Could lead-time bias explain the apparent benefits of early salvage radiotherapy?

Abstract

Early use of salvage radiotherapy in patients with prostate cancer with biochemical recurrence after radical prostatectomy has consistently been shown to provide better oncological outcomes than late use. However, the corresponding scientific literature might be subject to lead-time bias, given that in virtually all the available comparative studies, investigators calculated the survival period of included patients from the time of salvage radiotherapy — instead of from the time of radical prostatectomy.