Observation Versus Initial Treatment for Prostate Cancer
Authors: Julia H. Hayes, Michael J. Barry, Pamela M. McMahon
Journal: Annals of Internal Medicine (2013)

LettersOctober 15, 2013Observation Versus Initial Treatment for Prostate CancerJulia H. Hayes, MD, Michael J. Barry, MD, and Pamela M. McMahon, PhDJulia H. Hayes, MDFrom Dana-Farber Cancer Institute and Institute for Technology Assessment, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Medical Practices Evaluation Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; and Institute for Technology Assessment, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.Search for more papers by this author, Michael J. Barry, MDFrom Dana-Farber Cancer Institute and Institute for Technology Assessment, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Medical Practices Evaluation Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; and Institute for Technology Assessment, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.Search for more papers by this author, and Pamela M. McMahon, PhDFrom Dana-Farber Cancer Institute and Institute for Technology Assessment, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Medical Practices Evaluation Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; and Institute for Technology Assessment, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-8-201310150-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate Dr. Pinsky's concerns about the HR for prostate cancer–specific death for treatment versus watchful waiting used in the base case of our study. We chose to use the results from the low-risk subset of men in PIVOT, despite the small number of deaths in both groups, in the absence of data from other randomized, controlled trials comparing watchful waiting with treatment in the era of prostate-specific antigen level testing (1).The dearth of long-term data directing therapeutic choices in this context is one reason to perform decision analysis, which allows assumptions to be made and then ...Reference1. Wilt TJ, Brawer MK, Jones KM, Barry MJ, Aronson WJ, Fox S, et al. Prostate Cancer Intervention versus Observation Trial (PIVOT) Study Group. Radical prostatectomy versus observation for localized prostate cancer. N Engl J Med. 2012;367:203-13. [PMID: 22808955] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Dana-Farber Cancer Institute and Institute for Technology Assessment, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Medical Practices Evaluation Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; and Institute for Technology Assessment, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-0857. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoObservation Versus Initial Treatment for Men With Localized, Low-Risk Prostate Cancer Julia H. Hayes , Daniel A. Ollendorf , Steven D. Pearson , Michael J. Barry , Philip W. Kantoff , Pablo A. Lee , and Pamela M. McMahon Observation Versus Initial Treatment for Prostate Cancer Paul Pinsky Metrics October 15, 2013Volume 159, Issue 8Page: 574KeywordsAntigensDecision analysisForecastingLife expectancyProstate cancerRadical prostatectomy ePublished: 15 October 2013 Issue Published: October 15, 2013 CopyrightCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...