Reviewer’s report  
 
Title: Clinical effects of switching from minodronate to denosumab treatment in patients with 
postmenopausal osteoporosis: A retrospective study  
 
Version: 2 Date: 17 Mar 2019  
 
Reviewer: Tsutomu Nishida  
 
Reviewer's report:  
 
Thank you for giving me the opportunity to review the revised manuscript:  
"Clinical significance of regional lymph node enlargement in patients with EGC within  the 
expanded criteria for ESD". This paper shows that lymph node enlargement is not uncommon in 
patients within expanded criteria abut it might not be associated with metastasis. I enjoyed this 
paper that focused on regional lymph node enlargement in patients with EGC with the expanded 
criter ia.  
 
I have the following comments.  
 
 
Major comments  
 
1. Recently, JCOG0607 trial revealed that patients with expanded criteria in UL -negative 
tumor &gt;2 cm in size or UL -positive tumor &lt;3 cm in size were acceptable and should be the 
standard treatment in stead of gastrectomy (Hasuike N. et al. Gastric Cancer, 21:114 -123, 2018). I 
do not think that all expanded criteria are the same risk for lymph node metastasis. The authors 
should discuss it, citing above the paper.  
 
 
2. I recommended that the authors added  the following explanation about expanded indication.  
~when they are not accompanied with lymphovascular infiltration [ly( -), v(-)] 
 
 
3. I am interested in the case with increased lymph node during the follow -up period. This case 
had ulceration? How long di d he detect the increased size of the lymph node? Please explain this 
case more specifically.  
 
 
4. How many patients had metachronous multiple gastric cancers during the follow -up? As you 
know, after ESD of early gastric cancer, they are at high risk for syn chronous or metachronous 
multiple gastric cancers. I am interested in metachronous recurrence -risk compared with patients 
within principles of indication. In addition, I recommend the importance of EGD surveillance 
after ESD instead of CT surveillance in p atients within expanded criteria.  
 
 
Minor comments  
 
1. In the section of "ESD for EGD", line 55, (4)tumor size &gt; 3cm, histologcilally the 
differentiated type, pT1b → &lt; 3cm?  
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the nece ssary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
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 a ny statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
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 t he past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisatio n that 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 the 
manuscript?  
 
4. Have you received reimbursements, fe es, 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 the jou rnal. 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 agree 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 comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer’s report  
 
Title: Clinical effects of switching from minodronate to denosumab treatment in patients with 
postmenopausal osteoporosis: A retrospective study  
 
Version: 2 Date: 17 Mar 2019  
 
Reviewer: Tsutomu Nishida  
 
Reviewer's report:  
 
Thank you for giving me the opportunity to review the revised manuscript:  
"Clinical significance of regional lymph node enlargement in patients with EGC within  the 
expanded criteria for ESD". This paper shows that lymph node enlargement is not uncommon in 
patients within expanded criteria abut it might not be associated with metastasis. I enjoyed this 
paper that focused on regional lymph node enlargement in patients with EGC with the expanded 
criter ia.  
 
I have the following comments.  
 
 
Major comments  
 
1. Recently, JCOG0607 trial revealed that patients with expanded criteria in UL -negative 
tumor &gt;2 cm in size or UL -positive tumor &lt;3 cm in size were acceptable and should be the 
standard treatment in stead of gastrectomy (Hasuike N. et al. Gastric Cancer, 21:114 -123, 2018). I 
do not think that all expanded criteria are the same risk for lymph node metastasis. The authors 
should discuss it, citing above the paper.  
 
 
2. I recommended that the authors added  the following explanation about expanded indication.  
~when they are not accompanied with lymphovascular infiltration [ly( -), v(-)] 
 
 
3. I am interested in the case with increased lymph node during the follow -up period. This case 
had ulceration? How long di d he detect the increased size of the lymph node? Please explain this 
case more specifically.  
 
 
4. How many patients had metachronous multiple gastric cancers during the follow -up? As you 
know, after ESD of early gastric cancer, they are at high risk for syn chronous or metachronous 
multiple gastric cancers. I am interested in metachronous recurrence -risk compared with patients 
within principles of indication. In addition, I recommend the importance of EGD surveillance 
after ESD instead of CT surveillance in p atients within expanded criteria.  
 
 
Minor comments  
 
1. In the section of "ESD for EGD", line 55, (4)tumor size &gt; 3cm, histologcilally the 
differentiated type, pT1b → &lt; 3cm?  
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the nece ssary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
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 a ny statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
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 t he past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisatio n that 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 the 
manuscript?  
 
4. Have you received reimbursements, fe es, 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 the jou rnal. 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 agree 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 comments  
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: Clinical effects of switching from minodronate to denosumab treatment in patients with 
postmenopausal osteoporosis: A retrospective study  
 
Version: 2 Date: 17 Mar 2019  
 
Reviewer: Tsutomu Nishida  
 
Reviewer's report:  
 
Thank you for giving me the opportunity to review the revised manuscript:  
"Clinical significance of regional lymph node enlargement in patients with EGC within  the 
expanded criteria for ESD". This paper shows that lymph node enlargement is not uncommon in 
patients within expanded criteria abut it might not be associated with metastasis. I enjoyed this 
paper that focused on regional lymph node enlargement in patients with EGC with the expanded 
criter ia.  
 
I have the following comments.  
 
 
Major comments  
 
1. Recently, JCOG0607 trial revealed that patients with expanded criteria in UL -negative 
tumor &gt;2 cm in size or UL -positive tumor &lt;3 cm in size were acceptable and should be the 
standard treatment in stead of gastrectomy (Hasuike N. et al. Gastric Cancer, 21:114 -123, 2018). I 
do not think that all expanded criteria are the same risk for lymph node metastasis. The authors 
should discuss it, citing above the paper.  
 
 
2. I recommended that the authors added  the following explanation about expanded indication.  
~when they are not accompanied with lymphovascular infiltration [ly( -), v(-)] 
 
 
3. I am interested in the case with increased lymph node during the follow -up period. This case 
had ulceration? How long di d he detect the increased size of the lymph node? Please explain this 
case more specifically.  
 
 
4. How many patients had metachronous multiple gastric cancers during the follow -up? As you 
know, after ESD of early gastric cancer, they are at high risk for syn chronous or metachronous 
multiple gastric cancers. I am interested in metachronous recurrence -risk compared with patients 
within principles of indication. In addition, I recommend the importance of EGD surveillance 
after ESD instead of CT surveillance in p atients within expanded criteria.  
 
 
Minor comments  
 
1. In the section of "ESD for EGD", line 55, (4)tumor size &gt; 3cm, histologcilally the 
differentiated type, pT1b → &lt; 3cm?  
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the nece ssary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
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 a ny statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
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 t he past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisatio n that 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 the 
manuscript?  
 
4. Have you received reimbursements, fe es, 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 the jou rnal. 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 agree 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 comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant