Predictive role of preoperative sarcopenia for long-term survival in rectal cancer patients: A meta-analysis

Qiutong Su; Jia Shen

doi:10.1371/journal.pone.0303494

Peer Review History

Original SubmissionNovember 22, 2023
16 Jan 2024 Decision Letter - Zubing Mei, Editor PONE-D-23-38922Predictive role of preoperative sarcopenia for long-term survival in rectal cancer patients: a meta-analysisPLOS ONE Dear Dr. Su, 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. Please submit your revised manuscript by Mar 01 2024 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: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Zubing Mei, MD,PH.D Academic Editor PLOS ONE Journal Requirements: When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. We note that your Data Availability Statement is currently as follows: All data generated or analyzed during this study are included in this published article. Please confirm at this time whether or not your submission contains all raw data required to replicate the results of your study. Authors must share the “minimal data set” for their submission. PLOS defines the minimal data set to consist of the data required to replicate all study findings reported in the article, as well as related metadata and methods (https://journals.plos.org/plosone/s/data-availability#loc-minimal-data-set-definition). For example, authors should submit the following data: - The values behind the means, standard deviations and other measures reported; - The values used to build graphs; - The points extracted from images for analysis. Authors do not need to submit their entire data set if only a portion of the data was used in the reported study. If your submission does not contain these data, please either upload them as Supporting Information files or deposit them to a stable, public repository and provide us with the relevant URLs, DOIs, or accession numbers. For a list of recommended repositories, please see https://journals.plos.org/plosone/s/recommended-repositories. If there are ethical or legal restrictions on sharing a de-identified data set, please explain them in detail (e.g., data contain potentially sensitive information, data are owned by a third-party organization, etc.) and who has imposed them (e.g., an ethics committee). Please also provide contact information for a data access committee, ethics committee, or other institutional body to which data requests may be sent. If data are owned by a third party, please indicate how others may request data access. 3. 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 4. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information. Additional Editor Comments: The manuscript presents valuable insights into the prognostic value of sarcopenia in rectal cancer. The reviewers have provided constructive feedback that warrants a major revision. Specifically pay attention the following points: 1. The manuscript requires thorough English editing to correct grammatical and spelling errors. This is crucial to ensure clear communication of the research findings. 2. Clarifications regarding the inclusion and exclusion criteria of studies, particularly the rationale behind excluding studies that provide Kaplan-Meier survival curves instead of HR with 95%, are necessary. 3. The association between sarcopenia and postoperative short-term outcomes should be explored or discussed as a limitation. 4. Detailed methodology and clarity in reporting, such as literature search strategy, study selection process, and handling of hazard ratios, are necessary for reproducibility and transparency. 5. Include citations for statements concerning survival analysis and the types of included studies (prospective, retrospective, or RCT), as well as follow-up time specificity in table 1. 6. Subgroup analyses based on predefined criteria and a discussion on publication bias are recommended to strengthen the paper's validity. 7. Discrepancies in the numbers presented in tables regarding OS and DFS need to be addressed and corrected for consistency and clarity. 8. All abbreviations, such as SMI, must be fully described upon their initial mention in the text, ensuring accessibility for all readers. [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 Reviewer #3: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ****** 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 Reviewer #3: No ****** 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 Reviewer #3: 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: Thanks for giving me the opportunity to review this work. In overall, this manuscript was well designed and written. It is a update meta-analysis investigating the prognostic value of sarcopenia in rectal cancer. I have few concerns about this work which would be addressed. 1. English editing is recommended and some grammar errors exist in the manuscript. 2. Studies providing the Kaplan-Meier survival curves instend of HR with 95% were excluded? Why? 3. The authors did not identify the association between sarcopenia and postoperative short-term outcomes in rectal cancer patients. It's also a limitation. Reviewer #2: The authors included 15 studies and indicated the prognostic value of sarcopenia in rectal cancer. Congratulations on this successful manuscript. I have some minor suggestions for authors to further improve the quality of their work. 1. I would recommend suggest the author carefully check and modify the manuscript and some spelling mistakes and grammatical mistakes could be noticed in this paper. 2. In the "literature search" part, detailed process should be described. 3. "Thirteen studies explored the relationship between sarcopenia and OS among surgical rectal cancer patients." The references should be cited. The same suggestion for "Twelve studies manifested the association of sarcopenia with DFS among surgical rectal cancer patients." and "Only four studies explored the association of sarcopenia with postoperative CSS in rectal cancer patients." 4. What are the types of included studies? Retrospective or prospective? Or RCT? 5. In table 1, "mean" or "median" follow-up time should be specificly described for each studies. Reviewer #3: In this study, the authors conducted a meta-analysis to evaluate the prognostic significance of preoperative sarcopenia in rectal cancer patients. Interestingly, they found that preoperative sarcopenia is associated with poor clinical outcomes in this disease. The manuscript's field is interesting, the introduction and discussion are well-structured; the result section is appropriate; however, there are some concerns, and major revision is expected. 1. To enhance the transparency of the methodology, the authors should consider presenting the literature search strategy employed in various databases in a table. Furthermore, it is important for them to explicitly state the number of studies obtained from each database. 2. For a more comprehensive description of the inclusion and exclusion criteria, it is advisable to provide a thorough explanation that encompasses all relevant aspects. This should include any limitations on language or excluding review articles. 3. In the methods section, the authors should mention whether all hazard ratios (HRs) were provided in the included papers based on univariate or multivariate analysis (in table 1, add which one was for each study) or if they calculated the HRs based on the Kaplan-Meier curves. 4. In the method section, on page 5, lines 1-2, please replace the word 'or' with 'otherwise' (or any suitable synonym) in the following sentence: 'The random effects model was applied; or the fixed effects model was applied.' The use of 'or' is incorrect. 5. I recommend doing subgroup analysis based on different criteria such as sample size (based on mean or median), Newcastle–Ottawa Scale score (<7 and >7), ethnicity (Asian and non-Asian), and so on. 6. In the discussion part, specially limitation section, the authors should mention and interpret the results regarding publication bias. 7. In the table 2, the overall number of studies for OS is 13. However, the number of studies for Chemoradiotherapy and NO subgroups are written 4 and 3, respectively. It is unclear. Because 4 plus 3 will be 7, not 13. So, please correct these numbers for OS and, also, DFS. 8. Abbreviations such as SMI (Page 5) should be fully described when initially mentioned. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No Reviewer #3: No ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0303494.r001
Revision 1
22 Jan 2024 Author Response Response to editor: The manuscript presents valuable insights into the prognostic value of sarcopenia in rectal cancer. The reviewers have provided constructive feedback that warrants a major revision. Specifically pay attention the following points: Question 1. The manuscript requires thorough English editing to correct grammatical and spelling errors. This is crucial to ensure clear communication of the research findings. Answer 1: Thanks for your valuable suggestion. Our manuscript has been edited by AJE service with the verification code 8EDE-76A1-63BD-948C-319A. Question 2. Clarifications regarding the inclusion and exclusion criteria of studies, particularly the rationale behind excluding studies that provide Kaplan-Meier survival curves instead of HR with 95%, are necessary. Answer 2: Thanks for your valuable comment. We have added more description about the inclusion and exclusion criteria, especially the rationale behind excluding studies that provide Kaplan-Meier survival curves instead of HR with 95% CI as follows: “studies did not report the HRs with 95% CIs for survival, including studies providing Kaplan-Meier survival curves because of the significant bias during the calculation of HRs with 95% CIs from the Kaplan-Meier survival curves.” (Page 4, line 22-25) Question 3. The association between sarcopenia and postoperative short-term outcomes should be explored or discussed as a limitation. Answer 3: We have added this issue in the manuscript as one of the limitations: “Fourth, due to the lack of relevant data, we failed to explore the association between sarcopenia and postoperative short-term outcomes.” (Page 10, line 2-3) Question 4. Detailed methodology and clarity in reporting, such as literature search strategy, study selection process, and handling of hazard ratios, are necessary for reproducibility and transparency. Answer 4: Thanks for your valuable comment. The method part has been modified (Page 4, line 4 to Page 4, line 21) Question 5. Include citations for statements concerning survival analysis and the types of included studies (prospective, retrospective, or RCT), as well as follow-up time specificity in table 1. Answer 5: Thanks for your valuable comments. All these information have been updated and added in the manuscript. (Page 6, line 4; Table 1 and 2) Question 6. Subgroup analyses based on predefined criteria and a discussion on publication bias are recommended to strengthen the paper's validity. Answer 6: Thanks for your question. A discussion on publication bias has been added in the manuscript. “Fifth, significant publication bias was detected in our meta-analysis. Although the results of the fill-and-trim method indicated that “unpublished studies” did not affect the overall findings, more high-quality studies are still needed to verify our conclusions.” (Page 10, line 3-6) However, after careful team discussion, we deem that it is hard to conduct subgroup analyses based on predefined criteria. Therefore, we discussed this in the limitations part. “Secondly, some confounding factors such as the definition of sarcopenia including the cutoff values of SMI, PMV and PMI and adjuvant therapy exists in this meta-analysis and we are unable to conduct more detailed analysis due to the lack of original data” (Page 9, line 26-29) Meanwhile, subgroup analysis based on the sample size and ethnicity was further performed. Question 7. Discrepancies in the numbers presented in tables regarding OS and DFS need to be addressed and corrected for consistency and clarity. Answer 7: Dear editor, thanks for your question. Actually, as mentioned in the Table 1, some studies did not provide specific information about the neoadjuvant therapy, which were noted as “mixed”. Therefore, these studies were excluded during the subgroup analysis. Question 8. All abbreviations, such as SMI, must be fully described upon their initial mention in the text, ensuring accessibility for all readers. Answer 8: We have carefully checked and modified all abbreviations in this manuscript. Response to Reviewer #1: Thanks for giving me the opportunity to review this work. In overall, this manuscript was well designed and written. It is a update meta-analysis investigating the prognostic value of sarcopenia in rectal cancer. I have few concerns about this work which would be addressed. Question 1. English editing is recommended and some grammar errors exist in the manuscript. Answer 1: Thanks for your valuable suggestion. Our manuscript has been edited by AJE service with the verification code 8EDE-76A1-63BD-948C-319A. Question 2. Studies providing the Kaplan-Meier survival curves instend of HR with 95% were excluded? Why? Answer 2: Thanks for your valuable question. In this meta-analysis, we excluded studies providing the Kaplan-Meier survival curves instead of HR with 95% CI because there was significant bias during the calculation of HRs with 95% CIs from Kaplan-Meier survival curves. In other words, the HRs with 95% CIs calculated based on Kaplan-Meier survival curves differ greatly from actual HRs with 95% CIs. Therefore, for the accuracy of results, we decided to exclude these studies. Question 3. The authors did not identify the association between sarcopenia and postoperative short-term outcomes in rectal cancer patients. It's also a limitation. Answer 3: We have added this issue in the manuscript as one of the limitations: “Fourth, due to the lack of relevant data, we failed to explore the association between sarcopenia and postoperative short-term outcomes. ” (Page 10, line 2-3) Response to Reviewer #2: The authors included 15 studies and indicated the prognostic value of sarcopenia in rectal cancer. Congratulations on this successful manuscript. I have some minor suggestions for authors to further improve the quality of their work. Question 1. I would recommend suggest the author carefully check and modify the manuscript and some spelling mistakes and grammatical mistakes could be noticed in this paper. Answer 1: We have carefully checked and modified this manuscript. Meanwhile, our manuscript has been edited by AJE service with the verification code 8EDE-76A1-63BD-948C-319A. Question 2. In the "literature search" part, detailed process should be described. Answer 2: Detailed process has been described in the results part as follows “As shown in Figure 1, 764 records were found in these three databases and 101 duplicated records were removed. After reviewing the titles, 615 records were excluded. Then 25 publications were further excluded after reviewing the abstracts. After carefully reviewing full texts, 15 studies were eventually included in this meta-analysis” (Page 5, Line 25-29). Question 3. "Thirteen studies explored the relationship between sarcopenia and OS among surgical rectal cancer patients." The references should be cited. The same suggestion for "Twelve studies manifested the association of sarcopenia with DFS among surgical rectal cancer patients." and "Only four studies explored the association of sarcopenia with postoperative CSS in rectal cancer patients." Answer 3: This issue has been addressed and relevant references have been cited in the results part. (Page 6, line 11 to Page 7, line 9) Question 4. What are the types of included studies? Retrospective or prospective? Or RCT? Answer 4: All included studies were retrospective. (Page 6, line 4) Question 5. In table 1, "mean" or "median" follow-up time should be specificly described for each studies. Answer 5: The information about the follow-up time has been updated in the Table 1. Response to Reviewer #3: In this study, the authors conducted a meta-analysis to evaluate the prognostic significance of preoperative sarcopenia in rectal cancer patients. Interestingly, they found that preoperative sarcopenia is associated with poor clinical outcomes in this disease. The manuscript's field is interesting, the introduction and discussion are well-structured; the result section is appropriate; however, there are some concerns, and major revision is expected. Question 1. To enhance the transparency of the methodology, the authors should consider presenting the literature search strategy employed in various databases in a table. Furthermore, it is important for them to explicitly state the number of studies obtained from each database. Answer 1: Thanks for your valuable question. We have added the Supplementary file 1 describing the literature search strategy employed in various databases. The number of studies obtained from each database was presented in Figure 1. Meanwhile, we have added this information in the results part (Page 5, line 26). Question 2. For a more comprehensive description of the inclusion and exclusion criteria, it is advisable to provide a thorough explanation that encompasses all relevant aspects. This should include any limitations on language or excluding review articles. Answer 2：Thanks for your valuable suggestion. The inclusion and exclusion criteria have been modified as request. (Page 4, line 11-25) Question 3. In the methods section, the authors should mention whether all hazard ratios (HRs) were provided in the included papers based on univariate or multivariate analysis (in table 1, add which one was for each study) or if they calculated the HRs based on the Kaplan-Meier curves. Answer 3: We have added the description about the sources of HRs and 95% CIs in the statistical analysis part (Page 5, line 12-13) and also table 1. Studies providing Kaplan-Meier survival curves instead of HRs and 95% CIs were excluded in this meta-analysis. Question 4. In the method section, on page 5, lines 1-2, please replace the word 'or' with 'otherwise' (or any suitable synonym) in the following sentence: 'The random effects model was applied; or the fixed effects model was applied.' The use of 'or' is incorrect. Answer 4: The “or” has been changed to “otherwise”. (Page 5, line 11) Question 5. I recommend doing subgroup analysis based on different criteria such as sample size (based on mean or median), Newcastle–Ottawa Scale score (<7 and >7), ethnicity (Asian and non-Asian), and so on. Answer 5: Thanks for your valuable question. After careful team discussion, we have added subgroup analysis based on the sample size and ethnicity. (Table 2; Page 5, line 18-20; Page 7, line 4-6) Question 6. In the discussion part, specially limitation section, the authors should mention and interpret the results regarding publication bias. Answer 6: Thanks for your question. A discussion on publication bias has been added in the manuscript. “Fifth, significant publication bias was detected in our meta-analysis. Although the results of the fill-and-trim method indicated that “unpublished studies” did not affect the overall findings, more high-quality studies are still needed to verify our conclusions.” (Page 9, line 3-6) Question 7. In the table 2, the overall number of studies for OS is 13. However, the number of studies for Chemoradiotherapy and NO subgroups are written 4 and 3, respectively. It is unclear. Because 4 plus 3 will be 7, not 13. So, please correct these numbers for OS and, also, DFS. Answer 7: Dear reviewer, thanks for your question. Actually, as mentioned in the Table 1, some studies did not provide specific information about the neoadjuvant therapy, which were noted as “mixed”. Therefore, these studies were excluded during the subgroup analysis. Question 8. Abbreviations such as SMI (Page 5) should be fully described when initially mentioned. Answer 8: We have carefully checked and modified all abbreviations in this manuscript. Attachments Attachment Submitted filename: resonse to editor and reviewers.docx https://doi.org/10.1371/journal.pone.0303494.r002
6 Mar 2024 Decision Letter - Zubing Mei, Editor PONE-D-23-38922R1Predictive role of preoperative sarcopenia for long-term survival in rectal cancer patients: a meta-analysisPLOS ONE Dear Dr. Su, 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. Please submit your revised manuscript by Apr 20 2024 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: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Zubing Mei, MD,PH.D Academic Editor PLOS ONE Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Additional Editor Comments: Most of the concerns have been adequately addressed. However, the reviewer still raised small issues that should be revised. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed Reviewer #3: All comments have been addressed ******** 2. 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 #3: (No Response) ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #3: (No Response) ****** 4. 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 #3: (No Response) ****** 5. 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: (No Response) Reviewer #3: (No Response) ****** 6. 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: The authors have addressed all comments. I do not have additional comments. I would suggest publication for this paper. Reviewer #3: Thank you for replying appropriately to the comments. I have noticed a minor issue in the Prisma flow diagram (figure 1). The total number of studies included in the meta-analysis has been written as n=25, but I guess it should be n=15 (the authors have written n=15 in the result part, page5/19, line 22). Please take this into consideration. ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #3: No ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0303494.r003
Revision 2
6 Mar 2024 Author Response Response to Reviewer #3: I have noticed a minor issue in the Prisma flow diagram (figure 1). The total number of studies included in the meta-analysis has been written as n=25, but I guess it should be n=15 (the authors have written n=15 in the result part, page5/19, line 22). Please take this into consideration. Answer: We are sorry for this mistake. The Figure 1 has been modified and reuploaded. Attachments Attachment Submitted filename: resonse to editor and reviewers.docx https://doi.org/10.1371/journal.pone.0303494.r004
26 Apr 2024 Decision Letter - Zubing Mei, Editor Predictive role of preoperative sarcopenia for long-term survival in rectal cancer patients: a meta-analysis PONE-D-23-38922R2 Dear Dr. Su, 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 will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at Editorial Manager® and clicking the ‘Update My Information' link at the top of the page. If you have any questions relating to publication charges, 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, Zubing Mei, MD,PH.D Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0303494.r005
Formally Accepted
1 May 2024 Acceptance Letter - Zubing Mei, Editor PONE-D-23-38922R2 PLOS ONE Dear Dr. Su, I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now being handed over to our production team. At this stage, our production department will prepare your paper for publication. This includes ensuring the following: * All references, tables, and figures are properly cited * All relevant supporting information is included in the manuscript submission, * There are no issues that prevent the paper from being properly typeset If revisions are needed, the production department will contact you directly to resolve them. If no revisions are needed, you will receive an email when the publication date has been set. At this time, we do not offer pre-publication proofs to authors during production of the accepted work. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few weeks to review your paper and let you know the next and final steps. Lastly, 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 customercare@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. Zubing Mei Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0303494.r006

Open letter on the publication of peer review reports

PLOS recognizes the benefits of transparency in the peer review process. Therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. Reviewers remain anonymous, unless they choose to reveal their names.

We encourage other journals to join us in this initiative. We hope that our action inspires the community, including researchers, research funders, and research institutions, to recognize the benefits of published peer review reports for all parts of the research system.

Learn more at ASAPbio .