Letters Section Editor: Robert M. Golub, MD, Senior Editor.
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.
Porter MP. Outcomes of Treatment vs Observation of Localized Prostate Cancer in Elderly Men. JAMA. 2007;297(15):1651-1653. doi:10.1001/jama.297.15.1652-b