Author's response to reviews

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1 Author's response to reviews Title:Endometriosis node in gynaecologic scars. A study of 17 patients and the diagnostic considerations in clinical experience in tertiary care centre. Authors: Rocio Vellido-Cotelo (rociovellidoconuve@hotmail.com) Jose L Muñoz-Gonzalez (jlmunozg@yahoo.es) Maria R Oliver- Perez (reyes.oliverperez@gmail.com) Cristina de la Hera-Lazaro (krisdelahera@hotmail.com) Cristina Almansa-Gonzalez (cristinalmansa@gmail.com) Concepcion Perez-Sagaseta (cpsagaseta@hotmail.com) Jesus S Jimenez-Lopez (jjimenez.hdoc@salud.madrid.org) Version:3Date:16 December 2014 Author's response to reviews: see over

2 Author's response to reviews Title: Endometriosis node in gynaecologic scars. A study of 17 patients and the diagnostic considerations in clinical experience in tertiary care centre. Authors: Vellido-Cotelo, Rocío (rociovellidoconuve@hotmail.com) Muñoz-González, Jose L. ( jlmunozg@yahoo.es) Oliver- Pérez, Maria R. (reyes.oliverperez@gmail.com) de la Hera-Lázaro, Cristina (krisdelahera@hotmail.com) Almansa-González, Cristina ( cristinalmansa@gmail.com) Pérez-Sagaseta, Concepción (cpsagaseta@hotmail.com) Jiménez-López, Jesús S. (jjimenez.hdoc@salud.madrid.org) Version: 2 Date: 16 December 2014 Author's response to reviews: see over

3 December 15, The Biomed Central Editorial Team Object: Endometriosis node in gynaecologic scars. A study of 17 patients and the diagnostic considerations in clinical experience in tertiary care centre. Dra Vellido-Cotelo, Rocío et al. Thank you for consideration of our manuscript for publication in your journal. We have reviewed the above manuscript according to your reviewer s comments. Reviewer # 1 (Tirso Pérez-Medina) Version:1Date:24 October 2014 Reviewer's report: In reference to the remarks made by reviewer Dr Tirso Pérez-Medina: **The lines referred to Dr. Tirso, are those for version 1. The remarks have been corrected in version 1, but in version 2 the number of the lines may have been chaged because of the new paragraphs that we have included in version The writing of the institution is different in different places (12 October hospital, Hospital 12 de Octubre ) 2. Lines 33 and 102: The time of study (January 2000 to January 2012) is TWELVE years not eleven 3. Line 56: likelyrequired 4. Line 96: of a node is redundant 5. Line 105: Table 1 without brackets 6. Line 124: Mean must go along with SD 7. Lines 161 and 214: Endometiosis 8. Lines 175 and 175: Mean and median are not comparable We appreciate the comment and have corrected the error. 9. Line 185: The phrase has no sense 10. Line 188: C?? 11. Line 245: a,?? 12. Line 317: Literatura 13. Line 323: Line 325: Line 340: obstetrical 16. Line 340: análisis

4 17. Line 373: repot 18. Line 381: Line 388: This reference is repeated (reference 9) Reviewer # 2 (Dr Francisco Carmona): Reviewer's report: Major Compulsory revisions 1.- "Did the authors use the same diagnostic work-up in all patients?. If not, why? If yes, may the authors compare the diagnostic accuracy of the different methods used, i.e.: ultrasound, CT, MRI, fine needle aspiration?" Our institution has no standardized protocol for preoperative diagnostic testing in cases of nodes in gynaecological scars. We have included a new paragraph in which we have mentioned the diagnostic accuracy of the Imaging techniques. Version 2, Lines (Underlined in text of version 2). Also we have included an algorithm (figure 7) for preoperative diagnosis and treatment of a nodes in gynecological scars, suggestive of endometriotic origin. Version 2, lines (Underlined in text of version 2). Version 2: Figure " It is really surprising that only 30% of patients had pathological diagnostic confirmation (pag. 7, line 153). I suppose it is a mistake as the authors state several times that all the patients had pathological confirmation. " Indeed it is a mistake, thanks for observation. All the patients underwent resection of the Tumour and subsequent pathological diagnostic confirmation. Version 2, Lines (Underlined in text of version 2). 3.- "More emphasis should be done in the discussion section about the role of fine needle aspiration to previously diagnose the nodule's nature. Some role for thepreoperative trucut biopsy?" We followed the indication of the reviewer and have included in the discussion of fine needle aspiration to previos diagnose and preoperative trucut biopsy. Version 2, Lines (Underlined in text of version 2). 4.- "The authors state that although a multifactorial etiological hypothesis is plausible they emphasize the role of immune tolerance during pregnancy. Again, in this reviewer opinion, their data do not support that hypothesis neither do the literature." We have taken into account the remark of the reviewer and have corrected the paragraph in which made reference to the etiology, with particular reference to the multifactorial aetiology as causal hypothesis. Version 2, Lines (Underlined in text of version 2) and Version 2, Lines (Underlined in text of version 2).

5 Finally, we want to add that we made a deeper general revision of the paper s written English, making minor grammatical and orthographic changes that do not affect the original content at all. Sincerely yours, Rocio Vellido-Cotelo, et al. Madrid, Diciembre 2014.