Risk Factors and Prognostic Impact of Postoperative Complications in Patients with Advanced Gastric Cancer Receiving Neoadjuvant Chemotherapy

Round 1

Reviewer 1 Report

An interesting study addressing a timely topic in gastric cancer.

Some changes are required in my opinion:

- the introduction section should be expanded, and some , the background of medical treatment for gastric cancer patients should be better explained in the introduction, and some recently published paper included (PMID: 33916206 ; PMID: 33916915).

- the authors do not say anything regarding microsatellite instability. This biological and molecular feature represents a mechanism of resistance to neoadjuvant treatment and has a prognostic value. How many patients were MSI-H or not? Please specify.

- There are some grammar mistakes and oversights throughout the manuscript that should be corrected. We recommend a linguistic professional service revision in order to help the readability of the paper.

- the limitations of the current paper should be better discussed in the discussion section

- how do the authors think this paper could impact everyday clinical practice? the authors should better discuss this point.

Author Response

Thanks for your comments. We have made the following changes according to your comments.

Response 1: We have added background of medical treatment for gastric cancer in Introduction Paragraph 1 Line 45-52 according to your suggestions.

Response 2: We have added MSI relevant information in Introduction Paragraph 1 Line 53-57. Due to the long history of the database, pathological data of MSI do not exist in the database. We add this limitation disscussion in Disscussion Paragraph 8 Line 286-289. We have collected data related to MSI and other genes in recent databases, hoping to explore more conclusions.

Response 3: We have invited English majors to revise the paper.

Response 4: We have expanded limitations in Disscussion Paragraph 8. Understanding the limitations will help us to better refine the study in the future.

Response 5: We have further disscussed how we should do in clincal practice based on our study. We hope to enable clinicians to re-examine the impact of neoadjuvant chemotherapy on patients undergoing surgery.

Reviewer 2 Report

Dear authors,
congratulations for the atudy, conceptualization, method, statistical analysis and interpretation of results are adequate. Discussions are well oriented and correct. The only drawback as you mentioned is the monocentric study, but the information is important and so is the contribution to the evidence that neoadjuvant chemotherapy brings risk of postoperative complications and by this may alter overall prognosis

Author Response

Thanks for your comments. We hoped to clarify the effect of neoadjuvant chemotherapy on postoperative complications in patients with gastric cancer through this study. As the study concluded, postoperative complications do have a relationship with neoadjuvant chemotherapy and affect the prognosis of patients. We look forward to conducting multicenter prospective studies in the future to further clarify the pros and cons of neoadjuvant chemotherapy.

Round 2

Reviewer 1 Report

Acceptance.