Reviewer ’s report  
 
Title: Endoscopic and clinicopathological features of intramucosal, histologically mixed -type, 
low-grade, well -differentiated gastric tubular adenocarcinoma with the potenti al for late -onset 
lymph node metastasis  
 
Version: 0 Date: 03 Sep 2018  
 
Revie wer: Bruno Märkl  
 
Reviewer's report:  
 
Saitoh et al. performed a retrospective study enrolling 60 early gastric cancer cases treated by 
endoscopic submucosal dissection (ESD). The study focused on low -grade lesions and lesions 
that were combined with moder ately differentiated areas and high -grade areas.  
 
This study is well written in general and addresses a very special topic. As far as the reviewer 
can judge the study is thoroughly performed, the illustrations are informative.  
 
However, I have some points of criticism:  
 The topic of this report is of relevance only for a very defined group of highly specialized 
endoscopists and fits much more into the scope of an endoscopy journal  
 
 The usage of many cryptic acronyms makes this  manuscript very difficult to follow. I 
recommend starting with a table perhaps with included illustrations to make it easier to 
follow.  
 
 After reading this manuscript, it is still not clear to me what the aim of this study was.  
 
 The authors already addr essed the topic early gastric cancer on slightly small cohort 
published in 2016 (correctly cited in the current draft [8])  
 
 The conclusion is not clear to me: Do the authors recommend to exclude patients with 
patterns suspicious for LG -tub1>tub2?. The aut hors should clarify that and give a clear 
recommendation beyond that such patients need surveillance.  
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.  
 
Unable to assess  
 
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 any sta tistics 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 the past five year s 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 a ny 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 -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 journal. I u nderstand 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 repor t 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 e ditors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Endoscopic and clinicopathological features of intramucosal, histologically mixed -type, 
low-grade, well -differentiated gastric tubular adenocarcinoma with the potenti al for late -onset 
lymph node metastasis  
 
Version: 0 Date: 03 Sep 2018  
 
Revie wer: Bruno Märkl  
 
Reviewer's report:  
 
Saitoh et al. performed a retrospective study enrolling 60 early gastric cancer cases treated by 
endoscopic submucosal dissection (ESD). The study focused on low -grade lesions and lesions 
that were combined with moder ately differentiated areas and high -grade areas.  
 
This study is well written in general and addresses a very special topic. As far as the reviewer 
can judge the study is thoroughly performed, the illustrations are informative.  
 
However, I have some points of criticism:  
 The topic of this report is of relevance only for a very defined group of highly specialized 
endoscopists and fits much more into the scope of an endoscopy journal  
 
 The usage of many cryptic acronyms makes this  manuscript very difficult to follow. I 
recommend starting with a table perhaps with included illustrations to make it easier to 
follow.  
 
 After reading this manuscript, it is still not clear to me what the aim of this study was.  
 
 The authors already addr essed the topic early gastric cancer on slightly small cohort 
published in 2016 (correctly cited in the current draft [8])  
 
 The conclusion is not clear to me: Do the authors recommend to exclude patients with 
patterns suspicious for LG -tub1>tub2?. The aut hors should clarify that and give a clear 
recommendation beyond that such patients need surveillance.  
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.  
 
Unable to assess  
 
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 any sta tistics 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 the past five year s 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 a ny 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 -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 journal. I u nderstand 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 repor t 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 e ditors, 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: Endoscopic and clinicopathological features of intramucosal, histologically mixed -type, 
low-grade, well -differentiated gastric tubular adenocarcinoma with the potenti al for late -onset 
lymph node metastasis  
 
Version: 0 Date: 03 Sep 2018  
 
Revie wer: Bruno Märkl  
 
Reviewer's report:  
 
Saitoh et al. performed a retrospective study enrolling 60 early gastric cancer cases treated by 
endoscopic submucosal dissection (ESD). The study focused on low -grade lesions and lesions 
that were combined with moder ately differentiated areas and high -grade areas.  
 
This study is well written in general and addresses a very special topic. As far as the reviewer 
can judge the study is thoroughly performed, the illustrations are informative.  
 
However, I have some points of criticism:  
 The topic of this report is of relevance only for a very defined group of highly specialized 
endoscopists and fits much more into the scope of an endoscopy journal  
 
 The usage of many cryptic acronyms makes this  manuscript very difficult to follow. I 
recommend starting with a table perhaps with included illustrations to make it easier to 
follow.  
 
 After reading this manuscript, it is still not clear to me what the aim of this study was.  
 
 The authors already addr essed the topic early gastric cancer on slightly small cohort 
published in 2016 (correctly cited in the current draft [8])  
 
 The conclusion is not clear to me: Do the authors recommend to exclude patients with 
patterns suspicious for LG -tub1>tub2?. The aut hors should clarify that and give a clear 
recommendation beyond that such patients need surveillance.  
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.  
 
Unable to assess  
 
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 any sta tistics 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 the past five year s 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 a ny 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 -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 journal. I u nderstand 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 repor t 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 e ditors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant