Hormone Receptor Expression and Activity for Different Tumour Locations in Patients with Advanced and Recurrent Endometrial Carcinoma
, Hans Trum 9, Dorry Boll 10, Henrica M. J. Werner 11, Luc R. C. W. van Lonkhuijzen 12, Refika Yigit 13, Camilla Krakstad 14, Petronella O. Witteveen 15, Khadra Galaal 16, Alexandra A. van Ginkel 2, Eliana Bignotti 17, Vit Weinberger 18,19, Sanne Sweegers 1, Ane Gerda Z. Eriksson 6,7, Diederick M. Keizer 20, Andrea Romano 4,11, Johanna M. A. Pijnenborg 1 and add
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Round 1
Reviewer 1 Report
Comments and Suggestions for AuthorsThis article describes the difference in hormone receptor expression in different locations in patients with advanced and recurrent endometrial cancer. The authors used immunohistochemistry along with an ER-pathway activity test using mRNA. Their study is interesting and challenging. However, there are several things to be considered, as shown below.
1. The authors investigated ER/PR status and ERPAS in detail. Their study is challenging. However, regrettably, they cannot take significant results from a small number. They need to increase the number of samples to obtain more impact.
2. It is intriguing to know the chronological changes in ER/PR status and ERPAS.
3. In figure 3, the title of figure 3B is missing.
Comments on the Quality of English LanguageMinor editing of English language is recommended.
Author Response
Please look at the attached files for the reply.
Author Response File: 
Author Response.pdf
Reviewer 2 Report
Comments and Suggestions for AuthorsThe manuscript “Hormone receptor expression and activity for different tumour locations in patients with advanced and recurrent endometrial carcinoma” presents exciting findings on ER/PR-IHC and ERPAS expression in different metastatic locations of endometrial cancer. It highlights a potential association between lower PR-IHC/ERPAS in lymphogenic spread and reduced hormonal therapy (HT) efficacy. This study emphasizes the importance of receptor assessment before initiating HT, especially obtaining biopsies from multiple sites, particularly for lymphatic spread. Here, the authors advocate for prospective studies correlating ER/PR-IHC/ERPAS with treatment response.
However, authors should represent the IHC microscopic images in the manuscript to support their claims.
Overall, the authors raised valuable points about potential heterogeneity in ER/PR-IHC/ERPAS expression across metastatic sites. However, the limitations of the study design necessitate future investigation through prospective studies with larger cohorts.
The manuscript is impeccably composed and highly deserving of recommendation for publication after minor revisions regarding IHC data.
Author Response
Please look at the attachements for the reply to the review report.
Author Response File: Author Response.pdf
Round 2
Reviewer 1 Report
Comments and Suggestions for AuthorsThis version of the article is fine. Although the sample size is relatively small, conclusions were drawn from the data analyzed.
