Effect of Different Durations of Adjuvant Capecitabine Monotherapy on the Outcome of High-Risk Stage II and Stage III Colorectal Cancer: A Retrospective Study Based on a CRC Database

Round 1

Reviewer 1 Report

General comments:

1.Authors conducted a retrospective study which focused on stage II and III CRC patients who received oral chemotherapy as adjuvant therapy.

2.We usually regarded the stage III-IV disease as an advanced disease, and the stage I-II as an early disease. That is, patients with stage III disease had a worse prognosis than patients with stage II disease. Is it appropriate to compare patients of the two stages together? Is there any literature that can explain the theoretical basis of such a design of this study?

Abstract:

1.Line 18: in the 12M and 6M groups --> in the > 12 months (12M) and 6-12 months (6M) groups.

2.Please write a short and clear conclusion.

Introduction:

1.ref 5: Oxaliplatin-Based Adjuvant Chemotherapy for Rectal Cancer After Preoperative Chemoradiotherapy (ADORE): 323 Long-Term Results of a Randomized Controlled Trial.

Did ref 5 support ''a 6-month combination adjuvant 46 chemotherapy regimen has a better prognosis than a 6-month capecitabine monotherapy 47 for patients with stage II-III CRC [5]''.

Materials and methods:

1.line 78: what is follow up data?

2.What tools do you use to assess treatment outcome and prognosis?

3.line 99: (1) death out of any cause;  and/or (2) recurrence; and/or (3) occurrence of any cancer.

4.Please give the clear definition of high risk patients in this part.

Results:

1.Line 125-127: please showed the range of chemotherapy (from ? months to ? months)

2.The tracking time used on the figure is day. Can it be viewed by month instead?

Discussions:

1.If any previous study used the same oral chemtherapy, please discuss in discussion part.

2.You can write a paragraph supporting monotherapy and another paragraph not supporting it.

3.What is your advantage of this study?

4.How to overcome the limitation in this study?

5.This study will make you want to do the next research.

Conclusions:

1.Please write the most important conclusion, and what kind of clinical help this conclusion can provide.

Author Response

Please see the attachment.

Author Response File: Author Response.docx

Reviewer 2 Report

This is a retrospective analysis of extending the duration of capecitabine monotherapy on the outcome of high-risk stage II and stage III colorectal cancer in the Chinese cohort. They conclude that patients with stage III CRC who received capecitabine monotherapy, extending the duration of chemotherapy from 6 months to 12 months, resulted in improved DFS and OS. However, for patients with high-risk stage II CRC, extending the period did not improve DFS and OS. Several similar studies are already presented; however, this concept of studies has not been published previously. However, there are some concerns about this article. 1.     The authors did not report patients’ compliance. 2.     The authors could summarize and discuss AEs. 3.     In including criteria, how about the renal function of the patients? or other comorbidities? 4.     The number of patients for the endpoint is too small. It is an interesting article.

Author Response

Please see the attachment.

Author Response File: Author Response.docx

Round 2

Reviewer 1 Report

Authors improved paper according suggestion.