Author Affiliations: Departments of Oncology (Dr Biagi) (firstname.lastname@example.org) and Community Health and Epidemiology (Dr King) and Division of Cancer Care and Epidemiology (Dr Booth), Queen's University, Kingston, Ontario, Canada.
In Reply: We disagree with a number of statements in the letter by Dr Sargent and colleagues. First, we disagree that a hazard ratio for overall survival of 1.14 is not meaningful. This hazard ratio represents an effect per 4 weeks that is of a magnitude comparable with new adjuvant systemic therapies. Second, they assert that the analysis was dominated by 1 large study; as we described, the overall and disease-free survival results were maintained after sequential exclusion of each of the 3 largest-weighted trials. Furthermore, our analysis demonstrated consistency in results and effect sizes across overall survival, disease-free survival, and cancer-specific survival and are consistent with other published results in this field.1
Biagi JJ, King WD, Booth CM. Time to Initiation of Adjuvant Chemotherapy and Survival in Colorectal Cancer—Reply. JAMA. 2011;306(11):1199–1200. doi:10.1001/jama.2011.1321
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