This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related letters  • Related article  • Similar articles in JAMA  Topic Collections  • Statistics and Research Methods  • Prostate Disease  • Prognosis/ Outcomes  • Oncology  • Prostate Cancer  • Aging/ Geriatrics  • Alert me on articles by topic

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: The study of survival associated with treatment vs observation of localized prostate cancer by Dr Wong and colleagues¹ suggested that active treatment of elderly men with low- or moderate-risk prostate cancer was associated with a survival benefit. However, 5-year relative survival for localized or regional prostate cancer is 100%.² Therefore, any true survival benefit associated with a treatment would likely begin to first manifest only after 5 years of follow-up. This effect was seen in the recent randomized controlled trial comparing radical prostatectomy with watchful waiting conducted by the Scandinavian Prostate Cancer Group.³ This delay in survival advantage is why it is generally recognized that patients must have a life expectancy of approximately 10 years or more to significantly benefit from any active treatments for prostate cancer.

Figure 1 in Wong et al,¹ however, demonstrated that most of the observed survival differences occurred in the first 5 . . . [Full Text of this Article]

Grace L. Lu-Yao, MPH, PhD
luyaogr@umdnj.edu
Department of Environmental and Community Medicine
Cancer Institute of New Jersey
New Brunswick

Michael J. Barry, MD
Medical Practices Evaluation Center
Massachusetts General Hospital
Boston

Peter C. Albertsen, MD
University of Connecticut Health Center
Farmington

Siu-Long Yao, MD
Cancer Institute of New Jersey
New Brunswick

RELATED LETTERS

Outcomes of Treatment vs Observation of Localized Prostate Cancer in Elderly Men
Mark C. Scholz, Richard Y. Lam, and Laurence Klotz
JAMA. 2007;297(15):1651-1652.
EXTRACT | FULL TEXT  

Outcomes of Treatment vs Observation of Localized Prostate Cancer in Elderly Men
George A. Mark
JAMA. 2007;297(15):1652.
EXTRACT | FULL TEXT  

Outcomes of Treatment vs Observation of Localized Prostate Cancer in Elderly Men
Michael P. Porter
JAMA. 2007;297(15):1652.
EXTRACT | FULL TEXT  

Outcomes of Treatment vs Observation of Localized Prostate Cancer in Elderly Men—Reply
Yu-Ning Wong, Nandita Mitra, Gary Hudes, J. Sanford Schwartz, Fei Wan, Chantal Montagnet, and Katrina Armstrong
JAMA. 2007;297(15):1652-1653.
EXTRACT | FULL TEXT  

RELATED ARTICLE

Survival Associated With Treatment vs Observation of Localized Prostate Cancer in Elderly Men
Yu-Ning Wong, Nandita Mitra, Gary Hudes, Russell Localio, J. Sanford Schwartz, Fei Wan, Chantal Montagnet, and Katrina Armstrong
JAMA. 2006;296(22):2683-2693.
ABSTRACT | FULL TEXT