Title: Gamma-glutamyl Transferase to Aspartate Aminotransferase Ratio (GSR) Predicts
Prognoses in Patients with Colorectal Cancer with Liver Metastasis after Microwave Ablation
Version: 1 Date: 21 Jun 2024
Reviewer:  Gustavo Nari
Reviewer's report:
Dear authors, I have read your paper with great interest. In my opinion, it is difficult to
understand how the GSR index, applied pre-ablation, can be a predictor of poor oncological
prognosis. You point out Xiao's work with the use of the Gamma GT, trying to harmonize it
with her results, but said work mentions an elevation of the GGT post resection while you use
it pre-ablation. It is well known that GGT and alkaline phosphatase are associated, apart from
cholestasis, to hepatic parenchymal damage due to occupying lesions, so it is logical that in
Xiao's work it is an independent predictive factor of poor prognosis.
You mention that the elevation of the index is also associated with patients with cholelithiasis,
an association that is known and that some parameters were considered within the predictive
factors of common bile duct stones, for example by Heuer-Jensen.
They state that the elevation of the GSR index could be associated with an aggressive tumor
phenotype but they have not investigated the tumor biology of these patients to be able to confirm
this.
In my opinion, the paper has many methodological weaknesses and should be strongly revised.
Title: Gamma-glutamyl Transferase to Aspartate Aminotransferase Ratio (GSR) Predicts
Prognoses in Patients with Colorectal Cancer with Liver Metastasis after Microwave Ablation
Version: 1 Date: 21 Jun 2024
Reviewer:  Gustavo Nari
Reviewer's report:
Dear authors, I have read your paper with great interest. In my opinion, it is difficult to
understand how the GSR index, applied pre-ablation, can be a predictor of poor oncological
prognosis. You point out Xiao's work with the use of the Gamma GT, trying to harmonize it
with her results, but said work mentions an elevation of the GGT post resection while you use
it pre-ablation. It is well known that GGT and alkaline phosphatase are associated, apart from
cholestasis, to hepatic parenchymal damage due to occupying lesions, so it is logical that in
Xiao's work it is an independent predictive factor of poor prognosis.
You mention that the elevation of the index is also associated with patients with cholelithiasis,
an association that is known and that some parameters were considered within the predictive
factors of common bile duct stones, for example by Heuer-Jensen.
They state that the elevation of the GSR index could be associated with an aggressive tumor
phenotype but they have not investigated the tumor biology of these patients to be able to confirm
this.
In my opinion, the paper has many methodological weaknesses and should be strongly revised.
Please review this paper.
user
Title: Gamma-glutamyl Transferase to Aspartate Aminotransferase Ratio (GSR) Predicts
Prognoses in Patients with Colorectal Cancer with Liver Metastasis after Microwave Ablation
Version: 1 Date: 21 Jun 2024
Reviewer:  Gustavo Nari
Reviewer's report:
Dear authors, I have read your paper with great interest. In my opinion, it is difficult to
understand how the GSR index, applied pre-ablation, can be a predictor of poor oncological
prognosis. You point out Xiao's work with the use of the Gamma GT, trying to harmonize it
with her results, but said work mentions an elevation of the GGT post resection while you use
it pre-ablation. It is well known that GGT and alkaline phosphatase are associated, apart from
cholestasis, to hepatic parenchymal damage due to occupying lesions, so it is logical that in
Xiao's work it is an independent predictive factor of poor prognosis.
You mention that the elevation of the index is also associated with patients with cholelithiasis,
an association that is known and that some parameters were considered within the predictive
factors of common bile duct stones, for example by Heuer-Jensen.
They state that the elevation of the GSR index could be associated with an aggressive tumor
phenotype but they have not investigated the tumor biology of these patients to be able to confirm
this.
In my opinion, the paper has many methodological weaknesses and should be strongly revised.
assistant