Higher Rate of Lymphedema with Inguinal versus Axillary Complete Lymph Node Dissection for Melanoma: A Potential Target for Immediate Lymphatic Reconstruction?

Round 1

Reviewer 1 Report

I like the study. Simple, clear concept, clinically important, with practical remarks and sound discussion. 

Major limitation is low number of patients included - I would suggest multicenter retrospective study on the same subject. I declare my interest in joining - please forward my details to the Authors, when Editor's decision  on the paper would me finally made.

The only comment is that the study is important for surgical oncologists, not for general oncological audience.

However I do think it should be accepted in this particular journal.

Congrats! 

Author Response

Please see attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

In table 1 a statistical difference in number of lymph nodes resected is reported. The text  (line 119) should be modified accordingly

 

line 48. Lymphedema is indeed an insidious condition. Pathophysiology is still under intense investigation. However, a broad consensus could be found about the definition as a "collection of protein-rich lymphatic fluid in the interstitial space", and this is the basis for the effectiveness of ILR. Here you can find two comprehensive reviews on the topic that could be referenced.

Warren AG, et al. Lymphedema: a comprehensive review. Ann Plast Surg. 2007 Oct;59(4):464-72. doi: 10.1097/01.sap.0000257149.42922.7e.

de Sire A, et al. Surgical Treatment and Rehabilitation Strategies for Upper and Lower Extremity Lymphedema: A Comprehensive Review. Medicina (Kaunas). 2022 Jul 19;58(7):954. doi: 10.3390/medicina58070954.

Author Response

Thank you for your thorough review. In response to your first comment, the text under the subheading 3.1 has been altered to reflect findings in Table 1. Asfor your second point, we have read the two excellent reviews you have provided and have referenced them in our introduction. We have contrasted pathophysiological and clinical definitions of lymphedema. We hope this will correctly address the second issue.

Please find the revised manuscript attached.

Author Response File: Author Response.docx

Round 2

Reviewer 2 Report

The authors responded to my previous comments.