Peer Review History
Original SubmissionApril 1, 2021 |
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PONE-D-21-10743 Prognostic value of postoperative decrease in serum albumin on surgically resected early-stage non-small cell lung carcinoma: a multicenter retrospective study PLOS ONE Dear Dr. Tagawa, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Reviewers raised constructive comments on your manuscript. They pointed out the clarification of albumin measurement across multiple cohorts. And, you need to more clearly describe study design and statistical methods with updated staging system. Please submit your revised manuscript by Jul 09 2021 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript:
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Please include your amended statements within your cover letter; we will change the online submission form on your behalf. 5. PLOS requires an ORCID iD for the corresponding author in Editorial Manager on papers submitted after December 6th, 2016. Please ensure that you have an ORCID iD and that it is validated in Editorial Manager. To do this, go to ‘Update my Information’ (in the upper left-hand corner of the main menu), and click on the Fetch/Validate link next to the ORCID field. This will take you to the ORCID site and allow you to create a new iD or authenticate a pre-existing iD in Editorial Manager. Please see the following video for instructions on linking an ORCID iD to your Editorial Manager account: https://www.youtube.com/watch?v=_xcclfuvtxQ [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes ********** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: No ********** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ********** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ********** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Authors investigated the influence of the postoperative changes in the serum albumin level on the postoperative prognosis of the patients with Stage IA non-small cell lung cancer who underwent complete resection. Through the study, they found that the decrease of serum albumin level had a negative impact on the postoperative progression-free survival and overall survival. They set a cut-off level of the degree of changes in serum albumin levels from the training set, and adopt it to the validation set. The methodological design for the study was well organized, and the statistical analyses were well performed. There are some issues to settle. 1. Abstract, Conclusions: The first sentence is a bit too abstracted and obscure. It should be more concrete for summarizing the study. It may be “We demonstrated a negative impact of postoperative decrease of the serum albumin on the prognosis of patients with early-stage NSCLC.” 2. Patients and Methods, Study patients: The flow of the patients included in the study was a bit too complicated to understand by reading the text. Please provide a CONSORT diagram as a Figure for readers to understand the whole schema of the participants. 3. Patients and Methods, Evaluation of serum albumin: the data of albumin level was collected from three different hospitals. Are there any difference in the measuring method for serum albumin? 4. To be related with the #3, is there any adjustment with the serum calcium level to determine the serum albumin level? 5. Table 1: Does the smoking refer the preoperative status? I think the postoperative smoking status is more related with the postoperative changes of the patients. Could you provide the postoperative smoking status, if possible? 6: Authors did not include any pulmonary status, such as COPD or restrictive pulmonary disease. I wonder the nutritional status may influenced by those types of pulmonary diseases especially after the lung resections. Could you incorporate the pulmonary status in the statistical models for prognosis? Reviewer #2: This is a multi-institution, retrospective cohort study that examines 1,085 patients with a history of pathologic stage IA non-small cell lung cancer (NSCLC) in 2003 and 2014 designed to analyze the clinical significance of a postoperative change of serum albumin at 1 year after surgery as a marker of nutritional status on the long-term outcomes. You have concluded the alteration of serum albumin between preoperative and postoperative 1-year levels is an independent prognostic factor for disease-free survival (DFS) and overall survival (OS) in 443 patients in a training cohort and 642 patients in validation cohorts with pstage IA NSCLC. 1. Through large multi-institutional cohorts of patients with pstage IA NSCLC, the authors attempted to determine the association of nutritional change in albumin with long-term survival. However, this manuscript has several limitations to connect postoperative parameters, which may be affected by many confound variables including minimally invasive surgery, dietary modification, and additional treatment, with long term outcomes. 2. Based on your Figure 3, the effect of albumin changes looks more significant in T1a (based on the 7th edition) and adenocarcinoma. Subgroup analysis of T1a lung adenocarcinoma with the updated staging system (8th edition), which can be divided into new T1a and T1b, may be more interesting. Furthermore, more detailed histologic or pathologic findings in adenocarcinoma may be considered. 3. Please describe the method to measure serum albumin. And, please clarify if the same methods are applied to multiple cohorts and the range or standard deviations are similar across the cohorts. The cut off values of albumin are set up based on OS, which will lead to distinct survival curve of at least a training cohort. More objective way to set up the cutoff value may be required. Based on your finding considering both pre-albumin and albumin change, only 3.8 (17/443) % in a training cohort and 1% (7/642) in a validation cohort are classified into albumin-low-decreased, which has the worst prognosis. These numbers look too small to generalize your findings. And, the albumin values do not outperform other variables such as old age and male. There is no comparison of albumin changes with other nutritional markers. 4. If you consider that albumin change and prealbumin are modifiable variables, please describe more detailed strategies to improve the nutritional status. 5. As I know, adjuvant tegafur/uracil (UFT) chemotherapy is recommended for patients with completely resected Stage I NSCLC in Japan. I wonder if your cohorts include patients with adjuvant Tx. 6. Multivariate is an incorrect term since you have used a dependent variable such as OS or DFS. Multivariable analysis would be a correct terminology. And, you have not described how you have selected variables for multivariable analysis. T staging and smoking status are excluded although they are statistically significant during the univariable analysis. ********** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). 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Revision 1 |
Prognostic value of postoperative decrease in serum albumin on surgically resected early-stage non-small cell lung carcinoma: a multicenter retrospective study PONE-D-21-10743R1 Dear Dr. Tagawa, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Hyun-Sung Lee, M.D., Ph.D. Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: |
Formally Accepted |
PONE-D-21-10743R1 Prognostic value of postoperative decrease in serum albumin on surgically resected early-stage non-small cell lung carcinoma: a multicenter retrospective study Dear Dr. Tagawa: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Hyun-Sung Lee Academic Editor PLOS ONE |
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