Should Endometriosis-Associated Ovarian Cancer Alter the Management of Women with an Intact Endometrioma in the Reproductive Age?

Round 1

Reviewer 1 Report

1. Abstract:

Aren't premenopausal age and post-reproductive period opposites of each other? 

"While 30-70% ..." This sentence is ambiguous. 

2. line 160 : What does the :1:18 women" means?

3. line 86 : You mentioned that CA-125 is not helpful in the diagnosis of EOAC, which is correct, but it is still associated with prognosis of EOAC and may be useful in indicating surgery.  (doi: 10.1097/IGC.0000000000001317.)

4. In the conclusion of your article, you emphasize the importance of MRI. However, I would like to ask you to consider adding a section on machine learning, etc. to your paper. (DOI: 10.1111/aogs.14462)

5. There are also papers describing the differential between endometrioma and EOAC on MR. It would be good to include them (since you are emphasizing the importance of MRI). (doi: 10.1259/bjr.20201441.)

Overall, the sentence doesn't flow well.

I think it would be improved with English proofreading. 

Author Response

I thank the reviewer for his important remarks. I have revised the manuscript accordingly, adding the suggested references. In addition, I have employed Grammarly.com to improve the English flow. Furthermore, I have highlighted in yellow all revisions and supplements in the revised manuscript.

1. To prevent ambiguity among the terms premenopausal and post-reproductive period, I have included the actual numbers in the abstract and relevant spots throughout the text.
2. For clarity, I have changed it to 1 in 18 women.
3. The discussion on serum CA-125 has been expanded, and the reference by Barreta et al., 2017 and others were added.
4. The concept of machine learning for early detection of EAOC occurrence was added to the conclusions, with reference by Chao et al., 2022.
5. The reference by Zhang et al., targeting the MRI differences between endometrioma and EAOC features, was added to the relevant paragraph in the script.

Reviewer 2 Report

In my opinion, the analyzed topic is interesting enough to attract the readers’ attention. The current study tried to elucidate the role of the management of women in reproductive age with endometriosis in ovarian cancer with an intact endometrioma. I think that the abstract of this article is not very clear. In fact the aim of the study is not well highlighted. In my opinion, the discussion could be extended. Maybe, it could be useful the evaluation of the newest insights of treatment and prevention for this kind of disease. In particular, I suggest these articles to get deeper in the topic: PMID: 22558117 and PMID: 36141217. Because of these reasons, the article should be revised and completed. Considered all these points, I think it could be of interest for the readers and, in my opinion, it deserves the priority to be published after revisions.

a moderate review of English language should be performed.

Author Response

I thank the reviewer for finding our opinion paper interesting, attracting the reader’s attention, and deserves priority for publication after revision. I have revised the manuscript accordingly, adding one suggested reference. In addition, I have employed Grammarly.com to improve the English flow. Furthermore, I have highlighted in yellow all revisions and supplements in the revised manuscript. Specifically, the abstract was amended, the aims clarified, and the discussion throughout the manuscript was extended. Please note that it was not my intention to discuss in this short opinion paper the treatment of EAOC in women of reproductive age. I have already addressed this issue in a previous publication (PMID: 36421735).

Round 2

Reviewer 2 Report

In my honest opinion, the authors have responded satisfactorily to the reviewers’ criticisms.
The manuscript is well written and falls within the aim of this Journal.