Title: The Prognostic Role of the AST/ALT Ratio in Hepatocellular carcinoma Patients
Receiving Thermal Ablation Combined with Simultaneous TACE
Version: 0 Date: 10 Aug 2022
Reviewer's report:
In this study, the authors aimed to assess the prognostic value of the pre-treatment aspartate
transaminase (AST)/alanine transaminase (ALT) ratio in hepatocellular carcinoma (HCC)
patients receiving radiofrequency ablation (RFA)/microwave ablation (MWA) combined with
simultaneous TACE.
The endpoint of prognosis was overall survival (OS).
They found that  AST/ALT ratio cut-off value for OS prediction was 0.89, and patients with
a higher AST/ALT ratio had poorer overall survival. The median OS for the high-value AST/
ALT group was not reached, while the median OS for the low-value AST/ALT group was 48.5
months (P=0.0047). The univariate and multivariate analysis showed that AST/ALT ratio, AFP,
and tumor numbers were independent prognostic indicators for OS. The integrated nomogram
showed higher predictive accuracy for OS .
They concluded that the preoperative AST/ALT ratio can be a prognostic indicator for HCC
patients receiving thermal ablation combined with simultaneous TACE.
The study is of clinical interest. I have only a point requiring to be addressed. The
transaminase value has been previously investigated as prognostic indicator of HCC treatments.
In particular, the authors in the discussion should discuss the recent findings of transient
hypertransaminasemia after TACE as significantly related to the objective radiological response
(TRANS-TACE: Prognostic Role of the Transient Hypertransaminasemia after Conventional
Chemoembolization for Hepatocellular Carcinoma. J Pers Med. 2021 Oct 17;11(10):1041. ).
In my opinion, this study further supports the potential use of transaminase serum levels as
prognostic markers in HCC patients who underwent locoregional treatments.
Title: The Prognostic Role of the AST/ALT Ratio in Hepatocellular carcinoma Patients
Receiving Thermal Ablation Combined with Simultaneous TACE
Version: 0 Date: 10 Aug 2022
Reviewer's report:
In this study, the authors aimed to assess the prognostic value of the pre-treatment aspartate
transaminase (AST)/alanine transaminase (ALT) ratio in hepatocellular carcinoma (HCC)
patients receiving radiofrequency ablation (RFA)/microwave ablation (MWA) combined with
simultaneous TACE.
The endpoint of prognosis was overall survival (OS).
They found that  AST/ALT ratio cut-off value for OS prediction was 0.89, and patients with
a higher AST/ALT ratio had poorer overall survival. The median OS for the high-value AST/
ALT group was not reached, while the median OS for the low-value AST/ALT group was 48.5
months (P=0.0047). The univariate and multivariate analysis showed that AST/ALT ratio, AFP,
and tumor numbers were independent prognostic indicators for OS. The integrated nomogram
showed higher predictive accuracy for OS .
They concluded that the preoperative AST/ALT ratio can be a prognostic indicator for HCC
patients receiving thermal ablation combined with simultaneous TACE.
The study is of clinical interest. I have only a point requiring to be addressed. The
transaminase value has been previously investigated as prognostic indicator of HCC treatments.
In particular, the authors in the discussion should discuss the recent findings of transient
hypertransaminasemia after TACE as significantly related to the objective radiological response
(TRANS-TACE: Prognostic Role of the Transient Hypertransaminasemia after Conventional
Chemoembolization for Hepatocellular Carcinoma. J Pers Med. 2021 Oct 17;11(10):1041. ).
In my opinion, this study further supports the potential use of transaminase serum levels as
prognostic markers in HCC patients who underwent locoregional treatments.
Please review this paper.
user
Title: The Prognostic Role of the AST/ALT Ratio in Hepatocellular carcinoma Patients
Receiving Thermal Ablation Combined with Simultaneous TACE
Version: 0 Date: 10 Aug 2022
Reviewer's report:
In this study, the authors aimed to assess the prognostic value of the pre-treatment aspartate
transaminase (AST)/alanine transaminase (ALT) ratio in hepatocellular carcinoma (HCC)
patients receiving radiofrequency ablation (RFA)/microwave ablation (MWA) combined with
simultaneous TACE.
The endpoint of prognosis was overall survival (OS).
They found that  AST/ALT ratio cut-off value for OS prediction was 0.89, and patients with
a higher AST/ALT ratio had poorer overall survival. The median OS for the high-value AST/
ALT group was not reached, while the median OS for the low-value AST/ALT group was 48.5
months (P=0.0047). The univariate and multivariate analysis showed that AST/ALT ratio, AFP,
and tumor numbers were independent prognostic indicators for OS. The integrated nomogram
showed higher predictive accuracy for OS .
They concluded that the preoperative AST/ALT ratio can be a prognostic indicator for HCC
patients receiving thermal ablation combined with simultaneous TACE.
The study is of clinical interest. I have only a point requiring to be addressed. The
transaminase value has been previously investigated as prognostic indicator of HCC treatments.
In particular, the authors in the discussion should discuss the recent findings of transient
hypertransaminasemia after TACE as significantly related to the objective radiological response
(TRANS-TACE: Prognostic Role of the Transient Hypertransaminasemia after Conventional
Chemoembolization for Hepatocellular Carcinoma. J Pers Med. 2021 Oct 17;11(10):1041. ).
In my opinion, this study further supports the potential use of transaminase serum levels as
prognostic markers in HCC patients who underwent locoregional treatments.
assistant