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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.297.15.1652-b

To the Editor: Dr Wong and colleagues1 report a survival advantage in elderly men with low- and intermediate-risk prostate cancer who undergo active treatment compared with those who are observed. I believe that these results should be interpreted with caution.

In the active treatment cohort, 42% of the men underwent prostatectomy, the only group in which pathologic stage was available. Since the SEER database records the pathologic stage when available, these men were classified as low- or intermediate-risk based on pathologic staging. Similarly, these patients were classified as low- or intermediate-risk based on pathologic Gleason score. Nonsurgical patients were classified by clinical stage and biopsy Gleason score.

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