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 146 words of the full text and any section headings.

To the Editor: I have concerns about the mortality measures used in the study of survival in elderly men with prostate cancer by Dr Wong and colleagues.¹ The difference in the death rate from prostate cancer in these 2 groups was 0.6% (1.9% in the treatment group vs 2.5% in the observation group). Men aged 70 years and older were expected to have a 30-day perioperative mortality rate of 0.66%,² which is not included in the previously stated rates. Adding this 0.66% to the 1.9% prostate cancer-specific mortality in the treated group gives a mortality of 2.56%, which is the same as in the observation group. One fourth of the deaths in this surgically treated group would be expected to occur in the first 30 days. This raises the question of the benefit of surgery for men aged 70 years and older.

Financial Disclosures: None reported.

George A. Mark, MD
georgeamark@yahoo.com
Department of Internal Medicine
Elkhart General Hospital
Elkhart, Ind

1. Wong YN, Mitra N, Hudes G, et al. Survival associated with treatment vs observation of localized prostate cancer in elderly men. JAMA. 2006;296:2683-2693. FREE FULL TEXT 2. Alibhai SM, Leach M, Tomlinson G, et al. 30-Day mortality and major complications after radical prostatectomy: influence of age and comorbidity. J Natl Cancer Inst. 2005;97:1525-1532. FREE FULL TEXT

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2007;297:1652.

RELATED LETTERS

Outcomes of Treatment vs Observation of Localized Prostate Cancer in Elderly Men
Grace L. Lu-Yao, Michael J. Barry, Peter C. Albertsen, and Siu-Long Yao
JAMA. 2007;297(15):1651.
EXTRACT | FULL TEXT  

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
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