A House Divided: The Irradiation Versus Prostatectomy Debate Continues

We read with interest the recent Red Journal article "Radical Prostatectomy Versus Radiation and Androgen Deprivation Therapy for Clinically Localized Prostate Cancer: How Good Is the Evidence?" by Roach et al (1). This was a thoughtful and critical analysis of the complex literature relating to irradiation versus prostatectomy in men with localized prostate cancer. Overall, the authors assigned low reliability scores to many of the studies evaluated, citing an inadequate (or unreported) duration of androgen deprivation therapy (ADT) with radiation therapy for intermediate- or high-risk disease, unadjusted survival metrics, or incomplete reporting of patient or disease features.

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