A Comprehensive Review and Insights into the New Entity of Differentiated High-Grade Thyroid Carcinoma

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Excellent review, very clear

Very few comments

1) page 6 line 113 it is written "therefor"

2) we have to wait the last paragraph to read that a  minor component of PDTC or of DHGTC is sufficient to modify the prognosis; this very essential point should be explained earlier in the manuscript

Author Response

Please see the attachment

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

This manuscript provides valuable information on the clinical characteristics, diagnostic challenges, therapeutic approaches, and prognostic implications of high-grade differentiated thyroid carcinoma (DHGTC), an emerging entity in thyroid pathology. Overall, this manuscript is well written and provides an in-depth analysis of the topic. However, English editing and checking of spelling and punctuation are required. Furthermore, I think an addition to the references should be made (10.1002/cncy.22454; 10.1089/thy.2023.0350; 10.1007/s12020-022-03146-0; 10.1007/s12020-023-03336-4).

Comments on the Quality of English Language

English language should be ameliorated

Author Response

Please see the attachment

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

The authors conducted a comprehensive review of the newly characterized entity of differentiated high-grade thyroid carcinoma (DHGTC) as defined in the 5th edition of the WHO classification of endocrine and neuroendocrine tumors. Accurate pathological diagnosis of DHGTC is crucial for implementing tailored treatment strategies. This review encompasses fundamental to advanced knowledge on DHGTC.  There is several concerns as outlined below.

 

#1. Clarifications of the second section “New Classification of Malignant Thyroid Carcinoma” are needed. Certain descriptions require correction to avoid misleading readers:

 

1-1. Line 92: Replace "Thyroid neoplasms" with "thyroid follicular cell-derived neoplasms." This encompasses categories like Thyroid C cell-derived carcinoma and salivary gland-type carcinomas of the thyroid, which exclusively include malignant lesions.

1-2. Use the abbreviation "ATC" for anaplastic thyroid carcinoma, as per the WHO classification.

1-3. Line 99: The sentence stating, “These tumor types were classified morphologically by cell origins,” is inaccurate as it refers specifically to follicular cell-derived neoplasms (i.e., same cell origin).

1-4. Line 102: Clarify the term "histologic grade" for better understanding.

1-5. Correct the title of Figure 2 to “Classification of Malignant Thyroid Follicular Cell-Derived Neoplasms Related to Differentiation and Prognosis.”

 

#2. Focus of "Clinical Features" section is unclear.

The fourth section, “Clinical Features,” appears to contain overlapping information with sections 6 (Treatment and Management) and 7 (Prognosis). It is suggested to emphasize epidemiological aspects in this section.

 

#3. In Figure 8, replace "Hurthle cell carcinoma (HCC)" with "oncocytic carcinoma," reflecting the revised terminology in the 5th edition of the WHO classification.

 

#4. Streamlining the "Prognosis" Section is needed.

The "Prognosis" section should avoid redundancy by integrating pertinent information into the molecular and treatment sections.

 

5. Please address typographical errors throughout the manuscript to enhance clarity and professionalism.

Comments on the Quality of English Language

There are several typographical errors to be revised.

Author Response

Please see the attachment

Author Response File: Author Response.pdf