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J Thorac Cardiovasc Surg 2008;135:468-469
© 2008 The American Association for Thoracic Surgery

Letter to the Editor

Surgery for esophageal cancer: Do age or incorrect data analysis have any impact on clinical outcome?

William Yung, MD

Department of Medical Oncology, University of Alabama at Birmingham, Birmingham, Ala

The first 20% of the full text of this article appears below.

To the Editor:

Within the frame of a general concern about the quality of scientific articles published in peer-review international journals, I would like to make some considerations regarding the manuscript by Ruol and colleagues1Go recently published in the Journal of Thoracic and Cardiovascular Surgery, titled "Results of Esophagectomy for Esophageal Cancer in Elderly Patients: Age Has Little Influence on Outcome and Survival."

The authors conclude that age should not be considered a contraindication for elderly patients (>70 years) because in their retrospective study no significant survival difference was found between elderly and younger patients.

In the light of the large series described, the authors had the opportunity of providing the scientific community with a clinically relevant piece of information: unfortunately, owing to some evident limits in their data analysis, Ruol and colleagues have missed this opportunity by significantly undermining the reliability of their work.

My perplexities on this article mainly arise from the following considerations, which are mainly statistical in nature:

1. The authors state they used the Kaplan–Meier method to compute survival estimates, which is virtually the only method used worldwide to this aim. However, the curves illustrated in Figures 1 and 2 are not generated with the Kaplan–Meier method, as anybody . . . [Full Text of this Article]






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