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December 4, 1996

Prostatectomy and Survival Among Men With Clinically Localized Prostate Cancer-Reply

Author Affiliations

University of Chicago Chicago, Ill

JAMA. 1996;276(21):1724. doi:10.1001/jama.1996.03540210032027

In Reply.  —The primary goal of our study was to define metastasis-free and cancer-specific survival rates for men with clinically localized prostate cancer treated by radical prostatectomy. Until the results of randomized, prospective trials are available, we believe that multi-institutional pooled analyses provide the best available information regarding treatment outcomes. Our results support the conclusion that radical prostatectomy leads to high disease-specific survival rates in men with all tumor grades, but we readily acknowledge that these data cannot be used to assess the relative benefit of surgery in comparison with other management options. For this reason, we feel that direct comparisons, such as that presented by Dr Fryback and colleagues, are not appropriate due to an inability to determine the relative effects of selection biases and other factors on outcomes. We are currently analyzing the data from our study regarding men treated by radical prostatectomy along with the results of a previously