Optimizing Cancer Survivorship Care: Examination of Factors Associated with Transition to Primary Care

Round 1

Reviewer 1 Report

Dear authors,

this is a well presented study of patients outcomes after cancer treatment who are discharged in the community, and how they perceive their symptoms. It is a very interesting topic and the results are important in the perception of the sumptoms by the primary care physicians. The only point I would like to stand is the selection of statistics. I can only see basic descriptive statistics, have any correlation test been made between the time of discharge and the intensity of symptoms? Or the cancer staging and symptomatology? That could be a nice addition.

Author Response

We appreciate the thoughtful feedback and suggestions for improving the statistical and results aspects of the manuscript.  We had previously considered further exploratory analyses for patients in which ESAS scores were available, however our dataset included ESAS scores for approximately only half of our cohort population.  In addition, without a comparator group, we were concerned that carrying out further subgroup analyses on this smaller group of patients with ESAS scores could provide results that might be potentially misleading and difficult to interpret.  For this reason, we intentionally made an active decision not to include correlative analyses or subgroup analyses on the patients for whom ESAS scores were available within our dataset.

We hope this satisfactorily addresses the reviewers suggestions regarding further analyses relating to ESAS scores. 

Reviewer 2 Report

The Authors present a paper: " Optimizing cancer survivorship care: examination of factors associated with transition to primary care" very interesting from a clinical point of view. I don't have criticism looking at the Introduction , Methos and results reported in the paper as well as bibliography.

I ask Authors to be more convincing in the the Conclusion to promote the use of their methodology not demanding to future studies but giving suggestions to use in other Centers their approach. I only suggest to look in the pediatric area what in the last years PANCARE (an international network did for transition preparing the so called "Passport for cured subjects from childhood cancer").

Author Response

We thank the reviewer for their thoughtful recommendations.  As suggested, we have modified the conclusions section by adding suggestions on how research involving cancer survivors transitioned from the cancer centre can be carried out in an effective and reliable manner using our approach with transition codes.

Reviewer 3 Report

The paper is interesting : there are very few comments reported in the attached manuscript. The code  for transition seems very useful : this code could be a tool to be recommended for all professionals involved in survivorship.

Comments for author File: Comments.pdf

Author Response

Thank you for your feedback.  We will be sure to modify the conclusions section to reflect your recommendations regarding use of our methodology with transition codes to help other individuals involved with survivorship care and research.