Title: Is DEB-TACE  as  locoregional  therapy  before  liver  transplantation  for  hepatocellular
  carcinoma effective?
Version: 3 Date: 12 Jul 2024
Reviewer:  A. H. Kamel Abdelmaksoud
Reviewer's report:
Authors analyzed retrospectively 40 patients with different stages of HCC who underwent DEB-
TACE before liver transplantation (beyond Hangzhou  criteria) regarding demographics, disease
characteristics, treatment response, and adverse events.
The article is well written, yet I have some points to ask about:
1. According to results I don’t think all patients are “beyond Hangzhou  criteria” as the title
indicates because there are 50% of patients less than 8cm, 67.5% with AFP less than 400ng/mL
and 29% are well differentiated tumors. (Table 1)
2. Authors didn’t mention they performed biopsies to know the tumor differentiation.
3. Authors also stated the transplanted 22 (55%) of patients who had portal invasion at a time,
yes not all PV cases has distant metastasis but it’s a very crucial point to make sure its absence,
so authors should mention if they performed an imaging before transplant to verify no metastasis
occur before transplantation.
4. Timing after the BED-TACE session and transplant should be also mentioned and if there
was an intended delay in patients with PV thrombosis
I think the article has a main weakness that it analyzes a very wide disease nature with very
small sample size, this make the results data very shallow and can’t provide a solid strong
recommendation.
Title: Is DEB-TACE  as  locoregional  therapy  before  liver  transplantation  for  hepatocellular
  carcinoma effective?
Version: 3 Date: 12 Jul 2024
Reviewer:  A. H. Kamel Abdelmaksoud
Reviewer's report:
Authors analyzed retrospectively 40 patients with different stages of HCC who underwent DEB-
TACE before liver transplantation (beyond Hangzhou  criteria) regarding demographics, disease
characteristics, treatment response, and adverse events.
The article is well written, yet I have some points to ask about:
1. According to results I don’t think all patients are “beyond Hangzhou  criteria” as the title
indicates because there are 50% of patients less than 8cm, 67.5% with AFP less than 400ng/mL
and 29% are well differentiated tumors. (Table 1)
2. Authors didn’t mention they performed biopsies to know the tumor differentiation.
3. Authors also stated the transplanted 22 (55%) of patients who had portal invasion at a time,
yes not all PV cases has distant metastasis but it’s a very crucial point to make sure its absence,
so authors should mention if they performed an imaging before transplant to verify no metastasis
occur before transplantation.
4. Timing after the BED-TACE session and transplant should be also mentioned and if there
was an intended delay in patients with PV thrombosis
I think the article has a main weakness that it analyzes a very wide disease nature with very
small sample size, this make the results data very shallow and can’t provide a solid strong
recommendation.
Please review this paper.
user
Title: Is DEB-TACE  as  locoregional  therapy  before  liver  transplantation  for  hepatocellular
  carcinoma effective?
Version: 3 Date: 12 Jul 2024
Reviewer:  A. H. Kamel Abdelmaksoud
Reviewer's report:
Authors analyzed retrospectively 40 patients with different stages of HCC who underwent DEB-
TACE before liver transplantation (beyond Hangzhou  criteria) regarding demographics, disease
characteristics, treatment response, and adverse events.
The article is well written, yet I have some points to ask about:
1. According to results I don’t think all patients are “beyond Hangzhou  criteria” as the title
indicates because there are 50% of patients less than 8cm, 67.5% with AFP less than 400ng/mL
and 29% are well differentiated tumors. (Table 1)
2. Authors didn’t mention they performed biopsies to know the tumor differentiation.
3. Authors also stated the transplanted 22 (55%) of patients who had portal invasion at a time,
yes not all PV cases has distant metastasis but it’s a very crucial point to make sure its absence,
so authors should mention if they performed an imaging before transplant to verify no metastasis
occur before transplantation.
4. Timing after the BED-TACE session and transplant should be also mentioned and if there
was an intended delay in patients with PV thrombosis
I think the article has a main weakness that it analyzes a very wide disease nature with very
small sample size, this make the results data very shallow and can’t provide a solid strong
recommendation.
assistant