How to compare results after surgery or radiation for localized prostate carcinoma

Prostate specific antigen (PSA) outcome (No), posttreatment PSA doubling time (Maybe), or survival (Yes)?


  • Anthony V. D'Amico M.D., Ph.D.

    Corresponding author
    1. Department of Radiation Oncology, Brigham and Women's Hospital and Dana Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
    • Department of Radiation Oncology L-2 Level, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115
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  • See referenced original article on pages 2126–35, this issue.


In addressing the clinically relevant question regarding prostate specific antigen (PSA) outcome data in the study presented by Vicini and colleagues in this issue of Cancer, the author concurs with Vicini et al. that only a randomized trial powered to assess survival ultimately can answer the important question of the relative efficacy of surgery versus various forms of radiation therapy in the management of patients with localized prostate carcinoma. In addition, the author points out that one posttreatment clinical parameter, the posttreatment PSA doubling time, has emerged from both the surgical literature and the radiation literature as a potential candidate for predicting the likelihood of death from prostate carcinoma after primary treatment failure.

See also pages 2126–35.