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February 1986

Enucleation vs Cobalt 60 Irradiation of Melanomas-Reply

Arch Ophthalmol. 1986;104(2):176. doi:10.1001/archopht.1986.01050140027005

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In Reply.  —Dr Seddon and colleagues state that their analysis of my report utilizing Cox model changes the conclusion of the report. In fact, they came to the same conclusion that I reached—that the evidence for difference in treatment effect is inconclusive and that a randomized controlled clinical trial is required to determine the relative safety of the two modes of treatment. They cite the following as of possible importance in explaining the greater-than-twofold mortality in the cobalt group: (1) duration of follow-up prior to treatment, (2) tumor location, and (3) growth of tumor after cobalt treatment. The fact that less than 50% of the cobalt group were followed up for evidence of growth prior to treatment compared with 100% of the enucleation group suggests that, on the one hand, certain features indicative of greater malignancy were responsible for prompt treatment in the cobalt group and, on the other

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