Just how many RPs HAS your urologist done this year?

A new analysis of data from two independent databases suggests that (in the US) only 20 percent of urologic surgeons carried out 10 or more radical prostatectomies in 2005.

The “New” Prostate Cancer InfoLink has consistently emphasized the fact that  surgeons who carry out a relatively high number of radical prostatectomies each year have lower complication rates than those who do relatively few such procedures. It has also been shown that (on average) a surgeon needs to carry out at least 250 radical prostatectomies before he or she has learned how maximize cancer control. These first 250 or so procedures represent what is known as the surgical “learning curve” for radical prostatectomy.

Savage and Vickers analyzed data from the Nationwide Inpatient Sample (a nationally representative sample) and from New York State’s  Statewide Planning and Research Cooperative System (a complete record of all hospital discharges from the state) to gain a perspective on the actual numbers of radical prostatectomies carried out by individual surgeons in 2005.

According to their analysis:

  • > 25 percent of surgeons conducting radical prostatectomies in the US in 2005 performed just one procedure.
  • Approximately 80 percent of surgeons performed < 10 procedures per year.

The authors state that this suggests that 80 percent of urologists who carried out a radical prostatectomy in 2005 were unlikely to reach the plateau of the learning curve during their surgical career. They go on to conclude that, “The current pattern of surgical treatment for prostate cancer leads to many patients being treated by surgeons with low annual caseloads, with likely poorer outcomes as a result.”

As far as The “New” Postate Cancer InfoLink is aware, this is the first time that data of this type have actually been documented in a publicly available journal. While we have to say that we are not actually shocked by these data, we suspect that many people may be, and we intend to redouble our emphasis on the critical importance of surgical treatment for prostate cancer by appropriately skilled and experienced surgeons.

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