Reviewer's report
Title:Hepatitis B vs. Hepatitis C Infection on Viral Hepatitis-Associated
Hepatocellular Carcinoma
Version: 2Date:8 April 2012
Reviewer: Mark Bloomston
Reviewer's report:
This paper addresses an interesting issue and is worthy of publication. However,
I think it would be enhanced by addressing the following:
1. The authors suggest that screening for HCC in HBV carriers should start
earlier than age 40 as recommended by AASLD. It would be helpful if they
include data on HBV DNA concentrations to determine the correlation with
cancer risk. The AASLD considers high HBV titers as high risk for HCC
regardless of age.
2. The authors suggest that AFP may not be a useful screening tool for
HCV-associated HCC based upon an arbitrary threshold of 100, acknowledging
that this is well above their lab's upper limit of normal. This should be tempered in
the discussion as trends in AFP may more important in a screening program than
a threshold value.
3. As a reader, I would be interested to know what proportion of patients actually
underwent definitive therapy with curative (i.e. resection, transplant, ablation) or
palliative (i.e. TACE, chemo) intent. Suggesting that curative therapy was not
available to patients outside of Milan criteria is not a fair estimation of who could
(or did) undergo curative therapy since a large single lesion or limited multifocal
disease >3cm without major invasion may still be curable with resection.
4. Table 3 is not helpful as this single data point is already in the text.
5. "...highly statistically significant..." is a misnomer and should not be in the
results section
6. Although I doubt it will change the p value much, fisher's exact test is more
appropriate than chi-square when the # of events is <10 (table 1).
7. Data is introduced in the discussion regarding ethnicity which is not included in
the results.
8. Throughout the paper are multiple misuses of commas and hyphens.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Reviewer's report
Title:Hepatitis B vs. Hepatitis C Infection on Viral Hepatitis-Associated
Hepatocellular Carcinoma
Version: 2Date:8 April 2012
Reviewer: Mark Bloomston
Reviewer's report:
This paper addresses an interesting issue and is worthy of publication. However,
I think it would be enhanced by addressing the following:
1. The authors suggest that screening for HCC in HBV carriers should start
earlier than age 40 as recommended by AASLD. It would be helpful if they
include data on HBV DNA concentrations to determine the correlation with
cancer risk. The AASLD considers high HBV titers as high risk for HCC
regardless of age.
2. The authors suggest that AFP may not be a useful screening tool for
HCV-associated HCC based upon an arbitrary threshold of 100, acknowledging
that this is well above their lab's upper limit of normal. This should be tempered in
the discussion as trends in AFP may more important in a screening program than
a threshold value.
3. As a reader, I would be interested to know what proportion of patients actually
underwent definitive therapy with curative (i.e. resection, transplant, ablation) or
palliative (i.e. TACE, chemo) intent. Suggesting that curative therapy was not
available to patients outside of Milan criteria is not a fair estimation of who could
(or did) undergo curative therapy since a large single lesion or limited multifocal
disease >3cm without major invasion may still be curable with resection.
4. Table 3 is not helpful as this single data point is already in the text.
5. "...highly statistically significant..." is a misnomer and should not be in the
results section
6. Although I doubt it will change the p value much, fisher's exact test is more
appropriate than chi-square when the # of events is <10 (table 1).
7. Data is introduced in the discussion regarding ethnicity which is not included in
the results.
8. Throughout the paper are multiple misuses of commas and hyphens.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Please review this paper.
user
Reviewer's report
Title:Hepatitis B vs. Hepatitis C Infection on Viral Hepatitis-Associated
Hepatocellular Carcinoma
Version: 2Date:8 April 2012
Reviewer: Mark Bloomston
Reviewer's report:
This paper addresses an interesting issue and is worthy of publication. However,
I think it would be enhanced by addressing the following:
1. The authors suggest that screening for HCC in HBV carriers should start
earlier than age 40 as recommended by AASLD. It would be helpful if they
include data on HBV DNA concentrations to determine the correlation with
cancer risk. The AASLD considers high HBV titers as high risk for HCC
regardless of age.
2. The authors suggest that AFP may not be a useful screening tool for
HCV-associated HCC based upon an arbitrary threshold of 100, acknowledging
that this is well above their lab's upper limit of normal. This should be tempered in
the discussion as trends in AFP may more important in a screening program than
a threshold value.
3. As a reader, I would be interested to know what proportion of patients actually
underwent definitive therapy with curative (i.e. resection, transplant, ablation) or
palliative (i.e. TACE, chemo) intent. Suggesting that curative therapy was not
available to patients outside of Milan criteria is not a fair estimation of who could
(or did) undergo curative therapy since a large single lesion or limited multifocal
disease >3cm without major invasion may still be curable with resection.
4. Table 3 is not helpful as this single data point is already in the text.
5. "...highly statistically significant..." is a misnomer and should not be in the
results section
6. Although I doubt it will change the p value much, fisher's exact test is more
appropriate than chi-square when the # of events is <10 (table 1).
7. Data is introduced in the discussion regarding ethnicity which is not included in
the results.
8. Throughout the paper are multiple misuses of commas and hyphens.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
assistant