Variability in Prostatectomy Results Not Entirely Explained by Experience of the Surgeon

Even among surgeons with a similar degree of experience, rates of prostate cancer recurrence after open radical prostatectomy can vary greatly. These results were published in the Journal of Urology.

Prostatectomy for localized prostate cancer can be performed by retropubic radical prostatectomy, laparoscopic prostatectomy, and more recently, by laparoscopic robotic techniques. In all of these procedures there is a learning curve; rates of cancer recurrence tend to decrease as a surgeon gains more experience.  It’s possible, however, that other factors may also contribute to variability in surgical outcomes.

Researchers involved in the current study looked at the outcomes of 7,725 men with clinically localized prostate cancer treated with open radical prostatectomy in four major U.S. medical centers between 1987 and 2003. Patients were treated by one of 54 surgeons.

Outcomes varied even among surgeons with a similar degree of experience:

  • Among experienced surgeons, seven had a five-year prostate cancer recurrence rate of less than 10% and five had a prostate cancer recurrence rate of more than 25%.
  • Variability in outcomes among surgeons with similar levels of experience persisted even after accounting for possible differences in patient populations.

These results suggest that in addition to surgeon experience, other factors also influence prostatectomy outcomes. The researchers who conducted the current study note that it will be important to determine and characterize these other factors that affect surgical outcomes.

Reference: Bianco FJ, Vickers AJ, Cronin AM, et al. Variations among experienced surgeons in cancer control after open radical prostatectomy. Journal of Urology. 2010;183:977-983.

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