Title: Comparison of Outcomes Between Surgery and Non-Surgery After Conversion Therapy
for Advanced Gastric Cancer with Unresectable Factors: A Systematic Review and Meta-
Analysis
Version: 3 Date: 23 Mar 2025
Reviewer's report:
Thanks for giving me the chance to review this manuscript. In this work, the authors aim
to compare the survival and toxicities outcomes Between Surgery and Non-Surgery After
Conversion Therapy for Advanced Gastric Cancer with Unresectable Factors. The authors
found that conversion surgerywas associated with improved 1-year, 3-year, and 5-year OS rates
(RR 0.38, 95% CI: 0.31–0.47; RR 0.64, 95% CI: 0.54–0.76; RR 0.77, 95% CI: 0.65–0.91,
respectively) and increased 1-year and 3-year PFS rates (RR 0.57, 95% CI: 0.49–0.99; RR 0.67,
95% CI: 0.57–0.78, respectively). However, one major limitation should be addressed.
There are inherent differences in prognosis between patients who undergo conversion surgery
and those who do not. Patients who response to conversion therapy typically proceed to surgery,
whereas those who fail to respond to conversion therapy and consequently cannot undergo
surgery tend to show poor therapeutic outcomes, resulting in poorer prognosis. Furthermore, the
studies included in the analysis are retrospective in nature, which makes selection bias in the
study population less controlled. Therefore, comparing therapeutic efficacy between these two
groups (responders vs. non-responders to conversion therapy) holds limited clinical significance.
Title: Comparison of Outcomes Between Surgery and Non-Surgery After Conversion Therapy
for Advanced Gastric Cancer with Unresectable Factors: A Systematic Review and Meta-
Analysis
Version: 3 Date: 23 Mar 2025
Reviewer's report:
Thanks for giving me the chance to review this manuscript. In this work, the authors aim
to compare the survival and toxicities outcomes Between Surgery and Non-Surgery After
Conversion Therapy for Advanced Gastric Cancer with Unresectable Factors. The authors
found that conversion surgerywas associated with improved 1-year, 3-year, and 5-year OS rates
(RR 0.38, 95% CI: 0.31–0.47; RR 0.64, 95% CI: 0.54–0.76; RR 0.77, 95% CI: 0.65–0.91,
respectively) and increased 1-year and 3-year PFS rates (RR 0.57, 95% CI: 0.49–0.99; RR 0.67,
95% CI: 0.57–0.78, respectively). However, one major limitation should be addressed.
There are inherent differences in prognosis between patients who undergo conversion surgery
and those who do not. Patients who response to conversion therapy typically proceed to surgery,
whereas those who fail to respond to conversion therapy and consequently cannot undergo
surgery tend to show poor therapeutic outcomes, resulting in poorer prognosis. Furthermore, the
studies included in the analysis are retrospective in nature, which makes selection bias in the
study population less controlled. Therefore, comparing therapeutic efficacy between these two
groups (responders vs. non-responders to conversion therapy) holds limited clinical significance.
Please review this paper.
user
Title: Comparison of Outcomes Between Surgery and Non-Surgery After Conversion Therapy
for Advanced Gastric Cancer with Unresectable Factors: A Systematic Review and Meta-
Analysis
Version: 3 Date: 23 Mar 2025
Reviewer's report:
Thanks for giving me the chance to review this manuscript. In this work, the authors aim
to compare the survival and toxicities outcomes Between Surgery and Non-Surgery After
Conversion Therapy for Advanced Gastric Cancer with Unresectable Factors. The authors
found that conversion surgerywas associated with improved 1-year, 3-year, and 5-year OS rates
(RR 0.38, 95% CI: 0.31–0.47; RR 0.64, 95% CI: 0.54–0.76; RR 0.77, 95% CI: 0.65–0.91,
respectively) and increased 1-year and 3-year PFS rates (RR 0.57, 95% CI: 0.49–0.99; RR 0.67,
95% CI: 0.57–0.78, respectively). However, one major limitation should be addressed.
There are inherent differences in prognosis between patients who undergo conversion surgery
and those who do not. Patients who response to conversion therapy typically proceed to surgery,
whereas those who fail to respond to conversion therapy and consequently cannot undergo
surgery tend to show poor therapeutic outcomes, resulting in poorer prognosis. Furthermore, the
studies included in the analysis are retrospective in nature, which makes selection bias in the
study population less controlled. Therefore, comparing therapeutic efficacy between these two
groups (responders vs. non-responders to conversion therapy) holds limited clinical significance.
assistant