PONE-D-22-09016Effects of intravesical BCG maintenance therapy duration on recurrence rate in high-risk non-muscle invasive bladder cancer (NMIBC): Systematic review and network meta-analysis according to EAU COVID-19 recommendationsPLOS ONE

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Reviewer #2: Yes

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Reviewer #2: Yes

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Reviewer #1: Objectives: Authors purposes in this manuscript were to evaluate as a systematic and a network meta-analysis the recurrence rates after TURBT and BCG instillations (in patients with NMIBC receiving induction and maintenance therapy, under and over one year) available in the literature. The work has value in the context of identifying the best recommendation period of BCG instillation for NMIBC.

There are few minor issues that can improve the manuscript.

1. At line 72-73 the purpose of the review is indicated to be the appropriate duration of BCG maintenance therapy both during and after control of the COVID-19 pandemic. It is somehow misleading, because the readers can expect to see a comparative analysis on the studies performed pre and after pandemic. “After control of the COVID-19 pandemic” is the term that has to be modified. The Covid-19 pandemic is not over yet. I would like to ask the authors to rephrase the paragraph.

2. In the Discussion section, from line 194 to 199, the information can be better inserted in the introduction section.

Reviewer #2: I appreciate this meta-analysis and I only suggest minor revision as:

Introduction:

Add impact of reTurb on bcg response : see Urol Oncol. 2022 Jun 5:S1078-1439(22)00186-7. doi: 10.1016/j.urolonc.2022.05.016. Online ahead of print. ;

J Cancer 2018 Oct 20;9(22):4250-4254. doi: 10.7150/jca.26129. eCollection 2018.

Define concept of BCG unresposnsive , according new definition of FDA and add recent evidence of literature : Urol Oncol. 2022 Jun 5:S1078-1439(22)00186-7. doi: 10.1016/j.urolonc.2022.05.016. Online ahead of print.

In discussion remark the concept of delayed treatment during pandemic era

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Reviewer #1: Yes: Tataru Octavian Sabin

Reviewer #2: Yes: matteo Ferro

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Effects of intravesical BCG maintenance therapy duration on recurrence rate in high-risk non-muscle invasive bladder cancer (NMIBC): Systematic review and network meta-analysis according to EAU COVID-19 recommendations

PONE-D-22-09016R1

Dear Dr. Lee,

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Kind regards,

Giuseppe Lucarelli, M.D., Ph.D.

Academic Editor

PLOS ONE

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