Neoadjuvant Chemotherapy in Pregnant Patients with Cervical Cancer: A Monocentric Retrospective Study

Round 1

Reviewer 1 Report

The title is clear. However, ater reading the text, it makes me as a potential reader confused. Is it original article or review/systematic reviwe. While reading the text with methodas and results, the paper looks like an original article. Howvere, in the discussion part the table (#4) created a confusion as it is more applocable for a systematic review.

Thus, the nethodology needs rethinking and the text needs resctructuring.

Please correct designations for the authors' affiliations according to the journal requirements.

Simple summary. Lines 20-22 - please rephrase, as in the current version it sounds too general ("all patients" replace with number; "our institution" - name of the institution).

Abstract. The abstract more or less clearly represent the study content. However, the text could be improved by upgrading the style (need to reconsider and rewrite to meet the requirements for an academic paper writing).  Line 28 - "we report our experience in treatment of cervical cancer (CC) during pregnancy and analyze the oncologic, obstetric and neonatal outcome" need to be  rephrased.

Introduction part provides the study rationalle. Line 57 - "especially at early disease" - may be better to provide the data according to staging.

Methods include necessary parts.

Results er presented clearly and accompanied by good tables.

Discusion part is presented in an interesting way. How necessary is to put the table here? Might be better to follow the traditional structure for a discussion part? See below the suggested structure:

1     Discussion

1.1   Rationale of the study (why it was done)

1.1.1          Main findings of the study

1.1.2          What makes our study unique

1.1.3          What it adds to what we already know

1.2   Study subjects

1.3   Subject of the discussion

Comparison of our results with neighboring countries, with countries of the same development levels  (income), with developed high-income countries). Agreement and disagreement with the studies compared

1.4   Sum up of the study, study strength and limitations

1.5   Clinical implication

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

The manuscript entitled "Neoadjuvant chemotherapy in patients with cervical cancer, a monocentric retrospective study" by Bernardini et al. investigates the therapeutic beneficial of neoadjuvant platinum-based chemotherapy in pregnant women with cervical cancer.

In the present study, 13 patients have been treated with different chemotherapy regimens. Patients’ responses to the treatments were shown by disease-free and overall survival. Besides, the impact of chemotherapy on pregnancy as well as children health was evaluated.

Overall, the research idea and rational are clear to me; however, I have minor criticisms to the attention of the authors that should be considered in order to improve the quality of this manuscript for publication.

11. The reason for differential treatment cycles among patients is clear however, there was no justification for the various chemotherapy regimens among patients. For instance, patient# 1 was treated only with cisplatin, while other patients received combination of platinum and paclitaxel. The authors need to add a paragraph justifying different regimens for patients.

22. Given that each patients received different doses and regimens compared to the others, please discuss its possibility on the distinct outcome of each patient.

33. In table#1, the initial tumour size was mentioned for each patient, however the tumour size after the final chemotherapy treatment was not stated. Having these data as a graph would be very helpful to clarify the treatment outcome.

44. Format of references is not consistent, some references have PMID numbers and others don’t.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Thank you for the corrections performed.