Title: CIRRHOSIS IN INTRAHEPATIC CHOLANGIOCARCINOMA: PROGNOSTIC
IMPORTANCE AND IMPACT ON SURVIVAL
Version: 6 Date: 10 Sep 2022
Reviewer's report:
Existing evidence suggests that cirrhosis is one of the major risk factors for intrahepatic
cholangiocarcinoma (CCA). Unfortunately, the presence of cirrhosis can be a relative
contraindication for curative surgical resection depending on the degree of underlying liver
synthetic dysfunction. Whether or not cirrhosis is truly prognostic of oncologic outcomes
remains controversial based on existing studies, with some studies suggesting that cirrhosis is
associated with worse outcomes. In this study, the authors conclude that there is no statistically
significant difference in long-term (5-year) survival among patients with iCCA based on
cirrhosis status after adjusting for clinical and tumor characteristics.
Minor comments:
Abstract: When reporting the number of people with iCCA as 33,160, the percentage
(63.4%) that is reported is a bit confusing. I’m assuming they mean that of all the cases of
cholangiocarcinoma, 63.4% were iCCA? This should be stated more clearly.
Lines 133-135: This sentence seems like it was duplicated by mistake
Line 144: I thought a total of 33,160 patients with iCCA were identified and only 3,644 had
a liver biopsy.
Table 1: The cutoff for elderly and non-elderly should be stated. Would list the age ranges for
the age categories.
Table 5: Duplicated. One of the tables should be removed.
Title: CIRRHOSIS IN INTRAHEPATIC CHOLANGIOCARCINOMA: PROGNOSTIC
IMPORTANCE AND IMPACT ON SURVIVAL
Version: 6 Date: 10 Sep 2022
Reviewer's report:
Existing evidence suggests that cirrhosis is one of the major risk factors for intrahepatic
cholangiocarcinoma (CCA). Unfortunately, the presence of cirrhosis can be a relative
contraindication for curative surgical resection depending on the degree of underlying liver
synthetic dysfunction. Whether or not cirrhosis is truly prognostic of oncologic outcomes
remains controversial based on existing studies, with some studies suggesting that cirrhosis is
associated with worse outcomes. In this study, the authors conclude that there is no statistically
significant difference in long-term (5-year) survival among patients with iCCA based on
cirrhosis status after adjusting for clinical and tumor characteristics.
Minor comments:
Abstract: When reporting the number of people with iCCA as 33,160, the percentage
(63.4%) that is reported is a bit confusing. I’m assuming they mean that of all the cases of
cholangiocarcinoma, 63.4% were iCCA? This should be stated more clearly.
Lines 133-135: This sentence seems like it was duplicated by mistake
Line 144: I thought a total of 33,160 patients with iCCA were identified and only 3,644 had
a liver biopsy.
Table 1: The cutoff for elderly and non-elderly should be stated. Would list the age ranges for
the age categories.
Table 5: Duplicated. One of the tables should be removed.
Please review this paper.
user
Title: CIRRHOSIS IN INTRAHEPATIC CHOLANGIOCARCINOMA: PROGNOSTIC
IMPORTANCE AND IMPACT ON SURVIVAL
Version: 6 Date: 10 Sep 2022
Reviewer's report:
Existing evidence suggests that cirrhosis is one of the major risk factors for intrahepatic
cholangiocarcinoma (CCA). Unfortunately, the presence of cirrhosis can be a relative
contraindication for curative surgical resection depending on the degree of underlying liver
synthetic dysfunction. Whether or not cirrhosis is truly prognostic of oncologic outcomes
remains controversial based on existing studies, with some studies suggesting that cirrhosis is
associated with worse outcomes. In this study, the authors conclude that there is no statistically
significant difference in long-term (5-year) survival among patients with iCCA based on
cirrhosis status after adjusting for clinical and tumor characteristics.
Minor comments:
Abstract: When reporting the number of people with iCCA as 33,160, the percentage
(63.4%) that is reported is a bit confusing. I’m assuming they mean that of all the cases of
cholangiocarcinoma, 63.4% were iCCA? This should be stated more clearly.
Lines 133-135: This sentence seems like it was duplicated by mistake
Line 144: I thought a total of 33,160 patients with iCCA were identified and only 3,644 had
a liver biopsy.
Table 1: The cutoff for elderly and non-elderly should be stated. Would list the age ranges for
the age categories.
Table 5: Duplicated. One of the tables should be removed.
assistant