor
DLBCL.
4) As correctly noted in the limitations of the study, the selection bias, the
absence of important parameters such as surgical details, HP status and
eventually its molecular status studied with RT-PCR and or FISH regarding
possible antibiotic resistance, family history, but also HIV, EBV status, gastric
microbiota analysis and any associated gastric pathologies that could possibly
interfere with therapeutic strategies were not considered. This is a severe
limitation on the impact of the study on patients' management. Despite this, I
believe that the study brings some clarifications in the therapeutic management
of PGL's patients that could be useful in association with the aforementioned
parameters.
5) Finally, it should be noted that the authors refer to the seventh edition of the
Cancer staging manual of the AJCC even if the eighth edition is currently in use,
with some differences listed above.
Publons Reviewer Recognition
. Springer Nature can send verification of this
review directly to Publons (a subsidiary of Clarivate Analytics). If you would
like to take advantage of this service, please click on the “Yes” option below.
Your name, email address, title of the reviewed manuscript, name of the journal,
and date of your review submission (the “Review Data”) will then be transmitted
to Publons after the final decision on the manuscript has been made. If you have
already registered at Publons, they will notify you of the receipt of this review
and update your profile 
as per your settings and their policy. If you are not
registered with Publons, you will receive an email from them asking you to
register in order for them to be able to recognize your review on your new
profile page. Publons may use the Review Data to generate derivative metadata
for the benefit of Publons and you as a reviewer, carefully considering the
sensitivity of such information. For example, Publons may verify your record as
a reviewer by updating your profile published on its webservice if you have
registered for such service or help editors to identify candidate reviewers. Please
find the details of processing in Publons’ privacy policy
https://publons.com/about/terms
Yes
Declaration of competing interests
Please complete a declaration of competing
interests, considering the following questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
I declare that I have no competing interests
Reviewer Publication Consent.
 I agree for my report to be made available
under an Open Access Creative Commons CC-BY License (
http://creativecommons.org/licenses/by/4.0
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the
editorial office before completing the review.
If you wish, you can include your
name in your published report. Please note you must decide whether to include
your name at the start of the process and confirm this decision whenever
prompted. If you change your decision later, we will not be able to publish your
name.
I agree to the terms of the CC-BY 4.0 license; please 
do not
 publish my name
with my report. (default)
Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes
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