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—Dr Seddon and colleagues state that their analysis of my report utilizing Cox model changes the conclusion of the report. In fact, they came to the same conclusion that I reached—that the evidence for difference in treatment effect is inconclusive and that a randomized controlled clinical trial is required to determine the relative safety of the two modes of treatment. They cite the following as of possible importance in explaining the greater-than-twofold mortality in the cobalt group: (1) duration of follow-up prior to treatment, (2) tumor location, and (3) growth of tumor after cobalt treatment. The fact that less than 50% of the cobalt group were followed up for evidence of growth prior to treatment compared with 100% of the enucleation group suggests that, on the one hand, certain features indicative of greater malignancy were responsible for prompt treatment in the cobalt group and, on the other
Gass JDM. Enucleation vs Cobalt 60 Irradiation of Melanomas-Reply. Arch Ophthalmol. 1986;104(2):176. doi:10.1001/archopht.1986.01050140027005