Wednesday, July 30, 2014

Them's fighting words!

Gary Schwitzer offers a front-row seat to some conflicting claims.  It all starts with a news release from robotic surgeon David Samadi at New York's Lenox Hill Hospital that was picked up by the American Urological Association (AUA):

According to a new study from Detroit, Michigan, robotic prostatectomy yields highly successful long-term prostate cancer results. In fact, nearly all — 98.8% — of the patients remained prostate cancer survivors at ten years post-surgery; results comparable to the more invasive surgical method used in the past.

Oncologist Richard Hoffman replies:

“The AUA does misrepresent the data.  The 98.8% refers to the proportion of subjects who had not died from prostate cancer.  Only 73.1% were biochemically free of cancer, meaning that the rest had a rising PSA suggesting cancer progression/recurrence.  

The observational design means that investigators cannot make any meaningful comparisons of robotic surgery results with those obtained by open prostatectomy,  Thus, Samadi’s comment that robotic prostatectomy is “a preferred treatment” is not based on convincing evidence, just on the “preferences” of surgeons and patients who see the surgeons’ ads. 

Them's fighting words! Gary says, "Let’s see how the urologists duke it out." One already expressed some thoughts on Twitter.

1 comment:

nonlocal MD said...

It is very, very, VERY upsetting that a specialty society has taken up actual advertising under the guise of a 'study'. Individual doctors are one thing, but this represents a new low and a throwing to the wind of all pretense of scientific integrity.