Concomitant Bladder Tumor Is a Risk Factor for Bladder Recurrence but Not Upper Tract
, Hongda Zhao 1, Mario Alvarez-Maestro 2, Stavros Gravas 3, Koen Van Renterghem 4, Guohua Zeng 5, Chi-Fai Ng 1, Pilar Laguna 6, Jeremy Yuen-Chun Teoh 1,* and Jean De La Rosette 6Round 1
Reviewer 1 Report
I read with great interest the authors work. fantastic article.
Some minor suggestion
It is not clear the number of patients that receive intravesical treatment, please specify
Limitation markers of inflammation are not included in multivariable analysis
Clinical implications of findings are not well described
Author Response
Response to Reviewer 1 Comments
Point 1: It is not clear the number of patients that receive intravesical treatment, please specify
Response 1: Thank you for your question. We have checked our database. There were 42/218 (19.3%) and 113/916 (12.3%) patients who had received adjuvant intravesical instillation. All patients with concomitant bladder tumor had received intraoperative urethrocystoscopy. We add the information in the Results part.
Point 2: Limitation markers of inflammation are not included in multivariable analysis
Response 2: Thank you for your valuable comments! We totally agree with you that markers of inflammation should be included. However, due to the lack of such information in our database, unfortunately, we cannot add more parameters to this part.
Point 3: Clinical implications of findings are not well described
Response 3: Thank you for your suggestion. The key point of our study is clarified in the first paragraph of the Discussion part. We add the clinical implications of our findings.
Reviewer 2 Report
The authors present an analysis of the CROES-UTUC registry to examine whether concomitant bladder tumor is a feature to increase the risk of recurrence in upper tract urothelial carcinoma. A strength of this manuscript is that a large number of patients in the registry (n=1134) are examined.
Overall, the data are analyzed appropriately. The main finding is not surprising: concomitant bladder tumor increases bladder tumor recurrence but not upper tract recurrence. It is not surprising because it is well known that bladder tumors have a high recurrence rate after initial transurethral resection. Of course, upper tract tumors have a lower recurrence rate because in a majority of cases, the entire organ is removed (nephroureterectomy) as opposed to the bladder situation where only the tumor is removed (transurethral resection).
As a minor comment, some of the references in the text do not match the data in the tables (Table 2 vs. Table 4). The charts are small and hard to read. I suggest putting the title of each chart directly on the image in addition to the legend.
Author Response
Response to Reviewer 2 Comments
Point 1: As a minor comment, some of the references in the text do not match the data in the tables (Table 2 vs. Table 4). The charts are small and hard to read. I suggest putting the title of each chart directly on the image in addition to the legend.
Response 1: Thank you for your suggestion. We have revised it accordingly.
Author Response File: 
Author Response.docx
Reviewer 3 Report
LIu Kang and colleagues have done a retrospective study using data from CROES-UTUC registry to determine the effects of concomitant bladder tumor on survival outcomes of UTUC patients.
The insights they provided in the study will aid in better management of UTUC patients especially undergoing KSS treatment.
Author Response
Point 1: Liu Kang and colleagues have done a retrospective study using data from CROES-UTUC registry to determine the effects of concomitant bladder tumor on survival outcomes of UTUC patients.
The insights they provided in the study will aid in better management of UTUC patients especially undergoing KSS treatment.
Response 1: Thank you very much!
