Reviewer ’s report  
 
Title:  The association of liver function and quality of life of patients with liver cancer  
 
Version: 0 Date: 31 Aug 2018 
 
Reviewer:  Wei-Chu Chie  
 
Reviewer’s report:  
 
Please include all comments for the authors in this box rather than uploading your report as an 
attachment. Please only upload as attachments annotated versions of manuscripts, graphs, 
supporting materials or other aspects of your report which cannot be included in a text format.  
 
Please overwrite this text when adding your comments to the authors.  
 
The authors of this manuscript assessed the association between the EORTC QLQ -C30 and 
HCC18 scores and liver function indices of 472 patients with newly diagnosed HCC. There are 
some questions to be answered:  
 
1. The authors may describe the ways of detec tion and guidelines for treatment of HCC. Is there 
any screening program for high -risk groups?  
 
2. How was the sample size determined? Is there any prior information?  
 
3. The authors developed many indices for either C30 / HCC18 and liver biochemistry or ot her 
blood data.  
 
a. The index scores of C30 / HCC18 came from a paper reference 21. Usually the two 
questionnaires are analyzed with separate domain scores. The reference developed index 
scores  according to survival prediction. It is a little ambitious to develop such scores.  
 
b. The index scores for liver function are even more ambitious. The ALBI and MELD are 
composite scores of biochemistry data. The Alb -ALP and ALP -PL are ratios of 
biochemistry or blood cell data. These are seldom used in studies assessi ng liver diseases. 
The authors may provide more basis for development of them.  
 
4. The correlation is assessed by Pearson or Spearman's r rather than t -test or ANOVA. The 
statistical method in Table 4 sounds not appropriate. For those scores which are not n ormally 
distributed, Spearman may be better.  
 
5. For correlation, significant results are easy to obtained once the sample size is large. The 
authors may comment this issue in Discussion.  
 
6. This is a cross -sectional study. Did the authors conduct any follo w up? Both QOL and liver 
condition may change during treatment.  
7. The value of this study is also to be discussed. QOL and clinical or lab data are of different 
concepts and measurement constructs. What do the authors want to tell the readers?  
 
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 necessary 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 comm ents to the authors.  
 
No 
 
Are you able to assess any 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.  
 
I am able to assess the statistics  
 
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, consideri ng the following questions:  
 
1. Have you in the 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 organisation 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, fees, 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 -financi al 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 journal. 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 websi te 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:  The association of liver function and quality of life of patients with liver cancer  
 
Version: 0 Date: 31 Aug 2018 
 
Reviewer:  Wei-Chu Chie  
 
Reviewer’s report:  
 
Please include all comments for the authors in this box rather than uploading your report as an 
attachment. Please only upload as attachments annotated versions of manuscripts, graphs, 
supporting materials or other aspects of your report which cannot be included in a text format.  
 
Please overwrite this text when adding your comments to the authors.  
 
The authors of this manuscript assessed the association between the EORTC QLQ -C30 and 
HCC18 scores and liver function indices of 472 patients with newly diagnosed HCC. There are 
some questions to be answered:  
 
1. The authors may describe the ways of detec tion and guidelines for treatment of HCC. Is there 
any screening program for high -risk groups?  
 
2. How was the sample size determined? Is there any prior information?  
 
3. The authors developed many indices for either C30 / HCC18 and liver biochemistry or ot her 
blood data.  
 
a. The index scores of C30 / HCC18 came from a paper reference 21. Usually the two 
questionnaires are analyzed with separate domain scores. The reference developed index 
scores  according to survival prediction. It is a little ambitious to develop such scores.  
 
b. The index scores for liver function are even more ambitious. The ALBI and MELD are 
composite scores of biochemistry data. The Alb -ALP and ALP -PL are ratios of 
biochemistry or blood cell data. These are seldom used in studies assessi ng liver diseases. 
The authors may provide more basis for development of them.  
 
4. The correlation is assessed by Pearson or Spearman's r rather than t -test or ANOVA. The 
statistical method in Table 4 sounds not appropriate. For those scores which are not n ormally 
distributed, Spearman may be better.  
 
5. For correlation, significant results are easy to obtained once the sample size is large. The 
authors may comment this issue in Discussion.  
 
6. This is a cross -sectional study. Did the authors conduct any follo w up? Both QOL and liver 
condition may change during treatment.  
7. The value of this study is also to be discussed. QOL and clinical or lab data are of different 
concepts and measurement constructs. What do the authors want to tell the readers?  
 
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 necessary 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 comm ents to the authors.  
 
No 
 
Are you able to assess any 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.  
 
I am able to assess the statistics  
 
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, consideri ng the following questions:  
 
1. Have you in the 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 organisation 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, fees, 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 -financi al 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 journal. 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 websi te 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:  The association of liver function and quality of life of patients with liver cancer  
 
Version: 0 Date: 31 Aug 2018 
 
Reviewer:  Wei-Chu Chie  
 
Reviewer’s report:  
 
Please include all comments for the authors in this box rather than uploading your report as an 
attachment. Please only upload as attachments annotated versions of manuscripts, graphs, 
supporting materials or other aspects of your report which cannot be included in a text format.  
 
Please overwrite this text when adding your comments to the authors.  
 
The authors of this manuscript assessed the association between the EORTC QLQ -C30 and 
HCC18 scores and liver function indices of 472 patients with newly diagnosed HCC. There are 
some questions to be answered:  
 
1. The authors may describe the ways of detec tion and guidelines for treatment of HCC. Is there 
any screening program for high -risk groups?  
 
2. How was the sample size determined? Is there any prior information?  
 
3. The authors developed many indices for either C30 / HCC18 and liver biochemistry or ot her 
blood data.  
 
a. The index scores of C30 / HCC18 came from a paper reference 21. Usually the two 
questionnaires are analyzed with separate domain scores. The reference developed index 
scores  according to survival prediction. It is a little ambitious to develop such scores.  
 
b. The index scores for liver function are even more ambitious. The ALBI and MELD are 
composite scores of biochemistry data. The Alb -ALP and ALP -PL are ratios of 
biochemistry or blood cell data. These are seldom used in studies assessi ng liver diseases. 
The authors may provide more basis for development of them.  
 
4. The correlation is assessed by Pearson or Spearman's r rather than t -test or ANOVA. The 
statistical method in Table 4 sounds not appropriate. For those scores which are not n ormally 
distributed, Spearman may be better.  
 
5. For correlation, significant results are easy to obtained once the sample size is large. The 
authors may comment this issue in Discussion.  
 
6. This is a cross -sectional study. Did the authors conduct any follo w up? Both QOL and liver 
condition may change during treatment.  
7. The value of this study is also to be discussed. QOL and clinical or lab data are of different 
concepts and measurement constructs. What do the authors want to tell the readers?  
 
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 necessary 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 comm ents to the authors.  
 
No 
 
Are you able to assess any 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.  
 
I am able to assess the statistics  
 
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, consideri ng the following questions:  
 
1. Have you in the 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 organisation 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, fees, 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 -financi al 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 journal. 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 websi te 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