Electrochemotherapy in the Locoregional Treatment of Metastatic Colorectal Liver Metastases: A Systematic Review
, Alessandro Posa 1,*, Valentina Lancellotta 2, David C. Madoff 3, Alessandro Maresca 1, Patrizia Cornacchione 2, Luca Tagliaferri 2 and Roberto Iezzi 1,4Round 1
Reviewer 1 Report
Comments and Suggestions for Authors
Barbieri et al wrote comprehensive review about the use of electrochemotherapy in the locoregional treatment of metastatic colorectal liver metastases. Manuscript is clear, relevant for the field and presented in a well-structured manner.
Paper is excellently written, understandable and comprehensive. All relevant articles so far published in the field are taken into consideration. A lack of randomized trials in the literature comparing ECT to other ablative techniques was recognized and underlined as well as too small amount of observational studies .References are appropriately cited, mainly most recent ones. There is no excessive number of self-citations.
Figures are appropriate and informative. They are easy to interpret and understand. Ethics statements and data availability statements are adequate.
Similar review was not published recently. This paper is of value to the scientific community since it synthesizes the knowledge about the use of electrochemotherapy in the locoregional treatment of metastatic colorectal liver metastases while at the same time underlines practical problems about need for randomized studies.
The statements and conclusions are drawn coherently and are supported by the listed citations.
There are only a few minor issues regarding the paper:
1. In the Introduction, authors are starting with the description of liver cancer. Basically, liver cancer if primary is either hepatocellular either cholangiocarcinoma. Since two of those are not the topic of this review, Lines 36-38 could be erased. Or statements should be reformulated as secondary liver cancer. Again, it is unnecessary and misleading, since they are discussing only CRC.
2. Accordingly, Abstract should be corrected.
3. Line 127 Figure number is missing.
4. Lines 151-153 and 155-157: there are two incomplete sentences with verb missing.
Author Response
Dear Academic Editor,
First, we would really like to thank the reviewers for their accurate work and their precious suggestions.
We took into serious consideration all the remarks made by the reviewers and after discussion among the authors we modified the parts which needed to be clarified.
Reviewer 1
Barbieri et al wrote comprehensive review about the use of electrochemotherapy in the locoregional treatment of metastatic colorectal liver metastases. Manuscript is clear, relevant for the field and presented in a well-structured manner.
Paper is excellently written, understandable and comprehensive. All relevant articles so far published in the field are taken into consideration. A lack of randomized trials in the literature comparing ECT to other ablative techniques was recognized and underlined as well as too small amount of observational studies References are appropriately cited, mainly most recent ones. There is no excessive number of self-citations.
Figures are appropriate and informative. They are easy to interpret and understand. Ethics statements and data availability statements are adequate.
Similar review was not published recently. This paper is of value to the scientific community since it synthesizes the knowledge about the use of electrochemotherapy in the locoregional treatment of metastatic colorectal liver metastases while at the same time underlines practical problems about need for randomized studies.
The statements and conclusions are drawn coherently and are supported by the listed citations.
We thank the reviewer for these considerations.
There are only a few minor issues regarding the paper:
- In the Introduction, authors are starting with the description of liver cancer. Basically, liver cancer if primary is either hepatocellular either cholangiocarcinoma. Since two of those are not the topic of this review, Lines 36-38 could be erased. Or statements should be reformulated as secondary liver cancer. Again, it is unnecessary and misleading, since they are discussing only CRC.
We thank the reviewer for the suggestions. As requested we reformulated the sentence
- Accordingly, Abstract should be corrected.
As requested, we corrected the word
- Line 127 Figure number is missing.
As requested, we numbered the figure
- Lines 151-153 and 155-157: there are two incomplete sentences with verb missing.
As requested, we add the verb
Reviewer 2 Report
Comments and Suggestions for Authors
In this review paper, using systematic searches of PubMed, Cochrane, and Scopus data bases, explored the role of electrochemotherapy (ECT) in the management of liver metastases of colorectal cancer (CRC). They reviewed the literature and presented a comprehensive data on clinical outcomes and toxicity associated with percutaneous or intra-surgical ECT of CRC liver metastasis. They conclude that ECT method is safe and effective for the treatment of CRC liver metastasis \, especially for lesions unsuitable for other ablative techniques.
Comments:
Please expand several acronyms: For example, S.P.I.D.E.R, P.I.C.O, GRADE, PRISMA etc.,
Author Response
Dear Academic Editor,
First, we would really like to thank the reviewers for their accurate work and their precious suggestions.
We took into serious consideration all the remarks made by the reviewers and after discussion among the authors we modified the parts which needed to be clarified.
Reviewer 2
In this review paper, using systematic searches of PubMed, Cochrane, and Scopus data bases, explored the role of electrochemotherapy (ECT) in the management of liver metastases of colorectal cancer (CRC). They reviewed the literature and presented a comprehensive data on clinical outcomes and toxicity associated with percutaneous or intra-surgical ECT of CRC liver metastasis. They conclude that ECT method is safe and effective for the treatment of CRC liver metastasis \, especially for lesions unsuitable for other ablative techniques.
Comments:
Please expand several acronyms: For example, S.P.I.D.E.R, P.I.C.O, GRADE, PRISMA etc.,
We thanks the reviewer for the comments. As requested we expanded the acronyms
Reviewer 3 Report
Comments and Suggestions for Authors
This is a systematic review as applied to ECT in CRC liver metastasis. The study design adheres to standard practice and I think overall the approach is fine. I have some minor comments that I think should be addressed.
1. Line 36-38 I am not clear why liver cancer is being introduced. The study focusses on CRC metastasis to liver, and nowhere else is primary liver cancer considered.
2. line 127 - fig what?
3. line 139 - the language slips occasionally, "In Spallek paper" needs correcting to "In the Spallek paper".
4. line 142-143 "all the papers" and "all the 4 works" just needs a bit more clarity in terms of relating to the 4 sources selected through the exclusion criteria as initially I wasn't sure what was being discusssed.
5. line 177 citation for the Spallek paper.
6. Line 233-234 either S.P.I.D.E.R. or SPIDER, be consistent.
Comments on the Quality of English Language
English is fine, occasional lapses (eg see above) so a proof read would be beneficial.
Author Response
Dear Academic Editor,
First, we would really like to thank the reviewers for their accurate work and their precious suggestions.
We took into serious consideration all the remarks made by the reviewers and after discussion among the authors we modified the parts which needed to be clarified.
Reviewer 3
This is a systematic review as applied to ECT in CRC liver metastasis. The study design adheres to standard practice and I think overall the approach is fine. I have some minor comments that I think should be addressed.
- Line 36-38 I am not clear why liver cancer is being introduced. The study focusses on CRC metastasis to liver, and nowhere else is primary liver cancer considered.
We thanks the reviewer for these consideration. We changed the sentences
- line 127 - fig what?
As requested, we numbered the figure
- line 139 - the language slips occasionally, "In Spallek paper" needs correcting to "In the Spallek paper".
As requested we adjusted the sentence
- line 142-143 "all the papers" and "all the 4 works" just needs a bit more clarity in terms of relating to the 4 sources selected through the exclusion criteria as initially I wasn't sure what was being discusssed.
As requested we better specified the papers and added the reference.
- line 177 citation for the Spallek paper
As requested, we added the citation
- Line 233-234 either S.P.I.D.E.R. or SPIDER, be consistent.
As requested we use only the acronym S.P.I.D.E.R.
