A correction notice published in The Lancet identifies several figure-labeling errors in a recently published individual patient data meta-analysis examining hormone therapy use and duration in conjunction with postoperative radiotherapy for recurrent prostate cancer. The original article, authored by Kishan AU, Sun Y, Parker CC, and colleagues, appeared in The Lancet at volume 407, pages 1059 through 1071, in 2026. The errors affect figure 3 and figure 4 within the publication and do not alter the article’s underlying data, statistical analyses, or clinical conclusions.

The correction specifies three discrete labeling problems. In figure 3, the fourth column heading was rendered incorrectly and should read “Years (95% CI).” Additionally, the second sentence in the caption accompanying figure 3 should read: “The with or without long-term therapy subgroup includes data from RTOG 9601 and…” The figure 4 corrections address title designations across three panels. The title for figure 4A should read “Treatment effect: radiotherapy + hormone therapy vs radiotherapy,” the title for figure 4B should read “Treatment effect: radiotherapy + hormone therapy vs radiotherapy,” and the title for figure 4D should read “Treatment effect: radiotherapy + short-term hormone therapy vs radiotherapy.”

Context: The Underlying Meta-Analysis

The corrected article addresses a clinically consequential question in urologic oncology: among patients with biochemically recurrent prostate cancer following radical prostatectomy, does the addition of hormone therapy to salvage radiotherapy improve outcomes, and does the duration of hormone therapy modulate that benefit?

Individual patient data (IPD) meta-analyses represent the highest level of evidence synthesis available for such questions, pooling raw participant-level data from multiple randomized controlled trials (RCTs) rather than relying on aggregate published estimates. The Kishan et al. analysis draws on data from established cooperative group trials in this disease space, including the Radiation Therapy Oncology Group (RTOG) 9601 trial, which evaluated the addition of bicalutamide to salvage radiotherapy, as well as other trials examining androgen deprivation therapy (ADT) duration as a variable.

The clinical context is not trivial. Biochemical recurrence after radical prostatectomy, defined by a rising prostate-specific antigen (PSA) following surgery, affects a substantial proportion of patients. Salvage radiotherapy directed at the prostatic fossa represents a standard-of-care intervention for eligible patients, and American Cancer Society estimates suggest that tens of thousands of men face this clinical decision annually in the United States alone. The question of whether concurrent ADT confers additional survival benefit, and for how long that ADT should be administered, has direct bearing on treatment toxicity profiles, quality of life, cardiovascular risk, bone health, and resource utilization.

Prior RCT data, including those from RTOG 9601 and the GETUG-AFU 16 trial, have each contributed evidence favoring hormone therapy addition in specific patient subgroups, but differing follow-up durations, patient populations, and PSA entry criteria have complicated direct cross-trial comparisons. The Kishan et al. IPD meta-analysis was positioned to clarify these subgroup interactions and duration effects with greater statistical precision than any single trial could provide.

The Nature and Significance of Figure Errors in Meta-Analyses

Errors in figure labeling within IPD meta-analyses warrant particular attention because forest plots and subgroup analyses in this class of study carry substantial interpretive weight. Clinicians and guideline committees frequently rely on the visual representation of hazard ratios, confidence intervals, and subgroup estimates to assess treatment heterogeneity and apply findings to specific patient populations.

In the case of figure 3, the incorrect column heading, which omitted or misidentified the time-in-years format alongside the 95% confidence interval notation, could cause a reader to misinterpret the scale or units of the displayed estimates. The 95% confidence interval (CI) is a standard metric for uncertainty quantification in survival analyses, and its correct labeling is essential for accurate data interpretation. The caption correction, reinstating the complete description of the “with or without long-term therapy” subgroup’s constituent trials, directly affects a reader’s ability to verify which patient data contributed to that analytical subgroup.

The figure 4 corrections carry similar interpretive consequence. Forest plots in an IPD meta-analysis of this design typically display treatment effect estimates across multiple comparisons: the active treatment arm versus radiotherapy alone, with panels subdivided by ADT duration (long-term versus short-term) or by other effect modifiers. When panel titles are incorrectly assigned, a reader may attribute a hazard ratio to the wrong comparator arm. In the context of this article, a title conflating short-term ADT with long-term ADT effects, or misidentifying the radiotherapy-alone reference arm, could lead to an inaccurate understanding of the incremental benefit associated with each hormonal treatment strategy.

The correction notice does not indicate that any numerical data, point estimates, confidence intervals, p-values, or conclusions require revision. The errors are confined to labeling and descriptive text within the figures themselves.

Implications for Readers and Citing Authors

Authors who have already cited the Kishan et al. article or who plan to do so should consult the corrected version to ensure that any descriptions of figure content accurately reflect the intended labeling. This is particularly relevant for systematic reviews, clinical practice guidelines, or educational materials that reproduce or paraphrase the forest plot data from figures 3 and 4.

The Lancet’s Department of Error process serves an essential function in the biomedical literature by providing a transparent, indexed mechanism for post-publication corrections. Corrections published through this channel are linked to the original article in indexing databases including MEDLINE, allowing downstream readers to identify that a revision has been issued.

For practicing radiation oncologists and urologists, the clinical message of the Kishan et al. meta-analysis itself remains unaffected. The correction does not alter the study’s primary or secondary endpoint analyses, does not revise the reported event rates in any treatment arm, and does not change the authors’ conclusions regarding the benefit or duration-dependence of hormone therapy in the postoperative radiotherapy setting.

Current Guideline Context

The role of ADT in conjunction with salvage radiotherapy has been addressed in recent guideline iterations. The American Urological Association (AUA) and American Society for Radiation Oncology (ASTRO) joint guideline on the adjuvant and salvage radiotherapy after prostatectomy recommends consideration of concurrent ADT with salvage radiotherapy for patients with higher-risk features, consistent with a conditional recommendation given the evolving evidence base. The National Comprehensive Cancer Network (NCCN) guidelines similarly incorporate ADT as an option in the salvage setting, with duration informed in part by PSA kinetics and pathologic risk features.

The Kishan et al. IPD meta-analysis, once its corrected figures are reviewed, provides granular subgroup data that may further inform duration decisions within these guideline frameworks. The RTOG 9601 trial specifically examined 24 months of bicalutamide, a non-steroidal antiandrogen, rather than the gonadotropin-releasing hormone (GnRH) agonist or antagonist therapy more commonly employed in contemporary practice, a distinction that carries relevance for both efficacy and toxicity comparisons.

Transparency and the Peer Review Continuum

Post-publication corrections of this nature reflect the iterative character of scientific quality control rather than a failure of the review process. Complex multi-panel figures in IPD meta-analyses, which may be produced by multiple contributing biostatisticians working across institutions and trial consortia, present opportunities for labeling discordance during manuscript preparation and editorial production. The identification and transparent correction of such errors reinforces the integrity of the published record.

Readers of the Hawaii Medical Journal and the broader oncology community are encouraged to access the corrected version of Kishan AU, Sun Y, Parker CC et al., published in The Lancet at volume 407, pages 1059 through 1071, to ensure that any clinical, educational, or research use of figures 3 and 4 reflects the accurate labeling as specified in the correction notice.