A Systematic Review of Surgical Management Strategies in the Treatment of Peritoneal Carcinomatosis of Neuroendocrine Origin
Round 1
Reviewer 1 Report
We thank the authors for their attempt to analyse the studies that focus on the surgical treatment of peritoneal metastases in patients with neuroendocrine tumors.
However, there are some issues that render the conclusions unclear.
Some of the studies included in the analysis do not involve only patients with neuroendocrine tumors while the stydy of Woltering et al, provides data on all kinds of cytoreductive operations performed in patients with neuroendocrine tumors and not only in patients wiht peritoneal metastases.
A meta-analysis of surgery in case of peritoneal metastases in neuroendocrine tumors should only involve patients with peritoneal metastases from neuroendocrine tumors.
Author Response
To The Editor,
Thank you for your valuable time and thoughtful comments regarding our manuscript. We have made changes according to your recommendations, and feel that the manuscript has benefitted significantly from these additions. We hope that the manuscript will now be considered suitable for publication in your esteemed journal.
All these patients had NETs with peritoneal +/- visceral metastasis and underwent CRS +/- HIPEC, hence this represents the real life of clinicians treating patients with NETs, with valid outcomes, hence we believed this was relevant to include in the paper.
Thank you again!
Reviewer 2 Report
I read with interest the manuscript by Fallows et al titled ‘A Systematic Review of Surgical Management Strategies in the Treatment of Peritoneal Carcinomatosis of Neuroendocrine Origin ‘
Please find my review in a point-by-point manner:
- Intro The PROSPERO registration whould be reported at the beginning methods section along with the protocol number.
- discussion: considering the type of article, the authors should put more effort and implement the discussion, and the number of reference as well. Beside a good literature search, most of the work should come from citations and description of the available manuscripts, strengths and flaws of the studies on the topic. I believe the concept of HIPEC should be emphasized as well. Many oncologists may not be familiar with this surgical procedure considering its controversial use in cancer other than NETs and its limited use in NETs.
- discussion: I believe the authors left a paragraph that should have been maybe deleted? (highlighted in yellow).
- conclusions: please reduce the length of the conclusion to resume what the authors found and what they think may implement the evidence in the present literature. Other comments (e.g. speculations on HIPEC efficacy) should not be reported.
very good
Author Response
To The Editor,
Thank you for your valuable time and thoughtful comments regarding our manuscript. We have made changes according to your recommendations, and feel that the manuscript has benefitted significantly from these additions. We hope that the manuscript will now be considered suitable for publication in your esteemed journal.
In response to your comments we moved the location of the PROSPERO registration number to the methods section, added an additional paragraph regarding survival rates in the discussion, and shortened the conclusion as requested.
Thank you so much again!
Reviewer 3 Report
Dear Author
good work unless more description of the CCS (completeness cytoreduction score) of the paper should be done undermining that complete surgical removal of tumour is crucial to obtain better survival. New immunomodulate anticancer drug is under way to improve results.
before definitive editing you should made some corrections at the Tables
Tab 1 correction
Benhaim 88 pts
Goere 127 pts
Voltering 800 pts but PM no citation
Tab 2 procedures correction
Madson 2018 4th column-sinchronous peritonectomy. Hipec musy be written and no immediately chemo added.... (it is not correct)
Goere 2017 4th column, Hipec must be written(it's not a procedure made after surgery (it's intraoperative...otehrway confoundin with Epic)
Hjjar 2022 4th column Hipec must be written (no need to specify that was made sinchronouly)
Tab.4 correction
3rd column, treatmente related is not needed..... is confounding because you could intend that morb/mort is dependendent on different treat modalities that you not cite
last column survival results (mort/morb is wrong)
my best regards
Author Response
To The Editor,
Thank you for your valuable time and thoughtful comments regarding our manuscript. We have made changes according to your recommendations, and feel that the manuscript has benefitted significantly from these additions. We hope that the manuscript will now be considered suitable for publication in your esteemed journal.
We added the table corrections as suggested and made all appropriate changes.
Thank you again!
Round 2
Reviewer 1 Report
We thank the authors for their systematic review on surgical treatment of peritoneal metastases in neuroendocrine tumors.
They have adequately addressed and answered all the raised issues by the reviewers.
Reviewer 3 Report
Adequate corrections.
