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Survival and Outcomes After Noncompletion of Treatment for Anal Cancer—Reply

Survival and Outcomes After Noncompletion of Treatment for Anal Cancer—Reply Letters Despite these limitations, this study contributes to the lit- squamous cell anal carcinoma. As a secondary outcome, the erature on aspirin and CCA with a validated study design and authors estimated the association of treatment noncomple- detailed health examination data. Further research is needed tion with all-cause death, cancer-specific death, and the com- to investigate the minimum necessary exposure and effect bined outcome of colostomy or death. They reported a higher modifications in certain subgroups, if any, for the association cancer-specific death (hazard ratio [HR], 1.90; 95% CI, 1.32- between aspirin and the risk of CCA. 2.75) and overall death (HR, 1.47; 95% CI, 1.14-1.89) among patients who did not complete radiotherapy. Min-Hyung Kim, MD In the Methods, the authors stated that for all time-to- Sang Min Park, PhD event analyses, time zero was the first dose of radiation. While Jooyoung Chang, MD such an approach best emulates a randomized clinical trial set- In Cheol Hwang, PhD ting, it may introduce immortal time bias. Immortal time is a period of cohort follow-up whereby, because of the exposure Author Affiliations: Department of Biomedical Sciences, Seoul National definition, it is impossible for the outcome to occur. It fre- University College http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Oncology American Medical Association

Survival and Outcomes After Noncompletion of Treatment for Anal Cancer—Reply

JAMA Oncology , Volume 6 (12) – Dec 1, 2020

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Publisher
American Medical Association
Copyright
Copyright 2020 American Medical Association. All Rights Reserved.
ISSN
2374-2437
eISSN
2374-2445
DOI
10.1001/jamaoncol.2020.3963
Publisher site
See Article on Publisher Site

Abstract

Letters Despite these limitations, this study contributes to the lit- squamous cell anal carcinoma. As a secondary outcome, the erature on aspirin and CCA with a validated study design and authors estimated the association of treatment noncomple- detailed health examination data. Further research is needed tion with all-cause death, cancer-specific death, and the com- to investigate the minimum necessary exposure and effect bined outcome of colostomy or death. They reported a higher modifications in certain subgroups, if any, for the association cancer-specific death (hazard ratio [HR], 1.90; 95% CI, 1.32- between aspirin and the risk of CCA. 2.75) and overall death (HR, 1.47; 95% CI, 1.14-1.89) among patients who did not complete radiotherapy. Min-Hyung Kim, MD In the Methods, the authors stated that for all time-to- Sang Min Park, PhD event analyses, time zero was the first dose of radiation. While Jooyoung Chang, MD such an approach best emulates a randomized clinical trial set- In Cheol Hwang, PhD ting, it may introduce immortal time bias. Immortal time is a period of cohort follow-up whereby, because of the exposure Author Affiliations: Department of Biomedical Sciences, Seoul National definition, it is impossible for the outcome to occur. It fre- University College

Journal

JAMA OncologyAmerican Medical Association

Published: Dec 1, 2020

References