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July 14, 1956


JAMA. 1956;161(11):1094. doi:10.1001/jama.1956.02970110060016

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To the Editor:—  In my opinion, the article by J. Chandler Smith entitled "Superiority of Surgical Treatment of Endometrial Carcinoma" appearing in The Journal on April 28, 1956, page 1460, contains a number of serious errors. Early in his article, this author states, "The principle of treatment of endometrial carcinoma derives from four self-evident truths." The first of these "self-evident truths" he states as: "Untreated endometrial carcinoma is continuously invasive, metastasis is inevitable, and the moment of metastasis is not predictable." This statement cannot be shown to be true by any evidence. Certainly it is true that the moment of metastasis is not predictable, but the statement that all untreated endometrial carcinoma is continuously invasive and that metastasis is always inevitable cannot be supported by scientific observations.The second and third "self-evident truths" given by the author are acceptable but the fourth is questionable. This "self-evident truth" is given by

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