Only a randomised trial can provide the answer

摘要

Sooriakumaran and colleagues' study is one of several that conclude survival is better after prostatectomy than radiotherapy.12 These studies have many features in common. They assume a cause and effect association between survival and treatment. They claim that they corrected for confounders. They acknowledge suboptimal radiotherapy (dose and use of androgen deprivation therapy).3 They acknowledge limitations, including potential unaccounted for differences between groups.Yet they still imply that their findings are fact. Some studies ignore prostate specific antigen data and level I evidence on the use of androgen deprivation therapy and radiotherapy.3 This brings to mind the saying: "You can fool all the people some of the time, and some of the people all of the time, but you can't fool all the people all the time" (Abraham Lincoln).