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This letter is a response to the third publication of the Scandinavian randomized trial of radical prostatectomy vs. watchful waiting, which showed a trend to an improved survival in 'low-risk' prostate cancer patients treated with surgery. The letter points out that the mortality in the radical prostatectomy arm of the trial is much higher than in the Toronto active surveillance cohort, suggesting that the 'low-risk' patients in the Scandinavian trial, which was carried out in an unscreened population, were not in fact low risk by contemporary standards
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