Title: Transhepatectomy combined with arterial chemoembolization and transcatheter arterial
chemoembolization in the treatment of hepatocellular carcinoma: a clinical prognostic analysis
Version: 0 Date: 06 May 2023
Reviewer's report:
This is a retrospective multicenter study of patients treated for HCC with hepatectomy with
TACE or TACE alone between June 2016 and July 2021. The aim of this study is to compare
LR+TACE and TACE alone in the treatment of early HCC. Overall survivals were compared,
and risk factors related with OS were analysed. This manuscript is very concise and easy to read.
However, this study raises several major concerns:
1. The author mentioned the comparison of early hepatocellular carcinoma treatment in the
background of the abstract as the goal of this study. However, the conclusion of this study is
not a comparison of treatments in early-stage HCC. In addition, a description of the definition
of early stage HCC is needed in this study.
2. Overall survival is the primary endpoint in this study, However, to compare the effectiveness
of different two treatment methods, recurrence rate and recurrent free survival outcomes in two
groups should be presented along with OS.
3. This study is a multicenter study participating various tertiary hospitals in China. If possible,
can authors present all participating institutions? In addition, can authors present whether patient
data export from each institution has been approved by each institution?
4. The types of surgery (eg. Major vs mino LR or anatomical vs non-anatomical LR) are
important factor in determining the long-term survival rate of HCC patients. If the authors
present the types of hepatic resection in the LR+TACE group, they will be able to provide helpful
information for evaluating the efficacy of LR+TACE compared to TACE alone.
5. I recommend show the variables used for PSM. This will increase the reliability of the PSM
used in this study. Also, instead of cut-off values (Number of tumors # 2, Tumor size # 5 cm),
it is necessary to present tumor characteristics in baseline characteristics such as tumor size,
tumor number and location. And These tumor characteristics should be used as an variables for
matching.
6. In baseline patient characteristics, 123 (11.4%) and 164 (15.0%) of HCC patients according
to BCLC A and B respectively received only TACE rather than surgical treatment. Readers are
likely wondering why these patients only received TACE instead of liver resection.
7. First paragraph of the Discussion: “The most typical therapies for people with early liver
cancer are hepatectomy and TACE[11]” This may confuse the reader. In early-stage HCC,
the current BCLC guideline's first-line treatment is resection, ablation, or transplant. This
description seems inappropriate because it can mislead readers into thinking that TACE can be
included in the first treatment option for early stage HCC.
8. Did the patients included in this study receive other postoperative adjuvant treatments other
than TACE?
Title: Transhepatectomy combined with arterial chemoembolization and transcatheter arterial
chemoembolization in the treatment of hepatocellular carcinoma: a clinical prognostic analysis
Version: 0 Date: 06 May 2023
Reviewer's report:
This is a retrospective multicenter study of patients treated for HCC with hepatectomy with
TACE or TACE alone between June 2016 and July 2021. The aim of this study is to compare
LR+TACE and TACE alone in the treatment of early HCC. Overall survivals were compared,
and risk factors related with OS were analysed. This manuscript is very concise and easy to read.
However, this study raises several major concerns:
1. The author mentioned the comparison of early hepatocellular carcinoma treatment in the
background of the abstract as the goal of this study. However, the conclusion of this study is
not a comparison of treatments in early-stage HCC. In addition, a description of the definition
of early stage HCC is needed in this study.
2. Overall survival is the primary endpoint in this study, However, to compare the effectiveness
of different two treatment methods, recurrence rate and recurrent free survival outcomes in two
groups should be presented along with OS.
3. This study is a multicenter study participating various tertiary hospitals in China. If possible,
can authors present all participating institutions? In addition, can authors present whether patient
data export from each institution has been approved by each institution?
4. The types of surgery (eg. Major vs mino LR or anatomical vs non-anatomical LR) are
important factor in determining the long-term survival rate of HCC patients. If the authors
present the types of hepatic resection in the LR+TACE group, they will be able to provide helpful
information for evaluating the efficacy of LR+TACE compared to TACE alone.
5. I recommend show the variables used for PSM. This will increase the reliability of the PSM
used in this study. Also, instead of cut-off values (Number of tumors # 2, Tumor size # 5 cm),
it is necessary to present tumor characteristics in baseline characteristics such as tumor size,
tumor number and location. And These tumor characteristics should be used as an variables for
matching.
6. In baseline patient characteristics, 123 (11.4%) and 164 (15.0%) of HCC patients according
to BCLC A and B respectively received only TACE rather than surgical treatment. Readers are
likely wondering why these patients only received TACE instead of liver resection.
7. First paragraph of the Discussion: “The most typical therapies for people with early liver
cancer are hepatectomy and TACE[11]” This may confuse the reader. In early-stage HCC,
the current BCLC guideline's first-line treatment is resection, ablation, or transplant. This
description seems inappropriate because it can mislead readers into thinking that TACE can be
included in the first treatment option for early stage HCC.
8. Did the patients included in this study receive other postoperative adjuvant treatments other
than TACE?
Please review this paper.
user
Title: Transhepatectomy combined with arterial chemoembolization and transcatheter arterial
chemoembolization in the treatment of hepatocellular carcinoma: a clinical prognostic analysis
Version: 0 Date: 06 May 2023
Reviewer's report:
This is a retrospective multicenter study of patients treated for HCC with hepatectomy with
TACE or TACE alone between June 2016 and July 2021. The aim of this study is to compare
LR+TACE and TACE alone in the treatment of early HCC. Overall survivals were compared,
and risk factors related with OS were analysed. This manuscript is very concise and easy to read.
However, this study raises several major concerns:
1. The author mentioned the comparison of early hepatocellular carcinoma treatment in the
background of the abstract as the goal of this study. However, the conclusion of this study is
not a comparison of treatments in early-stage HCC. In addition, a description of the definition
of early stage HCC is needed in this study.
2. Overall survival is the primary endpoint in this study, However, to compare the effectiveness
of different two treatment methods, recurrence rate and recurrent free survival outcomes in two
groups should be presented along with OS.
3. This study is a multicenter study participating various tertiary hospitals in China. If possible,
can authors present all participating institutions? In addition, can authors present whether patient
data export from each institution has been approved by each institution?
4. The types of surgery (eg. Major vs mino LR or anatomical vs non-anatomical LR) are
important factor in determining the long-term survival rate of HCC patients. If the authors
present the types of hepatic resection in the LR+TACE group, they will be able to provide helpful
information for evaluating the efficacy of LR+TACE compared to TACE alone.
5. I recommend show the variables used for PSM. This will increase the reliability of the PSM
used in this study. Also, instead of cut-off values (Number of tumors # 2, Tumor size # 5 cm),
it is necessary to present tumor characteristics in baseline characteristics such as tumor size,
tumor number and location. And These tumor characteristics should be used as an variables for
matching.
6. In baseline patient characteristics, 123 (11.4%) and 164 (15.0%) of HCC patients according
to BCLC A and B respectively received only TACE rather than surgical treatment. Readers are
likely wondering why these patients only received TACE instead of liver resection.
7. First paragraph of the Discussion: “The most typical therapies for people with early liver
cancer are hepatectomy and TACE[11]” This may confuse the reader. In early-stage HCC,
the current BCLC guideline's first-line treatment is resection, ablation, or transplant. This
description seems inappropriate because it can mislead readers into thinking that TACE can be
included in the first treatment option for early stage HCC.
8. Did the patients included in this study receive other postoperative adjuvant treatments other
than TACE?
assistant