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Comparative effectiveness of radical prostatectomy and radiotherapy in prostate cancer: observational study of mortality outcomes

BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g1502 (Published 27 February 2014) Cite this as: BMJ 2014;348:g1502

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Re: Comparative effectiveness of radical prostatectomy and radiotherapy in prostate cancer: observational study of mortality outcomes

The authors of the above study should be commended on an excellent retrospective analysis of the large PCBaSe Sweden dataset. Specifically, they have employed sophisticated statistical methods (propensity score reweighted and sensitivity analyses) to attempt to reduce bias from confounding variables in this observational study.

The conclusions - that surgery leads to better survival than does radiotherapy, particularly in younger healthier patients with intermediate/high-risk organ-confined disease - are potentially very interesting, although must be interpreted with caution in the context of retrospective analyses.

We await, with huge anticipation, the results of the prospective randomised UK-based ProtecT study comparing these treatment modalities.

Competing interests: No competing interests

03 March 2014
Prabhakar Rajan
Urologist
Glasgow University/NHS Greater Glasgow and Clyde
CR-UK Beatson Institute, Bearsden, G61 1BD