In Reply.—The results of the Guy's Hospital study1 indicate that patients with T1-stage tumors who have achieved local control of disease have superior survival to those who do not. Our results show superior local control of disease and survival for patients with advanced local disease who have undergone radical mastectomy.2 The suggestion by Hayward and Caleffi1 that radical mastectomy is superior to wide local excision plus radiation therapy in that group is based on a retrospective reanalysis of two separate series of patients. The questions analyzed in this data set are not the ones that the Guy's Hospital study was originally designed to answer. The conclusion is true only for one subset (ie, T1-stage tumors in the second series); thus, the suggestion is more suitable as a new hypothesis than as a conclusion.3 There is no assurance that the groups with T1-stage lesions had comparable
MADDOX WA, URIST MM, CARPENTER JT, CLOUD G. Natural Killer Cells and the Guy's Hospital Trials-Reply. Arch Surg. 1988;123(7):914. doi:10.1001/archsurg.1988.01400310127029
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