The Role of Preoperative Chemotherapy in the Management of Synchronous Resectable Colorectal Liver Metastases: A Meta-Analysis

Round 1

Reviewer 1 Report

General Comments:

The paper titled "The role of preoperative chemotherapy in the management of synchronous resectable colorectal liver metastases. A meta-analysis" presents a meta-analysis on the role of preoperative chemotherapy in the management of synchronous resectable colorectal liver metastases. The paper is well-written, and the methodology is adequately presented. However, there are a few suggestions that the authors should consider to improve the quality of the paper.

 

Specific Comments:

 

The authors should include p-values for the comparison between pre-operative and surgery groups for the variables in Table 2. The inclusion of p-values will provide additional information to the readers, and it will allow them to better assess the statistical significance of the differences between the two groups.

 

In the factors where the I-squared statistic is high (>75%), the authors should mention that explicitly to avoid any confusion. The inclusion of this information will help the readers to better understand the heterogeneity of the studies included in the meta-analysis.

 

The authors should generate a multivariate analysis for disease-free survival and overall survival for important clinicopathological factors in the two groups that they identified (pre-op and surgery). The multivariate analysis will allow the authors to control for confounding variables and identify the independent predictors of disease-free survival and overall survival. This information will be valuable for clinicians and researchers who are interested in this topic.

 

Conclusion:

 

Overall, the paper titled "The role of preoperative chemotherapy in the management of synchronous resectable colorectal liver metastases. A meta-analysis" is well-written, and the methodology is adequately presented. The authors should consider the suggestions mentioned above to improve the quality of the paper.

 

Author Response

Please see the attachment.

Author Response File: Author Response.doc

Reviewer 2 Report

1. On pages 80 to 83 of the document, it is mentioned that there are three ways to treat synchronous colorectal liver metastases with surgery and chemotherapy. But the patients on page 138~140 and table2 can only be divided into preoperative group and surgery group. This classification does not correspond to the actual clinical treatment. Is there any mention of these classifications in the cited article?

I think you should reclassify the patients or explain in detail.

2. On page P140~141, you mentioned that there are three regimens in preoperative chemotherapy. Do different regimens have different outcomes?

Author Response

Please see the attachment.

Author Response File: Author Response.doc

Reviewer 3 Report

In my opinion,  the study design was described very well; however, as  highlighted by the authors, there are little evidence with inconsistent results and insufficient sample size. Therefore, more prospective studies are needed to clarify the role of PREC in patients  who developed  resecable colorectal liver metastasis.

Author Response

Please see the attachment.

Author Response File: Author Response.doc

Round 2

Reviewer 1 Report

The authors return a revised manuscript with much improved methodology, while address ing all the comments raised during the initial review process. The publication is now ready for publication.