Reviewer ’s report  
Title: Endoscopic submucosal dissection under general anesth esia for superficial esophageal 
squamous cell carcinoma is associated with better clinical outcomes  
 
Version: 0 Date: 24 Mar 2018  
 
Reviewer: Ichiro Oda  
 
Reviewer's report:  
The aut hors retrospectively evaluated the results of endoscopic submucosal dissection (ESD) for 
superficial esophageal squamous cell carcinoma (SESCC). Although it is an interesting topic, 
several changes are needed to improve the overall quality of this manuscri pt. 
 
1. The manuscript includes two major topics; long -term outcomes of ESD for SEECC and short -
term outcomes between conscious sedation and general anesthesia groups. Unfortunately, it is 
difficult for readers to understand the manuscript including two di fferent topics. It would be 
better to focus on each topic and split this manuscript into two.  
2. Long -term outcome; Please indicate the long -term outcomes using Kaplan -Meier method such 
as metachronous cancer incidence, overall survival and disease specifi c survival.  In addition, 
please comment on the long -term outcomes as compared with previous studies of ESD and 
surgery.  
3. Long -term outcome; Please indicate the detail of histopathological results of ESD and the 
clinical course in one LNM recurrence case  following curative resection.  
4. Short -term outcomes; In the Methods section, Please indicate the ESD experiences of the 
endoscopists between the conscious sedation and general anesthesia groups.  
5. Short -term outcomes; Even if there was not any differenc e in the ESD experience of each 
endoscopist between the two groups, there might be the institutional learning curve for 
esophageal ESD. Please comments on this limitation in the Discussion section.  
6. What does the abbreviation (AJCC) stand for?  
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
No 
Does the work include the necessary controls?  
If not, ple ase specify which controls are required in your comments to the authors.  
No 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
Yes 
Are you able to assess any statistics in the manuscri pt or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
I am able to assess the statistics  
Quality of written En glish  
Please indicate the quality of language in the manuscript:  
Acceptable  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
1. Have you in the past five years received reimbursem ents, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation t hat 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 th e 
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.  
 
I agree to the open peer review policy of t he journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agr ee for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confidential co mments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
Title: Endoscopic submucosal dissection under general anesth esia for superficial esophageal 
squamous cell carcinoma is associated with better clinical outcomes  
 
Version: 0 Date: 24 Mar 2018  
 
Reviewer: Ichiro Oda  
 
Reviewer's report:  
The aut hors retrospectively evaluated the results of endoscopic submucosal dissection (ESD) for 
superficial esophageal squamous cell carcinoma (SESCC). Although it is an interesting topic, 
several changes are needed to improve the overall quality of this manuscri pt. 
 
1. The manuscript includes two major topics; long -term outcomes of ESD for SEECC and short -
term outcomes between conscious sedation and general anesthesia groups. Unfortunately, it is 
difficult for readers to understand the manuscript including two di fferent topics. It would be 
better to focus on each topic and split this manuscript into two.  
2. Long -term outcome; Please indicate the long -term outcomes using Kaplan -Meier method such 
as metachronous cancer incidence, overall survival and disease specifi c survival.  In addition, 
please comment on the long -term outcomes as compared with previous studies of ESD and 
surgery.  
3. Long -term outcome; Please indicate the detail of histopathological results of ESD and the 
clinical course in one LNM recurrence case  following curative resection.  
4. Short -term outcomes; In the Methods section, Please indicate the ESD experiences of the 
endoscopists between the conscious sedation and general anesthesia groups.  
5. Short -term outcomes; Even if there was not any differenc e in the ESD experience of each 
endoscopist between the two groups, there might be the institutional learning curve for 
esophageal ESD. Please comments on this limitation in the Discussion section.  
6. What does the abbreviation (AJCC) stand for?  
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
No 
Does the work include the necessary controls?  
If not, ple ase specify which controls are required in your comments to the authors.  
No 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
Yes 
Are you able to assess any statistics in the manuscri pt or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
I am able to assess the statistics  
Quality of written En glish  
Please indicate the quality of language in the manuscript:  
Acceptable  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
1. Have you in the past five years received reimbursem ents, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation t hat 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 th e 
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.  
 
I agree to the open peer review policy of t he journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agr ee for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confidential co mments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
Title: Endoscopic submucosal dissection under general anesth esia for superficial esophageal 
squamous cell carcinoma is associated with better clinical outcomes  
 
Version: 0 Date: 24 Mar 2018  
 
Reviewer: Ichiro Oda  
 
Reviewer's report:  
The aut hors retrospectively evaluated the results of endoscopic submucosal dissection (ESD) for 
superficial esophageal squamous cell carcinoma (SESCC). Although it is an interesting topic, 
several changes are needed to improve the overall quality of this manuscri pt. 
 
1. The manuscript includes two major topics; long -term outcomes of ESD for SEECC and short -
term outcomes between conscious sedation and general anesthesia groups. Unfortunately, it is 
difficult for readers to understand the manuscript including two di fferent topics. It would be 
better to focus on each topic and split this manuscript into two.  
2. Long -term outcome; Please indicate the long -term outcomes using Kaplan -Meier method such 
as metachronous cancer incidence, overall survival and disease specifi c survival.  In addition, 
please comment on the long -term outcomes as compared with previous studies of ESD and 
surgery.  
3. Long -term outcome; Please indicate the detail of histopathological results of ESD and the 
clinical course in one LNM recurrence case  following curative resection.  
4. Short -term outcomes; In the Methods section, Please indicate the ESD experiences of the 
endoscopists between the conscious sedation and general anesthesia groups.  
5. Short -term outcomes; Even if there was not any differenc e in the ESD experience of each 
endoscopist between the two groups, there might be the institutional learning curve for 
esophageal ESD. Please comments on this limitation in the Discussion section.  
6. What does the abbreviation (AJCC) stand for?  
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
No 
Does the work include the necessary controls?  
If not, ple ase specify which controls are required in your comments to the authors.  
No 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
Yes 
Are you able to assess any statistics in the manuscri pt or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
I am able to assess the statistics  
Quality of written En glish  
Please indicate the quality of language in the manuscript:  
Acceptable  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
1. Have you in the past five years received reimbursem ents, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation t hat 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 th e 
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.  
 
I agree to the open peer review policy of t he journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agr ee for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confidential co mments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant