PONE-D-24-23002Development and validation of a practical score to predict 3-year distant metastatic free survival in nasopharyngeal carcinoma incorporating the number of lymph node regions.PLOS ONE

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PLOS ONE

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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

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: I Don't Know

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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

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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

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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: The sample size is good for this research work. But this work is confined only with deriving a range of scores. A complete nomogram with such a good sample may give a clear understanding of the predictive powers of the 8 candidates. For improving the writing context, author can consider revising the line 304 of Discussion section.

Reviewer #2: Having analysed this manuscript, I believe this is a relevant and interesting piece for publication.

The authors have described their research in a clear and well elaborated manuscript. The data collection and interpretation seems to have been done rigorously and efficiently, with a sample size appropriate for NPC. The protocol appears well thought out, planned and executed.

The discussion was explained well with ample data to substantiate the results. The analysis of the data appears sound and the topic itself is relevant and likely to spark discussion. While the sample is limited to a single institution, this has been acknowledged by the authors. This paper is also likely to encourage similar studies on a larger scale and at other institutions, maybe across a more diverse patient population, which can further substantiate on the topic and provide more data to possibly bolster this study.

The fact that the model developed by the authors can support clinicians in decision-making, treatment planning, risk estimation and predicting the outcome of patients with Nasopharyngeal carcinoma, especially compared to the TNM staging that is currently predominantly in use, makes it clinically relevant in the field of Head and Neck oncology. This is especially more feasible since the criteria evaluated in the study to predict distant metastasis are investigations that are relatively inexpensive and accessible in most cancer centres such as MRIs, ultrasounds, EBV levels and chest x-rays rather than more sophisticated genetic tests or PET-CT.

I am unable to satisfactorily comment on the statistical analysis as someone who has not had extensive experience in the same, so shall defer the same to fellow reviewers with more expertise.

I have also acknowledged the authors' declaration that all the gathered data was collected retrospectively and anonymously, and cannot be shared publicly because of local ethics committee regulations, and hence is not entirely available in the manuscript.

The language used in the manuscript is clear and grammatically correct. I do not anticipate any further editing to be necessary in this respect.

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Reviewer #1: Yes: Surega Anbumani

Reviewer #2: No

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Development and validation of a practical score to predict 3-year distant metastatic free survival in nasopharyngeal carcinoma incorporating the number of lymph node regions.

PONE-D-24-23002R1

Dear Dr. Anussara Prayongrat,

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.

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Kind regards,

Lu Zhang

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

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

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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

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

**********

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

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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: Yes

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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: All of my comments were addressed. And the manuscript looks okay to get published. My final thought is that the author can mention the radiotherapy technique used for treating NPC patients.

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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: Yes: Surega Anbumani

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