To the Editor: On the basis of their findings in a well-designed,randomized trial involving patients with muscle-invasive bladdercancer, Grossman et al. (Aug. 28 issue)1 conclude that neoadjuvantchemotherapy with methotrexate, vinblastine, doxorubicin, andcisplatin (M-VAC), followed by radical cystectomy, improvedsurvival, as compared with cystectomy alone. We want to pointout some important considerations about the treatment receivedby patients in the control group (those treated with cystectomyalone).
First, 19 percent of patients in the cystectomy-alone group(30 of 154) did not undergo cystectomy according to the protocol,and no additional information about the alternative treatmentsgiven . . . [Full Text of this Article]
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