Primary Signet-Ring-Cell Carcinoma in the Colorectum: A Case-Based Literature Review

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The manuscript deals with an interesting research topic but there is still room for organizational, structural and argumentation improvements prior it to be accepted for publication at the Gastroenterology Insights journal and, to this end, the following review comments can be considered.

 

1. In a grammar overview authors are recommended to use the past tense of the passive voice in actions taken by authors and completed in the past, not mixing the past and the present verb tense for actions completed in the past.

 

2. Due to the review type of the manuscript it is hardly acceptable only 5 citations to be included in the first 2 main sections. Therefore, a more extended and detailed literature coverage is recommneded. Actually in such a type of “Review” study it is impossible to be absent a “2. Literature Review” main section. For this, authors are recommended to retitle the “2. Search strategy” towards “2. Literature Review” and simultaneously reorganize and enhance it in order to meet its content as “Literature Review”, accordingly.

 

3. In the followed methodology the authors stated that “we employed an extensive search strategy using various databases, including PubMed, Medline, Scopus, Web of Science, and Google Scholar.” and later that “We confine our search up to March 2024.” However, it is critical authors to denote also the start date/year in which the yielded documents have been published.

 

4. The subsections of main section 3, prognosis and diagnosis, can be accompanied by an extra subsection that should refer to the “pharmaceutical treatment” that is prescribed in such a type of carcinoma.

 

5. The two blocks of image-wall of Figures 3 and 4 sustain hidden information of the case report which can be conveyed by authors in a more detailed and descriptive manner/explanatory paragraphs, each one per image-included, enabling a non specialized reader/researcher to understand what hidden information is each time depicted and what are the evolutionary characteristics per each one subgraph-image.

 

6. Section 4 has been titled twice:

 

“4. Our experience: a case report”

“4. Conclusions”

 

Please check and renumber accordingly. Besides, special provision has to be taken that the separate, autonomous “Discussion” section to be developed prior to the Conclusions section. Please also consider that the case report cannot be part of the Discussion section, since the Discussion is a section in which a coherent “synthesis” of the a) constraints, b) challenges, c) future prospects derived from the analysis of subsections 3 and the main section 4. Case report, to be conveyed. The critical point here, in this new, separate, autonomous, Discussion section is exactly to authors’ specification on what and to what extend the “Continued research endeavors and clinical vigilance are imperative to address the unmet needs of patients with this carcinoma.”, should be feasible and realistic? For this 2-3 and cross-cited text paragraphs are adequate.

 

7. I am sorry to say but I am not fully familiar with the following expression of the manuscript title: ……..Beyond the Enigma of Primary Signet…….., since it sounds somehow naive and informal.  It may be correct but please keep in mind and make provision to provide as much as rigid and formalized terminology as possible, where possible.

Comments on the Quality of English Language

Dear Editor,

 

Thank you very much for offering me the opportunity to review this manuscript. The manuscript deals with an interesting research topic but there is still room for organizational, structural and argumentation improvements prior it to be accepted for publication at the Gastroenterology Insights journal and, to this end, the suggested review comments can be considered.

 

Thank you very much again.

 

Kind regards,

Dr. Dr. Grigorios L. Kyriakopoulos

Author Response

The manuscript deals with an interesting research topic but there is still room for organizational, structural and argumentation improvements prior it to be accepted for publication at the Gastroenterology Insights journal and, to this end, the following review comments can be considered.

• Authors` reply: Thank you for your detailed and constructive review of our manuscript. We appreciate your feedback and suggestions for improvement, and we are committed to addressing each point to enhance the quality and structure of our paper. 

1. In a grammar overview authors are recommended to use the past tense of the passive voice in actions taken by authors and completed in the past, not mixing the past and the present verb tense for actions completed in the past.

• Authors` reply: We carefully check the manuscript to ensure consistency in using the past tense or passive voice, as per your recommendation.

2. Due to the review type of the manuscript it is hardly acceptable only 5 citations to be included in the first 2 main sections. Therefore, a more extended and detailed literature coverage is recommended. Actually in such a type of “Review” study it is impossible to be absent a “2. Literature Review” main section. For this, authors are recommended to retitle the “2. Search strategy” towards “2. Literature Review” and simultaneously reorganize and enhance it in order to meet its content as “Literature Review”, accordingly.

 Authors` reply: We understand the importance of a comprehensive literature review in a review-type manuscript. We revised and expand the literature coverage, including reorganizing the "Search strategy" section into a dedicated "Literature Review" section.

3. In the followed methodology the authors stated that “we employed an extensive search strategy using various databases, including PubMed, Medline, Scopus, Web of Science, and Google Scholar.” and later that “We confine our search up to March 2024.” However, it is critical authors to denote also the start date/year in which the yielded documents have been published.

 Authors` reply: We added the start date/year of the documents yielded from our search strategy, as requested, to provide a clearer context for the reviewed literature.

4. The subsections of main section 3, prognosis and diagnosis, can be accompanied by an extra subsection that should refer to the “pharmaceutical treatment” that is prescribed in such a type of carcinoma.

 Authors` reply: Your suggestion to include an additional subsection on pharmaceutical treatment in the prognosis and diagnosis section is valuable. We incorporated this aspect into the manuscript.

5. The two blocks of image-wall of Figures 3 and 4 sustain hidden information of the case report which can be conveyed by authors in a more detailed and descriptive manner/explanatory paragraphs, each one per image-included, enabling a non specialized reader/researcher to understand what hidden information is each time depicted and what are the evolutionary characteristics per each one subgraph-image.

 Authors` reply: We enhanced the description and explanatory paragraphs for Figures 3 and 4 to provide a clearer understanding of the depicted information. In the histological pictures in Figure 3 there is nothing hidden, in the most part they establish tumor cells and tumor cell emboli, which have been described already. The only thing that is not mentioned is well-expressed stromal immune reaction, composed of rich infiltration of lymphocytes, clearly visible in all slides.

6. Section 4 has been titled twice:

 

“4. Our experience: a case report”

“4. Conclusions”

Please check and renumber accordingly. Besides, special provision has to be taken that the separate, autonomous “Discussion” section to be developed prior to the Conclusions section. Please also consider that the case report cannot be part of the Discussion section, since the Discussion is a section in which a coherent “synthesis” of the a) constraints, b) challenges, c) future prospects derived from the analysis of subsections 3 and the main section 4. Case report, to be conveyed. The critical point here, in this new, separate, autonomous, Discussion section is exactly to authors’ specification on what and to what extend the “Continued research endeavors and clinical vigilance are imperative to address the unmet needs of patients with this carcinoma.”, should be feasible and realistic? For this 2-3 and cross-cited text paragraphs are adequate.

 Authors` reply: We rectified the duplicate titling of Section 4 and ensure the correct numbering and organization of sections, including developing a separate, coherent "Discussion" section.

 

7. I am sorry to say but I am not fully familiar with the following expression of the manuscript title: ……..Beyond the Enigma of Primary Signet…….., since it sounds somehow naive and informal.  It may be correct but please keep in mind and make provision to provide as much as rigid and formalized terminology as possible, where possible.

 Authors` reply: We appreciate your feedback on the title expression and we revised it to ensure a more formal and professional tone, aligning with rigorous scientific terminology. Thank you once again for your thorough review and valuable suggestions. We are committed to implementing these improvements to meet the standards of Gastroenterology Insights journal and enhance the overall quality of our manuscript.

Reviewer 2 Report

Comments and Suggestions for Authors

The authors comprehensively review PSRCCR and provide an own case report of this rare cancer type.

the following revisions might be considered:

Line 3: case report instead of experience

line 18: total incidence or percentage of colorectal cancers?

line 23: repeats line 17

line 28: please explicitly state that this is a case report and provide some details about the case

line 55: reference number missing

line 69: can some aspects about risk factors besides genetics be added. Alcohol? Smoking?

line 94, 96: 2.4 or 1%?
section 3.2, first paragraph: this might be condensed because the same information is presented several times

lines 179, 182: why is this about stomach when the article is on colon?

line 293 and throughout: state manufacturer or supplier for all materials and instruments

line 326: is the reference correct? Was the case already published? What was the survival of the patient following diagnosis?

references: recheck style guide

Author Response

The authors comprehensively review PSRCCR and provide an own case report of this rare cancer type.

• Authors` reply: Thank you for your detailed and constructive review of our manuscript. We appreciate your feedback and suggestions for improvement, and we are committed to addressing each point to enhance the quality and structure of our paper. 

the following revisions might be considered:

Line 3: case report instead of experience – CORRECTED as case-based literature review

line 18: total incidence or percentage of colorectal cancers? – we changed it to rate

line 23: repeats line 17 - CORRECTED

line 28: please explicitly state that this is a case report and provide some details about the case - CORRECTED

line 55: reference number missing - ADDED

line 69: can some aspects about risk factors besides genetics be added. Alcohol? Smoking? - ADDED

line 94, 96: 2.4 or 1%? – ADDED clarifying information

section 3.2, first paragraph: this might be condensed because the same information is presented several times – We agree and tried to condense

lines 179, 182: why is this about stomach when the article is on colon? – Thank you for the critical comment. It is a shared mechanism in ring cell CA, therefore, we changed “stomach” to “GIT”

line 293 and throughout: state manufacturer or supplier for all materials and instruments – thank you for the note, we provided all the information that we have

line 326: is the reference correct? Was the case already published? What was the survival of the patient following diagnosis? – Our case has not been published yet, As for the reference, it was attributed to the chemotherapeutic regimen (former [45]). Thank you for noticing this, we accept that this may lead to confusion and we corrected the issue.

references: recheck style guide – We corrected the issues

• Authors` reply: Thank you for pointing out these issues. We corrected the paper according to the recommendations and suggestions.  

 

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

At this revised manuscript authors have focused their review analysis on the therapeutic landscape/management/medical treatment for PSRCCR in the colorectum. This review study has been structured through a wide theoretical coverage coupling with the main operational-medical treatments available. All research parts have been fully developed and the findings have been systematically addressed, offering new and novel insights on the field examined. In this respect this revised manuscript can be accepted for publication at the Gastroenterology Insights journal as is.