We need more information to evaluate the validity of the propensity score matched pairs analysis of surgical treatment of malignant pleural mesothelioma by Nelson et al¹ that was based on the National Cancer Database. We need to know how many of the patients had surgery immediately and how many had it deferred. Deferral of surgery whether for collection of multiple opinions or for chemotherapy, radiation, or both (either sequentially or concurrently) would give patients a prolonged survival from diagnosis by virtue of the guarantee time they would have by surviving long enough to reach the time of surgery. Any patients with surgery planned who died during initial chemotherapy or radiation would be counted as nonsurgical patients, and their deaths would be counted as evidence that failure to perform surgery leads to early death. In truth, the early death led to failure to perform surgery. These deaths before they could be counted in the experimental arm gives this arm a guarantee of apparent improved survival.

中文翻译：

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胸膜间皮瘤的保时偏差和手术获益

我们需要更多信息来评估Nelson等人[ ^1]的倾向评分匹配对对手术治疗恶性胸膜间皮瘤的有效性。基于国家癌症数据库。我们需要知道有多少患者立即进行了手术以及有多少人推迟了手术。推迟手术（无论是征求多方意见还是进行化疗，放疗，或两者兼而有之）（顺序或同时进行）将使患者得以延长生存时间，这是由于他们有足够的生存时间才能保证达到手术时间。任何计划进行手术的患者在初始化疗或放疗期间死亡，将被视为非手术患者，其死亡将被视为无法进行手术导致早期死亡的证据。实际上，提早死亡导致无法进行手术。这些死亡在可以计入实验组之前就可以算出，这保证了该组的生存率明显提高。