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Other Comments:
Dear colleagues; i am sorry but i have many comments regarding your work
1- 50 patients done over 6 years is very low, i would prefer you do the work as multiinstitutional, and get data
from other hospitals, to add them with yours. I will be personally happy to share data with you in the future.
2- Mean follow up of 2 years is really short to comment on biochemical failure. i would prefer to use only data
for patients with a follow up of at least 5 years.
3- postoperative pathological stage, not clinical stage
4- the patient that died was managed by salvage, not radical prostatectomy. i would prefer not to include him in your work.
5- definition of PSA failure had to be more consistent. you had to only use the definition of 0.2 ng/ml with a
second rising test.
6- post radical prostatectomy radiotherapy use, can be termed adjuvant or salvage. you can't term it radical
7- the idea of risk stratification is to get some predictive data that help you in patients counselling about
different methods of treatment of prostate cancer. so it is of very high value and can't be replaced with
any postoperative risk criteria.
8- your conclusion is very strong and sharp concerning adjuvant treatment for postoperative high risk group. i don't really believe you can extrapulate that from outcomes of 8 patients.
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Competing interests:
No
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Invited by the author to review this article? :
No -
Have you previously published on this or a similar topic?:
Yes
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References:
Ahmed Kotb, Ahmed Elabbady. Prognostic factors for the development of biochemical recurrence after radical prostatectomy. Prostate cancer 2011; 2011: 485189. -
Experience and credentials in the specific area of science:
I am a uro-oncology surgeon.
- How to cite: Kotb A F.Sharing some experience about prostate cancer[Review of the article 'The Potential Usefulness of Pre and Post Operative Risk Group Stratification in Predicting PSA Failure after Radical Prostatectomy for Localised Prostate Cancer ' by Barnes D].WebmedCentral 2012;3(4):WMCRW001747
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Other Comments:
I am extreamly happy with this paper.
The Paper has clearly shown the usefullness of risk group Stratification in predicting recurrence of prostate cancer, and/ or biochemichal failure after radical prostatectomy.
It is usefull in that high risk group patient could be selected for adjuvant therapy, because of the high risk of biochemichal failure, and patients in the lower risk and intermediate group could be spared adjuvant therapy.
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Competing interests:
No
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Invited by the author to review this article? :
No -
Have you previously published on this or a similar topic?:
No
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References:
None -
Experience and credentials in the specific area of science:
Consultant Radiologist with special interest in Uro-Radiology, perform MR and intervention of prostate.
- How to cite: Bakir E .The Potential Usefullness of pre and post operative risk group stratification in predicting PSA failure after radical prostatectomy for localised prostate cancer[Review of the article 'The Potential Usefulness of Pre and Post Operative Risk Group Stratification in Predicting PSA Failure after Radical Prostatectomy for Localised Prostate Cancer ' by Barnes D].WebmedCentral 2012;3(4):WMCRW001716
This is a good audit study which has assessed the outcome of the initial 50 patients who had undergone
radical prostatectomy for localised prostate cancer in one institution.
The observation that all patients with PSA failure were in the high risk group should be of interest to all
urologist and uro- oncologists.
In view of this observation, it will be useful for all urologists who undertake radical prostatectomy,
to audit the outcome of their radical prostatectomy patients in order to find out if the outcome of their study
will be similar.
In addition if the outcome of further audit into the outcome of radical prostatectomy confirms similar findings
then, there would be the need for a large regional/national/international multicentre study.
If the results of such a study are similar, it would then provide a basis for a concensus opinion for the potential use of adjuvant therapy only for patients in thr high risk group.
No
No
No
None
I have been looking after patients with prostate cancer for more than 20 years.