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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-a

To the Editor: I have concerns about the mortality measures used in the study of survival in elderly men with prostate cancer by Dr Wong and colleagues.1 The difference in the death rate from prostate cancer in these 2 groups was 0.6% (1.9% in the treatment group vs 2.5% in the observation group). Men aged 70 years and older were expected to have a 30-day perioperative mortality rate of 0.66%,2 which is not included in the previously stated rates. Adding this 0.66% to the 1.9% prostate cancer-specific mortality in the treated group gives a mortality of 2.56%, which is the same as in the observation group. One fourth of the deaths in this surgically treated group would be expected to occur in the first 30 days. This raises the question of the benefit of surgery for men aged 70 years and older.