To the Editor.
—In the abstract of their article, Dr Gerber and colleagues1 state, "Radical prostatectomy leads to high 10-year disease-specific survival rates in men with all tumor grades." The bold inference, that prostatectomy causes high survival, cannot be drawn from their data for all the excellent reasons that they discuss in the body of the article. Indeed, the sweeping conclusion is unsubstantiated by their data for, at least, low-grade tumors and may mislead men with these tumors who are struggling to determine the appropriate treatment for their newly diagnosed disease.2Gerber et al1 report 10-year disease-specific survival for 2518 men followed up an average of 4 years. Our report (their reference 21) provides similar data on a slightly older group of men, who were almost certainly understaged by modern standards, treated conservatively and followed for an average of 15 years.3 We have used the methods
Fryback DG, Albertsen PC, Storer BE. Prostatectomy and Survival Among Men With Clinically Localized Prostate Cancer. JAMA. 1996;276(21):1723–1724. doi:10.1001/jama.1996.03540210031025
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