Letters Section Editor: Robert M. Golub, MD, Senior Editor.
To the Editor: Dr Wong and colleagues1 report a statistically significant reduction in overall mortality with immediate surgery or radiation for low- to intermediate-risk prostate cancer. The absolute difference in overall mortality between the men receiving immediate treatment compared with no treatment was large (24% in the treatment group and 37% in the observation group). However, we question the validity of using overall mortality as an endpoint for measuring the anticancer treatment efficacy when the difference in prostate cancer-specific mortality over the 12-year study period was small (612 of 32 022 [1.9%] in the treatment group vs 314 of 12 608 [2.5%] in the observation group).
Scholz MC, Lam RY, Klotz L. Outcomes of Treatment vs Observation of Localized Prostate Cancer in Elderly Men. JAMA. 2007;297(15):1651-1653. doi:10.1001/jama.297.15.1651-b