Hepatocellular Carcinoma in Cirrhotic Versus Non-Cirrhotic Patients: A Retrospective Study of 483 Patients

Review Data

Q: Is the topic relevant to the journal area of interest? Is it contemporary and interesting for

researchers?

A: Excellent

Abstract & Keywords

Q: Are all required components included in the abstract? Are the keywords appropriately chosen?

A: Very good

Goal

Q: Is the goal explicitly stated in the Introduction? Is its formulation clear and unambiguous?

A: Very good

Structure

Q: Is the paper's structure coherent? Is it in coherence with the goal of the paper?

A: Good

Tools and Methods

Q: Are methods the author uses adequate and well used?

A: Good

Discussion & Conclusion

Q: Is it related to the results presented before? Do you consider them as coherent?

A: Good

Comments:

The Discussion encompasses the relevant findings from the previous studies on clinical characteristics and outcomes of cirrhotic hepatocellular carcinoma (C-HCC) and non-cirrhotic hepatocellular carcinoma (NC-HCC) patients and provides a thorough analysis of the findings and their implications. This study provides important overview on the differences between NC-HCC and C-HCC patients in a European cohort. The Conclusions are consistent with the evidences presented in this article. Further it concludes that the NC-HCC patients were older with a higher female prevalence.

Literature

Q: Does the author utilize relevant literature?

A: Very good

Author's knowledge

Q: What is the level of the author’s knowledge? Does the author utilize all recent contributions relevant to the topic?

A: Good

Length

Q: Is the length of the paper adequate to the significance of the topic? Do you suggest shortening the paper without losing its value?

A: Good

Figures & Tables

Q: Does the author use them suitably? Are legend and notations clear?

A: Very good

Writing style

Q: Is it clear and understandable?

A: Good

Further comments on the paper

Comments: This retrospective study compares non-cirrhotic hepatocellular carcinoma (HCC) patients with cirrhotic HCC patients, by taking into consideration demographic characteristics, risk factors, tumor stage, treatment and survival. The HCC development in non-cirrhotic patients represents a serious health problem, making this study significant. As suggested by recent data, obesity, diabetes, non-alcoholic liver disease (NAFLD) are risk factors associated with HCC development, which represents an alarming issue, as the NAFLD prevalence globally is high and increasing. While the current study included a relatively large number of patients, it is limited by its retrospective nature and single centre data. Also, despite extensive tests, the study could not establish the underlying liver disease in 14.9 % of NC-HCC and 2.3 % of C-HCC cases.

Q: Would you recommend this manuscript for further publication?

A: Yes - Suitable to be published

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