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In Reply: In response to Dr Atkins’ questions, the log-rank P value of.04 was 2-sided and is the metric most frequently used when there is no a priori assumption made about early vs late differences, as was the case in our study at the time of its inception. This P value compares the entire distribution of both survival curves and not only the 5-year time point. There were no significant differences in the distribution of the known prognostic factors including age, PSA level, Gleason score, and clinical tumor category between the 2 treatment groups. Finally, the proportional hazard assumptions for the multivariable Cox models¹ were tested and met.

Dr Horwitz and colleagues raise 2 questions. First, who should be treated with short-term vs long-term AST? They point to what they consider convincing evidence that men with high-risk prostate cancer should receive long-term AST by citing a randomized study² in which . . . [Full Text of this Article]

Anthony V. D’Amico, MD, PhD
adamico@lroc.harvard.edu

Marian Loffredo, RN, OCN
Department of Radiation Oncology

Judith Manola, MS; Alyssa DellaCroce, BA
Department of Biostatistics

Andrew A. Renshaw, MD
Department of Pathology

Philip W. Kantoff, MD
Department of Medical Oncology
Brigham and Women’s Hospital
Dana Farber Cancer Institute
Boston, Mass

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