Lymph Node Dissection for Colon Cancer in Older Patients: D2 or D3?

Review Data

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

researchers?

A: Very good

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: Very good

Discussion & Conclusion

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

A: Excellent

Comments: The Discussion section aptly analyses the observations presented in this study with the help of relevant literature. It provides a valuable insight into the risk factors responsible for developing colorectal cancer in older patients. It aims to assess and compare the short and long-term outcomes of different extents of lymph node dissection (LND) which are evaluated by one-year and five-year overall survival, as well as five-year disease-free survival. It stresses on the importance of D3 LND which results in significant improvement in five-year overall and disease-free survival of older patients, and it does not affect the 30-day, 90-day, and one-year mortality. The Conclusion section is consistent with the evidences presented in this article. The limitations of this study are also properly addressed.

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: Very 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: Good

Comments: Table 1 is mentioned in the text section of the manuscript but it is not provided.

Writing style

Q: Is it clear and understandable?

A: Good

Comments:

·       In the 1st sentence of the Materials and Methods under the section of the Abstract, “was performed” should be inserted before “between 2006 and 2015.”

·       In the 2^nd sentence of the Materials and Methods under the section of the Abstract, the word “aged” should be inserted after “Patients” and “who” should be inserted before “underwent”.

·       Words like “standard”, “frequent”, “dissections”, “anaesthesiologist”, “patients”, “loss”, “discussed”, “comorbidities”, “guidelines”, “systematic”, “demonstrated”, “cancer”, “Performing” are misspelled in the text section of the article.

Further comments on the paper

Comments: This retrospective multicenter study by involving 201 older colorectal cancer patients, compares the short-term and long-term outcomes of D3 lymph node dissection (LND) with those of D2 dissection. It also assesses the impact of D3 LND on short and long-term results and on the quality of life of patients aged>75 years. It reports that male gender, stage III tumors and D2 LND are the risk factors which may cause death within 5 years after surgery. This study demonstrates that radical surgery in combination with D3 LND in older patients with colon cancer improves five-year overall and disease-free survival as well as it does not affect the 30-day, 90-day, and one-year mortality. However, the study is limited due to retrospective study design, selection bias, postoperative complications, involvement of different surgeons and different pre and postoperative management procedures taken up by different hospitals. Therefore, multicenter prospective randomized controlled trials are required in future studies.

Q: Would you recommend this manuscript for further publication?

A: Yes - Suitable to be published

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Science Repository Team