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April 18, 2007

Outcomes of Treatment vs Observation of Localized Prostate Cancer in Elderly Men

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2007;297(15):1651-1653. doi:10.1001/jama.297.15.1651-b

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).

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