In Reply to Dr. Froehner et al

Abstract

To the Editor: We thank Dr. Froehner and colleagues for their interest in our recently published article ( 1 Nanda A. Chen M.H. Moran B.J. et al. Predictors of prostate cancer-specific mortality in elderly men with intermediate-risk prostate cancer treated with brachytherapy with or without external beam radiation therapy. Int J Radiat Oncol Biol Phys. 2009; (in press) Google Scholar ). To assess the impact of cardiovascular disease on the risk of prostate cancer–specific mortality in men with intermediate-risk prostate cancer, an adjusted analysis using a multivariable competing risks regression model is necessary as performed in our study to avoid confounding by factors such as age and known prostate cancer prognostic factors. We do agree with Dr. Froehner and colleagues that our study is limited, given its retrospective design, and as a result our conclusions are hypothesis generating and require prospective validation. Response to “Predictors of Prostate Cancer–Specific Mortality in Elderly Men With Intermediate-Risk Prostate Cancer Treated With Brachytherapy With or Without External Beam Radiation Therapy” (Int J Radiat Oncol Biol Phys 2009, in press)International Journal of Radiation Oncology, Biology, PhysicsVol. 76Issue 4PreviewTo the Editor: We read with great interest the article by Nanda et al.(1) suggesting a decreased prostate cancer–specific mortality in elderly men with cardiovascular disease treated by brachytherapy with or without external beam radiation therapy for intermediate-risk prostate cancer. Attracted by this surprising finding, we performed an exploratory analysis of our sample of 2,205 consecutive patients who underwent radical prostatectomy in the years 1992–2005 (median follow-up, 5.4 years; median age, 65 years) stratified by several possible definitions of cardiovascular disease (the way of comorbidity assessment has previously been described in detail [2]). Full-Text PDF